Growing Pains of Remote Medicine for Chronic Pain Patients

Chronic pain remains a drastically underestimated condition in American society, and lack of access has always been a prevalent issue. The most common barriers include functional disabilities, lack of knowledge or awareness, socioeconomic standing, and geographical distance.

As COVID-19 accelerates the need for telemedicine services, the over 50 million people in the U.S. suffering from chronic pain continue to be especially vulnerable and remain at risk for vast undertreatment. Populations who had already been experiencing pain pre-COVID, such as older Americans (ages 65+), those with underlying conditions, and marginalized communities, are dramatically more likely to contract the virus, especially with such a sudden shift in access to their usual health care services. Pain is significantly exacerbated during times of stress, making it even harder for them to adjust to today’s new reality.

In a recent survey conducted by the U.S. Pain Foundation, 664 individuals across the country living with conditions from rheumatoid arthritis to multiple sclerosis were asked how the pandemic has impacted their care. Their April 2020 findings revealed:

• 77.4 percent are facing barriers to treatment.
• 63.8 percent are experiencing increased pain.
• 69.7 percent consider themselves to be at high risk for COVID-19.

These respondents reported heightened stress due to their conditions that cannot be addressed virtually, pointing out the need for “help with handling stress and anxiety” and “tips for managing pain at home.” Concerns about medication refills and basic follow-ups are prevalent as well.

Furthermore, in a survey conducted by Remedy Health Media, over 4,000 individuals with chronic conditions reported their greatest worries during the pandemic, with nearly 40 percent saying that they need to have clearer guidelines about treatment options.

Access to Telecare and Pain Medication

Under the new CMS waiver, Medicare will pay for patients to have office, hospital, and other visits with their providers. Virtual communications may include audio or video evaluations, brief virtual check-ins, or non-face-to-face communication through patient portals.

Since the onset of COVID-19, the DEA has announced:

For as long as the Secretary’s designation of a public emergency remains in effect, DEA-registered practitioners may issue prescriptions for controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided the following conditions are met:

• The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice.
• The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.

A Promising Future

While current data on telehealth as an alternative to in-person treatment for pain management is limited, remote care will soon be recognized as an invaluable asset for patients and health care providers alike. Telehealth overall had experienced tremendous growth of over 1400 percent in the past four years alone, and now the pandemic has confirmed it’s here to stay.

In a 2017 study published in the Journal of the American Medical Association, approximately 250 patients were being treated for chronic pain conditions by their primary care physicians. The patients who received telehealth services were twice as likely to report 30 percent less pain after three months. Long after the pandemic is behind us, telehealth will be an essential service for patients with limited access to the specialists they need, and for patients who struggle with disability-related mobility restrictions.

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