By Sian Stringer
We’ve all experienced pain in some form, whether it was that very first shocking expulsion from warm womb to the frigid outside world, jamming your finger in a car door, or tearing your ACL playing footy.
But for some people, pain comes a-knocking… and never leaves.
It’s known as chronic pain, and it’s a real problem for one in every five Australians.
Experiencing life through a pain haze
Chronic pain can either be an everyday occurrence or a recurring event. It can be caused by one or a range of conditions – think everything from osteoarthritis to fibromyalgia, lingering back problems, migraines, endometriosis and more – or there might not even be a known cause.
For many people it morphs from being a feeling to an all-consuming experience. It can disturb your sleep, wear you down, drill away at your mental health and your overall resilience.
Many people with chronic pain rely on painkillers for some relief, often opioids such as codeine, oxycodone, fentanyl or morphine. But long-term use of these pose serious risks, including dependence and addiction, and even accidental fatal overdose – a serious problem in Australia, where, according to a 2019 report from Deloitte Access Economics with Pain Australia, more people die from accidental opioid overdose than from illicit drugs.
Managing chronic pain and pain medication can be difficult, but good management can help improve people’s quality of life.
Activity pacing and tracking
One way to manage pain is called activating pacing. It’s centred around the idea that moving too much – or even not moving enough, staying in one posture for a long time – can trigger increased pain. By working with their clinicians to identify the activities that trigger symptoms, then breaking up and rescheduling those activities, a person can reduce their pain flareups, and possibly reduce the amount of painkillers they otherwise need to get them through the day.
However, some people struggle to use activity pacing strategies after they receive treatment. The challenge lies in figuring out what the problematic activities are for each person and finding a way to measure whether certain changes actually make a difference.
This is where the digital health gurus at our Australian e-Health Research Centre come in.
Mapping out pain and activities with Pain ROADMAP
In collaboration with Postdoctoral Research Fellow Nicole Andrews at Metro North Hospital and Health Service and The University of Queensland’s RECOVER Injury Centre, our research scientist Dr David Ireland developed Pain ROADMAP, a mobile platform made up of an app for patients with chronic pain, and a portal for clinicians.
Using the app, people can keep a log of each activity they do throughout the day, their pain levels as they did those activities, and what pain medication they take and when. They also wear an actigraph accelerometer around their waist, which keeps track of when they are moving and resting.
This information all feeds into Pain ROADMAP’s clinical portal. Clinicians can then see a daily and weekly summary of each person’s pain intensity and variation; how their time is split between resting, working and leisure activities; and build up a picture of if and when they take pain medication.
Armed with this detailed information, clinicians can then help patients work out how to better pace their activities through the day to reduce the frequency of intense periods of pain.
Helping to stabilise pain
We put our Pain ROADMAP app and portal to the test in a three-month feasibility study. Twenty people with chronic pain used the app to track their activities, pain levels and pain medications, and their clinicians could see this information through the portal.
The study found that interventions using the app helped people reschedule activities. They found they had fewer periods of over-activity, the app helped stabilise their pain, and help them get an average 49 minutes more productivity out of their days.
Importantly, for five of seven people in the study that relied on take-as-needed pain medication, they were able to stop taking it, and opioid medication decreased by 20 per cent on average.
We’re pleased to share that Pain ROADMAP was merit recipient for two awards at the at the National iAwards last night – congrats to our team and partners!
Next on the agenda, our researchers are also looking at whether they can create a gamified version of the platform to support children with chronic pain.
Living with chronic pain can be challenging. If you or anyone you know needs help:
- Beyond Blue on 1300 22 46 36
- Lifeline on 13 11 14
- Discuss your concerns with your GP, friends or family.
The Australian Government’s Health Direct website also has useful information and resources about chronic pain and its management.