Pain is hard to quantify. Consequently, it is underestimated as a problem and underresearched. At the same time, the studies that have been done on pain show that pain is the single most common and (unsurprisingly) the most distressing symptom for patients in all clinical settings. Often, pain is undertreated or not treated at all. And it’s not just the patients who suffer: pain takes its toll on the healthcare industry and public services, too. Researchers found that the total cost of pain is much higher than the total costs of heart disease, cancer, and diabetes.
When taken into account, pain is often improperly managed. In the US, researchers talk about the opioid crisis: strong opioids are often prescribed despite the common overuse and misuse of the drug and despite the questionable evidence for its benefits in many conditions. In some cases, such as with postoperative pain management, strong opioids are the main solution. But they are not as effective as you might expect: up to 70% of post-surgery patients report poor pain control. That is without taking into account opioids’ side effects and dependence qualities.
It would be easy to attribute the problem of pain management to something being out of scope of what medicine can do well. But researchers stress that one of the main reasons for such a failure is the fact that pain is not being “adequately acknowledged or assessed”. Researchers also point out that it’s the lack of relevant software that is at fault. Electronic Health Records (EHR), while being a revolutionary innovation for the healthcare industry, lacks features for chronic and acute pain management. This means that healthcare providers don’t have enough information to make data-based decisions. The data they do get is sporadic and unstructured, and lacks information on the location of the pain, intensity, quality and its impact on a patient’s activity.
Besides, patients themselves lack knowledge and means to manage their pain. In this article, we talk about how software of all kinds can help society deal with this huge and unfairly overlooked problem.
Pain management: how can software help?
- Gathering data (for clinics and researchers)
The first problem that software for pain management solves is the lack of information. Mobile apps gather data entered by patients. Ideally, they should also seamlessly upload it to a secure server connected to the physician’s EMR platform. This way a health professional would graph a patient’s pain levels across time. Cloud software often combines the features of an EMR platform and pain management apps. Such is, for example, Nextgen Healthcare ― a healthcare IT platform, which is one of the market leaders, and healthcare IT solutions described in the next paragraph. However, most stand-alone pain management apps described later in the article don’t have such a feature.
Having more data on pain is vital to improving the situation around pain management globally, so there is still a lot to be developed in this area.
- Managing patients from start to finish (for clinics)
For some clinics, pain management platforms are the best all-in-one solutions for patient evaluation, interventional treatments, medication management, and so on ― basically, everything concerning a patient suffering from the pain. For example, PrognoCIS software gathers information about pain (in addition to more traditional forms of evaluation, clinics can use voice recognition to allow the patient to narrate their experience); offers templates for most pain treatments out there: trigger point injections, back pain thoracic region, selective nerve root blocks, and so on (templates help with management workflow); and manages electronic prescriptions. Meditab, another huge medical software, in their pain management feature helps doctors visualize the clinical workflow and make better clinical decisions. The tool presents detailed anatomical diagrams for annotation of pain, procedures, and injection sites, and offers pre-installed pain management templates. The tool also works with e-prescriptions and allows doctors to meet patients remotely through the video chat and app. You will find a number of platforms like that: usually, pain management is a part of how they maintain the clinical workflow.
- Psychological support (for patients)
Psychological factors play a vital role in how patients experience and control pain. Too often, patients suffering from chronic conditions or rehabilitating from surgery receive emergency help when required and then go home to deal with their pain on their own. The first thing they lack in such cases is emotional support. Patients may feel abandoned and forgotten. This worsens their conditions even further.
Pain management apps create a sense of care and support: many apps, such as Branch, are connected to a user’s medical professionals, a medical resource team, and a supportive community. Buddy Healthcare, a care coordination and patient engagement platform, remotely monitors, guides and supports chronic pain patients after they have left the clinic. The platform sends automated, digitized care plans, instructions and reminders. In addition to the obvious usefulness of such actions, this decreases patients’ anxiety and shows them they are not alone.
A whole list of pain management apps asks the user to keep track of their pain. Some apps, such as MySymptoms, also ask for other data, such as on the patients’ diet, sleep, and exercise. This isn’t just a source of valuable data for the doctors and researchers. This creates a sense of control. By asking patients to keep a close track of how they are feeling and what they are doing, apps encourage the patients to develop internal locus of control ― a psychological term that describes an attitude where the quality of one’s life depends on one’s actions as opposed to the things that happen to them. People with such an attitude have been shown to better deal with a whole range of challenges, including pain.
- Psychological practices (for patients)
While psychological support deals with vague issues such as the need to feel support and presence of other people, the benefits of feeling in control of your destiny, and the importance of just not giving up, psychological practices focus on direct therapeutic methods of pain reduction. Different pain management apps focus on different approaches to pain management, but all of these methods have been found to help with pain. For example, the app Branch offers tools that employ online Cognitive Behavioral Therapy (CBT), which is the current gold standard of psychological therapy for most conditions. Pathways Pain Relief offers a pain therapy programme with different sections for mindfulness, meditation, and physical therapy. Curable uses a biopsychosocial approach to help users better manage their pain. When logging in, users are asked to answer questions about their pain and are then presented with a programme that includes guided meditations, visualizations, and even expressive writing. The app Flowly uses biofeedback training that is often used for patients with anxiety. It teaches patients to monitor and adjust breathing patterns, focus, and regulate their nervous system better.
- Education (for patients)
There is a lot to learn about pain and how to manage it better, and many platforms provide people with easy access to this knowledge. Buddy Healthcare educates their users, and so do other tools, such as Pathways Pain Relief that creates “masterclasses” about chronic pain. Some tools use their power to educate patients about themselves based on the data the software collects. For example, Wave gathers condition-related information like medications and pain scale numbers, and more general information like water consumption, sleep, and step count. Then it uses AI to identify correlations that “help you do more of what helps you feel better, and less of what makes you feel worse”.
Pain management: the power of VR
It would be wrong to talk about pain management and healthcare IT solutions and not mention Virtual Reality (VR). VR has been used for the past decade to manage pain, as well as a whole range of purely psychological disorders, such as PTSD, anxiety, phobia, and phantom limb syndrome. VR helps with refocusing the patients’ attention, by, for example, combining the visual images with deep breathing instructions ― BreatheVR by Neon does exactly that. In addition to being used for chronic and acute pain management, VR is often used as a distraction to manage pain during medical procedures and for children undergoing medical care. Being distracted by something as immersive as Visual Reality helps people to survive visits to the dentists and even childbirth without pain medications. VR methods can vary from interactive scenarios to hypnotherapy.
Pain management is a field that’s hard to overestimate. Almost everyone has dealt with pain at some point of their lives, and would do a lot to avoid it in the future. Perfectly healthy people deal with pain regularly: during periods, dentist visits, hangovers, and so many other occasions. Billions live with chronic conditions, and for some pain is much worse than it is for others. Old age also comes with pain, and we should expect more people to experience it in the years to come, as the population of most countries is aging.
Informational Technology is on its quest to ease people’s lives by helping them manage their pains better. We have solutions for clinics and for patients, from simple apps that anyone can download and use to complex VR technologies. In this article, we’ve merely touched on what the technology is doing for pain management. There is a lot more of what is happening, and more importantly, there is a lot more to come. Stay tuned.