1. 2021;24;319-325The Effect of Social Isolation During the COVID-19 Pandemic on Patients with Chronic Low Back Pain Who Underwent a Spine Intervention
   Prospective Study
   Kutay Tezel, MD, Ayca Uran San, MD, and Serdar Kesikburun, MD.

BACKGROUND: The COVID-19 infection poses a serious threat to global health for millions of people. In addition to therapeutic treatment methods, preventive measures are also important in controlling the pandemic. As a result, billions of people are quarantined in their homes to prevent the spread of coronavirus. However, social isolation may result in immobility, which can lead to musculoskeletal problems and an increased level of pain, depending on the weakness of the muscles.

OBJECTIVES: To examine the effect of social isolation during the recent COVID-19 pandemic on patients with chronic low back pain.

STUDY DESIGN: A total of 145 patients who underwent a spine intervention within the past year were enrolled in this prospective and cross-sectional study.

SETTING: The study was performed in the interventional pain unit of a tertiary rehabilitation center in Turkey.

METHODS: Patient data were obtained by telephone interview and included information pertaining to demographics, pain history, an assessment of pain, analgesic use, activity levels, and an evaluation of stress and sleep habits. Additionally, the International Physical Activity Questionnaire (IPAQ) was used to evaluate patient activity levels.

RESULTS: It was detected that social isolation has increased the intensity of low back pain experienced by patients during the COVID-19 pandemic. We also found that patients who benefited from spinal injections administered in the prepandemic period experience less severe low back pain (P = 0.000) and took fewer analgesics (P = 0.000) during the pandemic. The findings of our study revealed that there was a significant reverse correlation between IPAQ walking scores and the prepandemic Visual Analog Scale (VAS) scores (P = 0.015, r = -0.201) and the pandemic VAS scores (P = 0.000, r = -0.313).By contrast, the level of benefit from injections decreased (P < 0.05) and the duration of spinal intervention was shortened in patients with high IPAQ sitting scores (P < 0.05).

LIMITATIONS: The limitations of the study are the small number of patients and the fact that our results are based on patients’ self-reported data.

CONCLUSIONS: Social isolation has had an increasing effect on low back pain during the COVID-19 pandemic. The results of our study showed a significant relationship between activity level and pain intensity. We also found that patients who have benefited from spinal injections administered in the prepandemic period experience less severe low back pain during the pandemic.

KEY WORDS: COVID-19, spine intervention, physical activity,  low back pain, social isolation