The Impact of Isolation During COVID-19 on Chronic Musculoskeletal Pain in the Geriatric Population: A Narrative Review

Abstract

Background: During the COVID-19 pandemic, social distancing has been employed to decrease the spread of COVID-19, especially within the geriatric population; however, the resulting loneliness and isolation carry their own detrimental effects. Loneliness resulting from the COVID-19 pandemic may also have negative implications on those with chronic musculoskeletal pain.

Objectives: The aim of this review was to identify the role of loneliness specific to the recent COVID-19 pandemic as it relates to the prevalence and severity of chronic pain in the geriatric population and to provide an overview for clinicians.

Study design: Narrative review.

Methods: A literature search was conducted using combinations of relevant search terms. Databases included PubMed and relevant grey literature sources. Reference lists of selected articles were also searched for additional relevant literature.

Results: Recent literature supports that social isolation and loneliness stemming from the COVID-19 pandemic have negative implications on chronic musculoskeletal pain. Loneliness has been well documented to have deleterious effects on physical and mental health, and it is increasingly linked to worsening debility and pain interference for those with chronic musculoskeletal pain. This has been found to be most prominent in the geriatric population, who are at the greatest risk for social decline and loneliness. Loneliness has also been found to have negative effects on cardiovascular disease, infectious disease, and mental health, as well as cognitive decline.

Limitations: Potential selection bias due to the narrative review design. Some included studies required the use of online questionnaires, which may not be accessible for the geriatric population, those without technology literacy, or low socioeconomic status populations. Future studies should emphasize screening patients for access to technological devices and reliable internet while partnering with community programs focused on digital literacy and resource access.

Conclusions: A myriad of deleterious effects stemming from social isolation and loneliness have been documented, of which geriatric populations are especially susceptible. Both early identification of at-risk patients and safe interventions are essential to mitigate loneliness and stop the progression of debility. Further resources and research are necessary to illuminate how best to proceed, both in the setting of the ongoing pandemic and how interventions can be applied to alleviate suffering in those with limited ability to receive hospital or clinic-based care.

Keywords: COVID-19 pandemic; geriatric; loneliness; mental health; musculoskeletal pain; pain medicine; social isolation; Chronic pain.