Chronic pain is a complex biopsychosocial condition. It involves an interplay of factors, including biological (e.g., tissue damage, disease, genetics), psychological (e.g., anxiety, depression), and social influences (e.g., cultural, financial, access to care).
As such, chronic pain is a uniquely personal condition that affects each person differently. For some, the main issue is the direct experience of pain – the pain intensity. However, for most, the impact of chronic pain is felt through its deterioration of quality of life, such as sleep, activity, mood, and general health.
Table of Content
|1.||Multidisciplinary pain management program|
|2.||Features of digital multidisciplinary platforms|
|3.||Electronic health (eHealth)|
|4.||Mobile health (mHealth)|
Multidisciplinary pain management program
The gold standard for non-invasive chronic pain management is a holistic biopsychosocial approach, which combines:
- Physical therapy (physiotherapy)
- Psychological exercises (e.g., mindfulness)
Such treatment programs are, however, costly and often restricted to specialized medical centers with waiting lists for admissions.
Imagine a future where pain can be alleviated or managed using a combination of digital technologies and devices, significantly reducing the risks brought about by conventional painkillers.
The future is now.
Features of digital multidisciplinary platforms
A combination of various forms of digital health tools can help improve chronic pain coping mechanisms. It can provide an accessible intervention to transform health service delivery and ensure the quality of care for people with chronic pain.
Several digital features can help with chronic pain management and improve the quality of life. This includes:
- Self-monitoring and real-time assessment
- Pain medication management
- Personalized treatment strategies
- Connection with a multidisciplinary care team
Self-monitoring and real-time assessment
Pain may be underreported and undertreated because pain is mistaken as a normal process of aging. You may struggle to find words to express what you are going through – it is difficult to describe the pain. Sometimes, you aren’t even believed that your pain is real.
Smartphone-based pain assessment and monitoring apps can address this challenge. It allows you to record how you are feeling and track your symptoms. It uses artificial intelligence (AI) to score pain levels in real-time and update medical records in the cloud system. The app summarizes these reports for you so you could observe the trends. Your physician can also monitor you through the app and print out the pain report before you come for an in-office visit.
Pain medication management
The app can help to track how pain impacts your life and how the pain medication is being used to manage the pain. The app will feature algorithms that calculate pain fluctuation, along with mobility or medication usage. By generating an ongoing report of your condition, physicians can step in to adjust medication levels or set goals to increase daily exercise.
Personalized treatment strategies
Using AI, treatment programs can be tailored to the daily rhythms and demands of your life. You will receive in-app video and text messages that guide you through strategies to manage and prevent pain.
Furthermore, motion sensors can be used to ensure that you perform the exercises correctly. This empowers you to regain control and self-manage your condition at home.
Connection with a multidisciplinary care team
The design of the online intervention will involve a team of pain management physicians, orthopedic, surgeons, physiotherapists, and psychologists. Regular formative evaluations can ensure that the program applies to real-world conditions (e.g., self-directed and self-paced) and adheres to health informatics methodologies.
Social and community support
Platforms such as Facebook have given rise to a growing number of online patient peer-to-peer support communities. Here, you can connect with others to source and share information. Engagement in an online community will foster positivity, emotional expression, and support.
Electronic health (eHealth)
Electronic health (eHealth) interventions can be used to develop formal stepped-care systems of pain management. It can provide short- and intermediate-term improvement in pain intensity for patients with chronic pain.
eHealth interventions often employ the same principles, give the same information, and teach the same self-management skills as face-to-face interventions. However, they are carefully designed to be provided through the internet without the need for face-to-face contact. Therefore, it bypasses geographic or socio-demographic care disparities often associated with conventional face-to-face models of intervention.
The eHealth interventions aim to:
- Provide information that helps you to make sense of pain
- Teach evidence-based cognitive and behavioral skills (thought challenging, de-arousal strategies, activity scheduling, activity pacing, graded exposure)
- Reduce pain-related disability, anxiety, and depression by supporting the adoption of evidence-based skills taught within the program
Clinical informatics and patient portal
Web-based portals can allow you to access your personal health information such as laboratory results, upcoming appointments, and medication information. Additionally, you can use the web portal for bidirectional communication with your primary care providers about your health status and treatments. Your care provider can access your health data via the interoperable and open cloud-based platform.
Clinical informatics can also be leveraged to deliver evidence-based treatment information. It will build your knowledge of various behavioral pain treatments and direct you to the existing digital therapeutics tools.
After you are officially diagnosed, you can start receiving assistance from the chatbot. You will be engaged in having a meaningful conversation within the context of your diseases or drugs. The chatbot provides educational and psychological support. You will not be talking to a person, and there is no real human hiding at the back of a chatbot to answer your questions.
The chatbot is built in a way that 80% of the informed conversation relationships are based around pleasant, small talks. In comparison, the remaining 20% is embedded with medical content relevant to you so that you will not be distracted by something else.
This means the chatbot function without much human supervision and can deploy to situations where humans are less available. All informational content is pre-scripted and closely aligned with the drug providers. At the same time, the chatbot requires a certain level of human support for handling emergency or adverse events.
Patient decision aids
Patient decision aids can help you decide between several treatment options. It allows you to personalize information about treatment efficacy, outcomes, and the inherent uncertainties of potential benefits versus potential harm.
The program includes:
- An information module illustrating the benefits and side effects of the medications
- A preference elicitation module facilitating you to consider the pros and cons of using particular medicine
- A set of health questionnaires
It reduces your decisional conflict (i.e., the feeling of uncertainty and being supported while making a treatment decision) and improves your medication knowledge.
You will be given positive input in your daily lives through practical and personalized advice on pain management. The solution should fit into your existing everyday routines, giving you a break, positive input, and reminders in your daily lives. You will not be receiving too much information or too much choice, flashy graphics such as sound and animation effects, or cumbersome log-in procedures.
Intelligent videoconferencing system for online coaching
Telehealth for pain management can be implemented using a variety of models, including:
- Direct contact consultation
- Hub-and-spoke consultation
- Home-based service delivery
CBT- and ACT-based psychological interventions are effective, improving quality of life, depressive symptoms, and pain acceptance for people living with chronic pain.
The psychological interventions should accommodate your varying pain levels, your challenges with feeling guilty of never doing enough, and your concentration issues.
Self-management interventions can encourage you to take ownership of self-identified essential matters, while given space for normalization and independence. You will have the option of using the intervention at your own preferred time and pace, allowing for knowledge and skills to be reinforced even after CBT has ended. As such, the positive effects can be prolonged, and you will feel empowered.
The resource section contains a library of information that can be accessed at any time, anywhere. Yet, you should not be receiving too much information. The informational content should also be trustworthy.
Interactive online social support community portal
Platforms such as Facebook have given rise to a growing number of online patient peer-to-peer support communities. The online social portal includes a discussion forum for people with chronic pain to connect, share information, and offer each other support. It is built to replicate and deliver the same successful offline model to a larger range of individuals.
The social networking feature can foster strong engagement, positivity, and support. It is also associated with significant improvement for pain, distress, and activity limitation.
Mobile health (mHealth)
Mobile health (mHealth) pain apps can supplement conventional care with adaptive, comprehensive, multidisciplinary programs for the management of chronic pain. It has a vast potential in addressing gaps with current eHealth approaches by analyzing, processing, and conveying data from a suite of sensors.
Interactive symptom checkers may use algorithms to screen photographs or data from sensors embedded in the smartphone. A touch-capable app can also allow your own hands to serve as remote surrogates for the physicians in the screening of acute pain. Most of the symptom checker apps can give appropriate triage equivalent to that seen from junior physicians and senior nurses.
Simultaneously, a web app can be designed for physicians, where app-generated alarms can be received daily. Patient app responses can also be monitored in real-time to help your physician determine whether or not you are in imminent danger.
The use of technology might serve to change regular patient monitoring into momentary ecological evaluations, which can be visualized by physicians in real-time. It allows the collection of both passive and self-reported data unbiased by the retrospective recall.
Data from your app will be seamlessly uploaded to a secure server connected to your physician’s EMR platform. The physicians can utilize a graphical interface of your pain levels across time.
When first using the app, you will be asked about your pain levels and your daily routines. You will also be invited to list your questions about your pain, activity, sleep, mood, and medication use during the past 24 hours. You can also indicate on a visual analog scale whether these have improved or worsen.
The pain data may be augmented by questions from the validated chronic pain PEG (Pain, Enjoyment, and General Activity) scale, which includes items on interference with function and enjoyment. The interference may also include data on self-administered pain interventions, such as taking pain medications. A combination of PEG and pain interventions real-time data can assist physicians in making decisions on the most effective management of your chronic pain. Keeping a record of pain data will help you and your doctor identify patterns and trends that can lead to better pain management.
Body maps on a mobile device are also a great communication tool for you to inform physicians regarding pain location, intensity, and quality. With this tool, physicians can promptly obtain detailed persistent information using the interface without prolonged conversations with you.
Remote coaching in the form of text messages can improve self-management of symptoms and promote long-term behavior change retention. The mHealth app can be integrated with a web app to deliver holistic remote coaching options.
The remote coaching app offers a two-way short message service (SMS) messaging system that allows you to connect with the healthcare provider. Tailored content and interactivity are essential features of successful SMS interventions. The use of SMS could improve your adherence to medication and medical monitoring.
Personalized physical therapy via motion-tracking
The AI-embedded mobile app can use 2D motion-tracking technology to monitor your real-time movements through a smartphone camera visually. The app automatically counts and records which workout repetition you are on and whether you put in the necessary effort. It audits and provides personalized audio feedback on the physical therapy exercises performed to instruct you on how to perform the exercises correctly.
By using motion-sensing technology during physical therapy, your physical therapists will have better insight and measurable data on how you are progressing. Consequently, they’ll know precisely when you are ready to move on to a more vigorous level in your treatment. When you have metrics by which to quantify your results, you might be more inclined to go to your therapy sessions.
Communication between you and your therapist will be available via push notifications and in-app feedback threads that are stored in the app’s secure cloud server. It also has a built-in chat tool that allows you to consult with a physiotherapist for additional support.
Behavioral and psychological interventions
App-based behavioral change interventions can improve long-term adherence to chronic pain management. They can also enhance engagement with an established measure for the treatment and prevention of disease through personalized goal setting, alerts, gamification, and individualized dosing reminders.
You can use the app to record the psychological effects of pain and then provide it to your physician in a logical, concise format to aid in your treatment.
Electronic pain diary
The electronic pain diary can alert you to how your everyday life is affected by:
- Pain level
- Mood level
- Daily activities
From a cognitive-behavioral therapy (CBT) standpoint, this could be useful, as increasing your awareness and ability to take a proactive role in your life is crucial.
Tracking progress with an electronic pain diary can deliver several benefits:
- Increase compliance
- Ease of data sharing
- Improve self-management of pain
- Focus on improvements rather than daily limitations
With appropriate design, training, and monitoring, an electronic pain diary can capture daily pain data on a large scale.
Virtual reality for acute pain
Virtual reality (VR) is a computing environment that skews reality with computer-generated imagery. It allows you an escape from real life with immersive, lifelike visuals, sound, gesture-based interaction to shift your attention away from your pain.
Not only is it an excellent form of entertainment, but the temporary escape that VR confers can effectively distract your brain from pain. VR can also be used to teach you to manage your pain in the real world. It can take pain relief beyond mere distraction by offering immersive content on mindfulness, breathing techniques, and relaxation. In essence, VR rewires your brain to help you to disassociate your body from the pain.
A non-invasive digital multidisciplinary pain management platform can confer an effective treatment modality and help improve your knowledge of your condition. It could also significantly reduce your pain, disability, and interest in surgery. This program is a convenient, flexible, and interactive tool that can help you achieve a pain-free lifestyle.