People with chronic pain may be able to use online tools to manage their symptoms, lessening the need for frequent doctor visits, an Australian study suggests.
Researchers tested a series of web-based pain management tutorials on a group of adults who had been suffering symptoms for more than six months. Regardless of how much contact the patients had with clinicians, they all experienced significant reductions in disability, anxiety and average pain levels at the end of the eight-week experiment as well as three months down the line.
“While face-to-face pain management programmes are important, many adults with chronic pain can benefit from programmes delivered via the internet, and many of them do not need a lot of contact with a clinician to benefit,” lead study author Blake Dear, a psychology researcher at Macquarie University in New South Wales said.
Dear and colleagues recruited patients online, then whittled the group down to 490 adults who had seen a doctor to assess their pain within the past three months, had no psychotic illnesses or severe depression and had regular access to a computer and the internet.
Participants were divided into one of three treatment groups to receive the web-based tutorials along with regular contact with clinicians during the study, optional contact with providers or no contact. A fourth control group was told they were on a waiting list for the online programme and carried on their usual treatment with their doctors.
The regular contact group had an average of 68 minutes of contact with clinicians over the eight-week treatment period, compared with 13 minutes for the optional contact group and about 5 minutes for the group with only emergency contact.
During that time, people in the treatment groups also had five web-based lessons that focused on pain management using cognitive behaviour therapy techniques.
At the end of the eight weeks, patients in the treatment groups had average reductions of at least 18 per cent in disability, 32 per cent for anxiety, 36 per cent for depression and 12 per cent in typical pain levels.
These improvements were sustained or even improved after three months, and there were no significant differences between the intervention groups based on how much contact people had with clinicians.
In addition, people in the treatment groups had significantly greater reductions in disability, depression and anxiety than the patients on the waiting list for the online courses.
One limitation of the study, the researchers acknowledge in the journal Pain, is that the study didn’t examine what therapies people received in the control group getting “treatment as usual”, which makes it impossible to know if people in that group would have recovered without any treatment.
It’s also possible that, given more than just the three months of follow up, more differences would emerge between the treatment groups, said Christine Rini, a behavioural health researcher at the University of North Carolina Chapel Hill.
“More broadly speaking, it may be that the most critical information that patients get from doctors working with an internet-based pain management programme is communicated relatively quickly, and that additional contact does not really matter,” Rini, who wasn’t involved in the study, said.