Chronic pain: can treatment over the Internet help?

A short blog looking at Cochrane evidence on psychological therapies for adults with chronic pain.

Page last updated 27 June 2022

Artwork - pain and disturbance Credit: Chris Nurse. Wellcome Images
Artwork – pain and disturbance
Credit: Chris Nurse. Wellcome Images

Using the Internet to deliver therapies has obvious benefits, including its reach free from geographical constraints, convenience and low costs. People living with chronic pain, lasting longer than three months, are in it for the long haul and should be able to access support to help them manage their condition away from expert healthcare centres.

A Cochrane Review Psychological therapies (Internet‐delivered) for the management of chronic pain in adults (February 2014) explored whether pain management therapies can be successfully delivered via the Internet to reduce pain and disability and improve anxiety and depression in adults with non-cancer chronic pain. The reviewers were also interested in whether people liked the programmes and whether they improved their quality of life. They found 15 randomized controlled trials (RCTs) with just over 2000 adults and compared those having internet-delivered therapies with those on waiting lists but, disappointingly, the key message is that “There is insufficient evidence to make conclusions regarding the efficacy of psychological therapies delivered via the Internet in participants with headache conditions”.

 

Visual phenomena during migraine Credit: Debbie Ayles. Wellcome Images
Visual phenomena during migraine
Credit: Debbie Ayles. Wellcome Images

 

What about traditional methods of delivering these treatments?

This review complements another Cochrane ReviewPsychological therapies for the management of chronic pain (excluding headache) in adults (updated August 2020). It has moderate- to low-certainty evidence on cognitive behavioural therapy (CBT) from 59 studies with over 5000 people, showing that CBT probably has very small beneficial effects for reducing pain, disability, and distress compared with an active control (alternative interventions that engage people, such as exercise or education). Compared with ‘treatment as usual’, CBT probably has small benefits for reducing pain and distress at the end of treatment and may have small benefits for reducing disability. These effects were largely maintained at follow-up for the comparison with treatment as usual but not active control. There remains uncertainty about any harms that might be associated with treatment.

There is growing support for the effectiveness of psychological therapies, and particularly CBT, for the management of chronic pain and its delivery via the Internet shows promise. Clearly there is more work to be done to increase our understanding of the usefulness of these therapies and means of delivery.

Links:

Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Psychological therapies (Internet-delivered) for the management of chronic pain in adults. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD010152. DOI: 10.1002/14651858.CD010152.pub2.

Williams  AC de C, Fisher  E, Hearn  L, Eccleston  C. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD007407. DOI: 10.1002/14651858.CD007407.pub4.

 



Chronic pain: can treatment over the Internet help? by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

4 Comments on this post

  1. A fascinating discussion is worth a comment. I do think that you ought to publish more about this issue, thanks for sharing this info

    تمريض منزلي / Reply
  2. Hi Sarah,

    I’m Maegan with Healthline, the fastest growing consumer health site on the web. Our mission is to make the world a stronger, healthier place by informing and uplifting.

    One of the ways we do that is by sharing articles and information with health communities. One way we do that is by answering common questions that can help people improve the quality of their lives.

    Our article about the causes of chronic pain details potential causes, treatments, and lifestyle remedies that can help people with chronic pain understand and treat their condition. We’ve gotten a lot of positive feedback that this article has helped those struggling with pain to find answers and effective solutions. You can read the article here:

    http://www.healthline.com/health/chronic-pain

    We would love it if you could share our article with your audience. We hope it will go a long way in helping those with chronic pain live happier, healthier lives.

    If you have any questions, please feel free to reach out!

    Warmly,

    Maegan Jones | Content Coordinator
    Healthline
    Your most trusted ally in pursuit of health and well-being

    Maegan Jones / Reply
  3. Reblogged this on eHealthOxford.

    carolinacic / Reply
  4. Reblogged this on Soumyadeep B.

    Soumyadeep B / Reply

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