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 programs are important, many adults with chronic pain can benefit from programs delivered via the internet, and many of them do not need a lot of contact with a clinician in order to benefit,” lead study author Blake Dear, a psychology researcher at Macquarie University in New South Wales, said by email.
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 wait-listed for the online program and carried on their usual treatment with their doctors.
Patients in the regular contact group were required to have weekly phone or email conversations with clinicians trained in psychology, while people in the optional contact group were told this was available if they wanted to do it and the non-contact group was told clinicians were only available if they had technical difficulties or a mental health emergency.
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 behavior therapy techniques.
At the end of the eight weeks, patients in the treatment groups had average reductions of at least 18% in disability, 32% for anxiety, 36% for depression and 12% 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.