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Staying Pain-Free During Covid-19

STAYING PAIN-FREE DURING COVID-19

Some of you may be in a state of panic as you find it more difficult to see your physicians, especially with regard to your pain. Firstly, let me say that doctors are probably working on making telemedicine visits available to you. I’m set up for that, as are my partners. I would remind everyone to be as patient with us as we are going to be with you, while we work through this process. Trust me when I say that as with any medical software program, no one is trying to make it easy on us.

I can’t help you with your hypertension or diabetes, but I can help with your pain, since that is my bailiwick. And I DO have some tips. These are things I do for myself as well as my patients, but I thought now would be a good time to bring it up to all my readers.

  • Modify activities which are painful. This is not a time to try to work through your pain. Stop or curtail the painful activity. If it hurts to walk…do less walking.
  • Be mindful of your pain. Find those positions in which you don’t have pain, and get there more often. Accept this for now!
  • R.I.C.E. (Rest, Ice, Compression, Elevation). It’s an old standby, and it works, particularly for acute pain due to injuries.
  • There may be some concern regarding the use of NSAIDs (ibuprofen, Aleve, and prescription NSAIDs, such as meloxicam or Celebrex, to name a few), in the presence of COVID-19. However, as of this writing, there is no absolute evidence for this concern. And certainly, there is no evidence that use of NSAIDs, in the absence of COVID-19 symptoms or a positive test, is dangerous, any more than under ordinary circumstances. If you are in pain, and can ordinarily take NSAIDs*, you can still consider using them. I’ve already used them in the past week. *Avoid NSAIDs if you have end stage renal disease, liver disease, a history of stomach ulcers or are taking blood thinners.
  • Tylenol…unless you have liver disease or an allergy.
  • Arthritis, and many chronic musculoskeletal conditions often respond to warmth in the form of warm packs, heating pads, heating blankets, warm baths/showers, and warming salves such as Tiger Balm or Icy Hot.
  • Walking aids, like crutches, walkers, hiking sticks and canes can be used if you are experiencing lower extremity pain, or are limping. Don’t hesitate to use them. This is not a time to worry about “looking old.”
  • Pain relieving salves such as Aspercreme, Salonpas, Tiger Balm, or CBD oil (according to friends and patients), etc., are often effective pain relievers. And you have to massage them onto your skin, which brings me to the next tip.
  • Touching works…unless your bone is sticking out of the skin. I cannot overemphasize the importance of a nice massage.
  • Meditation. There are many apps and websites out there to help you with this, and thankfully, some of them are offering their services for free right now!
  • Occupation. Do something. Many of us are spending a lot more time at home. We’re working from home. We’ve been laid off. We can’t go to the gym. Absence of our usual routine gives us more time to think about our pain. Find other things to do. Play cards or board games. Learn a foreign language. Pick up a musical instrument. Start a diary. Keep your brain occupied and off the thought of your pain. Your brain has the ability to do this!
  • Kiss the boo boo. Yes…kissing works.
  • Don’t do things which have a high likelihood of hurting you right now. This is common sense. You do not want to have to go to the emergency room.
20 comments
  1. Loretta

    Ha, a “bailiwick”, is that something like “ in your wheel house” ??..(I shall use my Google machine). Hopefully other great docs will send such informative (needed to hear) email. Crazy times indeed, simple direction and reminders were perfect. Thank you and Happy Sunday

    1. Barbara

      Yes, that’s exactly what it means. Old timey lingo. I’m thinking of getting other specialists to help me with blogs on subjects that are in their wheelhouse!

  2. ANGIE KIELAR

    Hello Doc- When do you anticipate surgeries to start up again? I was scheduled for total hip replacement on March 18 and it was canceled on the 17th due to the outbreak in Michigan. I have avascular necrosis. As you are aware, the condition is quite painful. It has been all of 2020 so far that I have been trying to get a diagnosis and finally early March I got an MRI. I am in great health and an athlete so staying still is not easy for someone who is accustomed to moving and moving a lot.

    1. Barbara

      Nancy,
      I’m sorry the Covid-19 outbreak has occurred at such a bad time for you. I will soon be posting a blog on how to decrease pain in hips, but other than that, and any pain meds your surgeon has given you, there is not much you can do at this point.
      Elective cases are no longer being done in hospitals and surgery centers. My group has even formed a committee to review any case which is scheduled by any of our partners, to verify that it is necessary and not elective. I don’t see this changing for a few months. We need to protect patients. But we also must protect our doctors and nurses, who are very vulnerable in the operating room. Additionally, there is a national shortage of supplies, so we must conserve where we can.
      When you hear that elective surgeries can be done again, remember that your surgeon will only have so much energy and so many hours in the day to perform these operations. Your name will have a place on a list of other who might have been scheduled earlier than you, or might be in more pain/disability. You should be a squeaky wheel, to perhaps advance your position on that list. If you are suffering a great deal, then by all means, make an appointment to see the doc, so you can express the degree of pain from which you suffer. For now, this is truly all you can do.
      Watch for my post on pain-relieving tips for the hip. Hips are more complicated than other joints. They are very much part of your core, and therefore are stressed, even when you are sitting!
      Take care-

  3. Nancy

    Thanks for the info on NSAID’s although I have heard that they affect the cells wall in a way that makes it vulnerable to COVID-19. Can you elaborate?

    1. Barbara

      Nancy,
      Thank you for your inquiry. If is always difficult for a physician to give the general public self-help information. In fact our malpractice insurers advise against it! Whenever I recommend/suggest/mention the use of NSAIDs, I always get a little queasy feeling in my stomach. Of course, they’re available over-the-counter, so patients can and do, make that decision to use them independent of my blog post. The purpose of my blog is to give people information on how to decrease their pain, and not necessarily to discuss medications on a more granular level. As with my patients, I try to make sure they understand the general potential for complications, as well as try to make sure they have no contraindications to taking the medications. I have never actually gotten into a discussion of the biochemical reasoning behind complications associated with use of NSAIDs, or any other medication for that matter. I have looked up the information regarding use of NSAIDS in the face of Covid-19, and have as much information as you have access to in fact. With my own patients, I also try to think in terms of whether or not I would take a treatment for myself or a friend or family member, before I decide to recommend the treatment to them. I have done the same on my blog. As I mentioned in the post, I have taken…and my husband (a kidney specialist) has taken NSAIDs during this period. There is no conclusive evidence, to my knowledge, regarding use of NSAIDs right now. He and I both weighed the paucity of information regarding the dangers during Covid-19, compared to the level of our discomfort, and opted to take the medications. They helped, and as of this writing, neither of us is suffering from Covid-19. And even if we were, we would certainly not attribute it to the use of NSAIDs. If you have any doubt as to whether or not it is something you want to use, then I would avoid its use. Sorry for the long explanation, and no discussion regarding the effect of NSAIDs on the cell wall. Don’t use it if you have any doubts. That is always the safest bet. I did do an earlier blog regarding the use of NSAIDs. Again, no granular discussion of their effects, but more about whether or not to use them. https://drbarbarabergin.com/nsaids-beware/

  4. carol

    I want you to know of my great appreciation for you and your obvious love and concern for us your patients. Thankfully I have not needed your services very often but I’ve gained a lot of helpful information and advice from you on your blog – you are a breath of fresh air just when we need it – God bless !!

  5. Inga

    Love your blog and wisdom. Having a newly diagnosed hip injury, I look forward to your upcoming hip blog. Hips are a different animal, for sure and hip pain is a new beast for me.

      1. Barbara

        Thank you Carol…for being my patient, and for your kind words. I hope you can continue this altogether too long a respite from the doctors office! LOL! I’m trying to help.

  6. Ellen Niles

    Hi Dr. Bergin!
    A friend shared your SLAM article with me as I was dealing with trochanteric bursitis after my hip replacement. Little did she know I’m only about an hour north of you. Been following you ever since. Great stuff! Would you mind if I share this info with my friends at Bonesmart.org? We’re having lots of friends trying to deal with cancelled surgery and think this would be helpful. Thanks for what you do!

  7. Nancy

    Thanks so much for that information. I appreciate all of your articles. I started sitting like a man a year ago and it really helps. I had a stress fracture on the left foot back in February and it still hurts in the joint area. Have been icing and elevating the leg each night and it does help but I am a walker and I still walk 1 to 2 mikes each day if not twice a day. That spring is beautiful in Virginia and you have to get out to appreciate it.

  8. Lynda

    Dr. Bergin,
    Thank you so much for your posts. I am suffering from hip and both knees pain. I was about to make an appointment with a orthopedic before the COVID19 began. I know now it will be a while before I can get an appointment now so thank you so much for your advice on what can be done at home. I am listening.
    Lynda

    1. Barbara

      I’m sorry this is happening, and you’re in pain. If you were here in Austin, you could make a telemedicine visit and we could get mobile xrays if needed.

      Watch for my upcoming posts on knee and hip pain for sure.

      Take care-

  9. Paulette

    I saw you for the first time and was treated in Feb for R knee and hip pain. Canceled FU appointment due to this craziness. Also, I am doing much better, mostly pain free, walking 1 1/2 miles and alternating days with riding my bike. Was really bummed when the gym closed and I couldn’t swim anymore. I think one of the most important factors is wearing the knee sleeve with exercise. I still feel an annoying “click” in my R hip, and do plan to FU regarding that. Thanks for your help, I was able to go to my granddaughters Bat Mitzvah and even did a little dancing in celebration. Almost forgot, loved your book, still pondering the ending 🙂

    1. Barbara

      Thanks for reading my blog and my book! Sorry the ending confuses! You are not alone, and it was meant to be that way! I’m also glad you’re better. Just FYI, we are doing telemedicine visits, as well as in-office visits if needed. Hopefully my future blog posts will help you as well.

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