• Patients with musculoskeletal pain were more likely to receive strong painkillers including opioids during a consultation with their GP during the Covid-19 pandemic lockdown periods, compared to consultations happening immediately before and after the height of the pandemic.
• A research team led by Keele University found that although fewer people sought help from primary care services for their pain in the early pandemic, a greater proportion of those who did were prescribed strong painkillers, including strong opioids.
• These findings are crucial for planning for future pandemics and provide insights for commissioners and policymakers when dealing with future healthcare crises. 

Higher proportion of painkiller prescriptions 

Patients with musculoskeletal pain were more likely to receive strong painkillers including opioids during a consultation with their GP during the Covid-19 pandemic lockdown periods, when compared to consultations happening immediately before and after the height of the pandemic, researchers have found.  

The team from Keele University studied six million anonymised GP records, as they set out to investigate the impact the pandemic restrictions have had for patients with musculoskeletal disorders including conditions like osteoarthritis, which are commonly managed with self-care, physiotherapy, and specialist healthcare services. 

Their findings indicate that consultations for musculoskeletal disorders – both new and existing cases - had been steadily increasing in the years up to March 2020 when the national lockdown came into effect, after which a substantial drop occurred. 

Greater impact in deprived areas 

Although fewer people sought help from primary care services for their musculoskeletal symptoms including pain during the lockdown period starting March 2020, a greater proportion of those who did were prescribed painkillers, including strong opioids. 

In total, the proportion of patients with a painkiller prescription increased from 27.72% in February 2020 to 38.15% in April 2020, and the effect was particularly evident in more deprived areas, which saw a higher proportion of strong opioid prescriptions. However, prescribing of strong painkillers reduced once Covid restrictions began to lift and GPs were able to refer to other services, including physiotherapy. 

Publishing their findings in the British Journal of General Practice, the researchers attribute this increase to GPs and primary healthcare professionals responding to patient needs during the early pandemic as patients were unable to access support services, for example physiotherapy and specialist care.   

Crucial insights for policymakers 

Lead author Dr Victoria Welsh from Keele University’s School of Medicine said “The restrictions associated with the Covid-19 pandemic have impacted upon the care of people living with musculoskeletal disorders in the community, with a short-term reduction in consultations and concurrent increase in the prescribing of strong analgesia whose side effects are potentially harmful. The greatest impact was seen in people living in more deprived communities.  

“Policymakers and commissioners must take this into account when considering future restrictions to healthcare and when designing national strategies to address health inequalities.”