Pain, Covid and the growing waiting lists

By Steve Dechan

Chronic pain is currently defined as any persistent pain lasting three months or longer. By that definition, there are currently 28 million adults are living with chronic pain.(1) That’s a huge number of people and given that many of these individuals are waiting for treatment of conditions such as hip and knee replacements, it is one which will only grow.

COVID-19 has been the greatest public health challenge our country has faced in a generation – it will mark our lives for years to come. There have been countless examples of how our NHS has changed and adapted to the era of COVID-19 – a mass increase in video consultations being one of them. However, beneath the positive innovations the pandemic is set to leave a lasting and deep mark on our health service.


Waiting lists are now at an all-time high. NHS statistics from December 2020 showed that there were 162,000 people waiting more than a year for care. There had been just under 4 million fewer referrals for hospital care from March-December 2020 compared to the same time last year, with more patients having their conditions managed by their GP or in the community instead. Indeed, the King’s Fund concluded that we just don’t know how many more people will need urgent or routine care next year as a result, but this can only add to the considerable backlog of 4.4 million people waiting for care.

Of that huge NHS backlog, orthopaedics is the largest cohort – these are people largely living in pain. Given the confirmation by the RCS’ restart system that most orthopaedics surgeries are to be delayed for 3+ months, this will push thousands more into pain simply because the NHS is unable to treat them in a timely manner.

This isn’t an attack on the NHS, far from it. The NHS is something we should all be proud of, but policy leaders will now need to think much more broadly about how we manage the pain of patients whilst we wait to treat them. We have seen in the USA what happens if we let pain management fall into disrepair, we must ensure we encourage that broad thinking and adapt quickly.

  1. British Pain Society. Available at: