Does social isolation affect pain?

Pain comes in many forms, from minor irritations that come and go to debilitating pain that is persistent and may become chronic. One of the most important issues is how much it interferes with being able to go about activities that once were a normal part of day to day life.
The current COVID-19 pandemic has been a difficult challenge for most people to cope with, but those who are also struggling with painful conditions face added challenges.
As humans, we are wired for connection. Meaningful social interactions are important to our wellbeing. When we are unable to be with those we normally look to as part of our social circle, we are going to miss them. Be it at home, school, work, sports, hobbies, or just saying hi and sharing a greeting across the hall or over the fence, social connections help keep our brains and our bodies engaged in life, and help us in many other ways. 
Even for people who don't struggle much with pain, social isolation can interfere with energy, focus, and enjoyment of life. Pain can make all of these worse!
And to stay safe in the face of COVID, many people are having to adapt to changes, as far as going to school vs on-line, going to work vs working from home, etc. It's not easy to be unable to see friends and family,  or get together for fun, exercise, self-care, shopping,
etc.
In studies of people with challenging injuries and other causes of chronic pain, those who are also socially isolated often experience higher levels of pain.
More importantly, a look at how their lives are affected by their pain when they are also socially isolated showed higher "pain interference scores" and lower pain coping scores - that is, the pain they experience affects them more if it interferes with activities of daily living and functional activities, for those people who are also socially isolated. (ref below).
On the other hand, it was also true that interference in quality of life was less of a problem in individuals who perceive a greater sense of inclusion from and engagement with others. Smiles, eye contact, and even laughing with others also helps!

A few tips that may help if you or a loved one are struggling with pain while feeling more isolated from social contact and support: 
Reach out by phone, email, text, or social media to others who you trust. Using a video based app to talk with them may also be possible. 
Include time to talk about meaningful things, and also more lighthearted things - smiling and laughter helps your brain produce more endorphins (natural pain reducing chemicals it needs)  Consider more frequent, shorter calls, and making it a regular addition to your week.
Do what you can to stay active. Regular low intensity exercise improves energy and mood. Stretching can also help release tight muscles and trapped energy, especially if you have been sitting more, or are on your device for longer times.
Support yourself to get regular sleep and healthy food. Limit caffeine, sugar,  and other stimulants, as well as alcohol (which can act as a depressant). Drink more water! Getting outside, even for a 5 or 10 minute walk at lunch or on your break can help .
Pills are not magic - and can have side effects. Call in to discuss medications and other strategies with your doctor, or health provider. Reach out to a counselor, or call the Distress Center (403 266-1601 - open 24 hours), if you need more support.
If you need help making better sense of your pain, or treating injuries, book an appointment with your physiotherapist or MSK health care provider. Contact us if you need assistance.
Its a stressful time! Which means it is time to take the best care of yourself possible. Why not reach out to one of our clinics?! We would be happy to help you.

- Dr. Adrian R Gretton, MD, CCFP, FCFP, CIME, has a particular interest in musculoskeletal assessment as well as pain and injury management. His primary focus at Evidence Sport and Spine North is Prolotherapy treatment, which effectively treats injuries and degenerative changes in ligaments, joints, and tendons. Dr. Gretton has a background in family medicine and occupational medicine, as well as chronic pain. He enjoys teaching and life-long learning, and is a community-based clinical assistant professor in the Department of Family Medicine at the University of Calgary, where he completed his medical training in 1986.

Reference: The Impact of Social Isolation on Pain Interference: A Longitudinal Studyhttps://academic.oup.com/abm/article/53/1/65/4969712 from Annals of Behavioral Medicine, Volume 53, Issue 1, January 2019, Pages 65–74,