Summary: Millions of adults in the US are living with poorly understood conditions like long Covid and chronic pain. These health issues do not fit into a classical biomedical disease model. It means that doctors struggle to identify their cause and provide optimal care. Therefore, researchers propose changes in how these issues are managed, like better-defined diagnostic criteria, treatment beginning with primary care, the need for multi-specialty clinics, and a holistic treatment approach.
Doctors say that we can learn much from chronic Covid on how to manage chronic pain since both conditions share many traits. Both these conditions are challenging to manage since they do not seem related to the disease condition that initiated these issues. Moreover, both in long Covid and chronic pain, doctors struggle to understand the cause. Quite often, they are unable to find any significant pathological changes in the body, and thus they struggle to treat these conditions. They do not fit into the classical biomedical disease model.
Though the pandemic is far from over, it’s slowing down. Covid might have resulted in close to 7 million deaths, but there are more than 600 who have survived the disease and made a recovery. Many of those who have completely recovered from Covid now do not have any signs of the infection. They have lungs, and other organs in good condition and lab tests are normal.
Yet, many of them continue to experience distress. Doctors are struggling to explain what is causing these health issues, like body aches, fatigue, lack of concentration, sleep disorders, and so on. Quite like in chronic pain, doctors are not only able to identify the cause of long Covid, and they are struggling to explain the reason for such symptoms. Therefore, health experts recommend a new model for providing care to such patients:
Though the main symptoms of long Covid might be fatigue, lack of concentration, and sleep issues, researchers have identified more than 200 symptoms of the condition. The condition is regarded as long Covid if someone continues to experience these issues for more than three months.
However, at present different definitions of long Covid exist. Not only that, doctors are even unsure if those living with organ damage due to Covid can be included in this category or not. There are still no universally accepted diagnostic criteria for the condition. Thus, estimates of long Covid vary wildly from anywhere from 2% to 50% of Covid-19 infected patients.
Simply said, in most conditions of long Covid, doctors continue to manage symptoms, but they do not recognize long Covid as a disease in itself. Similarly, studies suggest that in about 10-15% of cases of chronic pain, doctors identify it as a disease in itself. It means that in the vast majority of cases, doctors do not identify chronic pain as a distinct disease.
Though in many nations, long Covid and chronic pain are managed by primary care, it is not the case in the US. It means that millions of people continue to live with these conditions. It means that there is a need to bring change, and these issues must be treated at primary care, and only small numbers of more severe patients might be referred to certain specialists or pain clinics.
To manage long Covid, there is a need to create large medical clinics. Additionally, small and independent clinics must be better prepared to handle these issues. In the US, there are already about 200 clinics helping manage long Covid. However, that is insufficient for a large nation like the US.
Finally, it is about providing holistic care to long Covid and chronic pain patients. No single treatment is going to work in all cases. Some may benefit from painkillers, others from the treatment of sleep disorders, depression, anxiety, and so on. Many may benefit from complementary chronic pain treatment methods.
To sum up, it is time to recognize the massive burden of poorly understood health conditions like long Covid and chronic pain. If we need to manage these issues effectively, we also need to change our approach toward these conditions ensuring better diagnostics and care.
By Gurpreet Singh Padda, MD, MBA, MHP