Harriet Wilkinson

This talk will give a perspective on the relatively new experience of living with pain. Musculoskeletal and joint pain has been a predominant symptom of the speaker's Long COVID journey. It has gone from being a constant presence to having the occasional day pain free. This presentation will describe how others have been self-managing the pain while not being under the care of one of England's Long COVID clinics or any other pain clinic.

There have been a wide array of symptoms reported by long-COVID patients with pain and fatigue showing as dominant features. This presentation will aim to explore how patients have clinically been presenting in our long-COVID clinic with their pain and fatigue. The importance of managing symptoms, rather than looking at the treatment of them will be discussed, as well as exploring the tools recommended to help support patients with these challenges. Attendees will learn of the approach of focusing on the importance of a biopsychosocial approach within a multidisciplinary setting. Additionally, patient case studies will be discussed to demonstrate the broad range of presentation and management strategies within this patient group.

The discussion will center around the experience of living with chronic pain, the additional influence of having COVID-19 in March 2020 and now living with Long COVID too. The difference between previous pain and dysfunction and the added factors of Long COVID will be discussed, including what it is like to try and access help from the NHS during the pandemic, not just for the previous conditions, but also COVID related assistance. The lived experience of Accident and Emergency with 3 of 4 signs of viral sepsis, the treatment there, and how it has influenced onward treatment will be explored as it has had a huge impact on the trajectory of recovery. The various interventions tried will be deliberated as Long COVID and the challenges with its recognition add increasing levels of complexity to an already difficult situation. Medical attitudes and language and what can be improved so that patients are appropriately managed on an interpersonal level will also be covered as the frustrations and stresses caused by a lack of effective listening also prevent access to effective treatments.

While research was being presented as early as May 2020 that chronic pain would get worse with COVID-19, it became very apparent that COVID-19 itself could cause chronic pain for a variety of reasons, all of which are context dependent and biopsychosocial. A multitude of reasons exist for the occurrence of new onset pain that can often be resistant to mainstream therapies and calls for a more integrated, patient-centered and trauma informed way of working with the Long COVID patient. With co-existing fatigue and new digital technologies, it is important to harness the benefits that they bring while mitigating risks and then find a way to bring community support into a Long COVID service. This presentation will be aiming to highlight what can be done when systems can work with patients to coproduce new ways of support.