Spine pain in COVID-19

5 Things you can do for spinal pain during the COVID-19 pandemic?

If you have had a flare up of spinal pain during the COVID-19 pandemic there are a number of things that can be done despite restricted access to the health system and social distancing. Many of us have found we have more time on our hands and we can use this time for making positive change. Spinal pain rarely means spinal surgery and there are more options than ever for less invasive options of treatment. In this blog I want to share what I think you can do for yourself.

i) Time is a great healer

The first thing to remember is that for many people with spinal pain there will be fluctuations in pain from day to day and month to month and many times flare ups will be self-limiting. Even if this is your first episode of severe spinal pain, in a number of days the pain is likely to settle. So be patient and stay calm. Being overly anxious about pain can exacerbate and prolong symptoms.

ii) Find your comfortable place

Most patients with spinal pain conditions can find some relief with certain postures or positions. If you find bending forwards painful, try lying face down and performing a back arch. If you find standing and walking painful then try lying with hips and knees bent. You can go to your comfortable place as often as you need to for 15-30mins in between other activities.

iii) Do something active everyday

Even if you have quite severe spinal pain, most people find being active helpful. You will find that you will be less active than usual but there will be some activities that you can do that do not aggravate your pain. If you have not been active for a while it is important to pace yourself with step wise reactivation. For example; If your activity is walking then you should plan to begin by walking a short distance that you know will not cause an exacerbation of pain and then plan to increase that everyday by a small amount so that you might double your distance in the first week and subsequent weeks.

If you have a set-back during the program then just reset your distances to remain within pain thresholds.

iv) Avoid escalating dependence on medication

Use of simple analgesics such as paracetamol or non-steroidal anti-inflammatory medication (eg ibuprofen) can be very helpful for relief of low grade arthritic pain and are safe as long as they are taken in recommended doses and ceased if gastric side effects are experienced. Although narcotics (morphine-based medication) can be very effective for acute pain, the use of narcotics for chronic pain can actually lower pain thresholds and result in the requirement for higher and higher doses and potential for dependence.

v) Seek Help if required

Communicate to your health care providers if you develop new symptoms, in particular, problems with bladder or bowel control or new neurological symptoms of numbness or weakness. If you are feeling unwell with fever or have loss of appetite or unintentional weight loss then you require urgent further medical evaluation.

Consider seeking further advice from a specialist if your pain continues at a high level or if you cannot get relief with rest and change of posture or use of simple pain relief medication. Your specialist can consult with you via telehealth and determine if you require further investigation or diagnostic injections. All radiology centres are maintaining access for imaging and procedures.

Your specialist will be able to make the best decision about management once all the information is available and will often require a face to face consult if your condition deteriorates or if a procedure is considered necessary.

Hospitals are still open for business and are very safe in regards to risk of exposure to COVID-19. Elective surgery is being performed back at 100% capacity in most private centres and there is no significant wait times. You may find more use of personal protective equipment than previously and visiting times and visitor numbers are more restricted. If you require ICU care then your specialist and the hospital will make sure they are working within their capacity.

In Victoria, you are now required to have a clear COVID-19 swab test prior to elective surgery and when visiting a hospital to wear a face mask. This is keeping it safe for our patients and hospital staff.