Review supports potential benefit of online pain management

Chronic pain can massively impact a person's life and wellbeing.

Psychological therapies have been found to improve mood and pain‐related disability. One common example is cognitive behavioural therapy (CBT), which focuses on the interrelationship between thoughts, feelings, and actions, to support pain management.

Unfortunately, gaining access to CBT is difficult given the finite number of therapists and the difficulties patients may face in attending clinics, so interest is rising in the potential of online or remote treatments.

A new review for the Cochrane Library by experts in academia and clinical settings has found evidence that such technological interventions may have real value.

A growing and hopeful field

Dr Ben Rosser, a clinical psychologist and lecturer in the School of Psychology at LJMU said: “There is a growing and hopeful field engaged in developing and investigating the use of technologies to deliver psychological interventions."

Dr Rosser and colleagues from the University of Bath, Bath Centre for Pain Services and Cochrane Pain, Palliative and Supportive Care Group, explored results from 32 studies that included almost 5,000 people with chronic pain conditions ranging from back pain and osteoarthritis to fibromyalgia and rheumatoid arthritis.

The vast majority of studies investigated treatments based on CBT and were delivered online.

They found:

• Compared to usual treatment, online CBT probably reduces pain and may reduce disability slightly. Current evidence is unclear in terms of whether it improves quality of life or has unwanted negative effects.
• Compared to non-psychological treatments for pain (education, online discussion boards), online CBT probably reduces pain slightly. However, it may make little or no difference to disability and probably makes little or no difference to quality of life. Current evidence is unclear in terms of unwanted negative effects.
• The benefits of online CBT compared to usual treatment are probably no longer present at three to 12 months after treatment ends.
• More research high quality research is needed. In particularly, we need more studies investigating a wider range of psychological therapies and technologies, and that consider possible unwanted effects.

Dr Rosser summarised: "Our review suggests that technology delivered interventions may have a place alongside traditional face-to-face therapy as part of the range of services offered to help support individuals experiencing chronic pain.”

- The Cochrane Library is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the results of medical research.