Chronic pain has a significant impact on people’s lives and people experiencing homelessness is no exception. There are several different types of chronic pain, but what is common between them is that they all affect the individual’s quality of life. Whether the chronic pain is physical or mental, it is important to consider factors such as barriers to pain management, treatments for chronic pain, and other medical conditions that are influencing access to healthcare.

Before discussing the challenges and barriers regarding chronic pain and diseases, it is crucial to define these terms and identify how these relate back to homelessness. According to Vogel et. al., “chronic pain, defined as persisting beyond normal tissue healing time assumed to be three months, affects a substantial portion of the general population” (2017). But, specifically pertaining to the homeless population, it is especially challenging to access healthcare because of barriers, lack of stable living conditions, and other underlying issues. Moreover, the relationship between chronic pain and homelessness is a multifaceted issue. “Physical pain is damaging to mental health and mental health issues limit people’s ability to manage chronic pain” (Amp, 2018). Additionally, chronic pain “commonly affected general activities (86%), walking (75%), mood (74%), and sleep (71%)” (Vogel et al., 2017). Taking into account drug and alcohol misuse, lack of access to care, and the daily stresses of everyday life, chronic pain causes several implications for any individual; adding to the fact that these individuals are also homeless further indicate the difficulty and complexity of their situations.

Since every individual’s experience is different, the level of chronic pain also differs as well as the barriers to chronic pain management. When asked about the problems with managing their pain, participants’ responses were “recorded verbatim and categorized according to the following categories: health care system (general and physician-related), shelter system, biomedical, financial, personal, and physical environment” (Hwang et. al., 2011). Barriers due to social determinants of health as well as disparities in healthcare continue to be obstacles for individuals experiencing homelessness. Low income (inability to afford medications), transportation (trouble getting to medical appointments), and housing instability (Hwang et. al., 2011) are just a few of the many examples that homeless individuals go through regarding barriers to chronic pain management.

Furthermore, the stigma and discrimination that the homeless community face when attempting to access healthcare results in negative implications. According to the study conducted by Gilmer and Buccieri (2020), the issues that participants commonly identified; addiction, mental health, and chronic pain, were underserved in primary and emergency care settings. More specifically, “when seeking care for one or more of these three issues through emergency care, participants felt judged and stigmatized, with clinicians assuming they were seeking out prescriptions for narcotics” (Gilmer & Buccieri, 2020). This also shows that if there were any type of patient-provider relationship, it would be suboptimal due to stereotyping of these individuals. On-going pain management is necessary especially for chronic pain, “being labeled as “drug seekers” may lead clinicians to take a conservative approach with potentially less-effective outcomes for these already vulnerable patients” (Gilmer & Buccieri, 2020). However, one thing is for sure, studies have demonstrated that there is a need for improved approached to the management of chronic pain in the homeless community.

In conclusion, chronic pain in the homeless population is just one of many issues that needs to be addressed. Healthcare providers should consider the barriers to healthcare such as their housing situations, management of chronic pain, and their socioeconomic status. In addition, outreach efforts and initiatives “may be necessary to engage homeless individuals who suffer from chronic pain but are not seeking appropriate care” (Hwang et. al., 2011).