Effectiveness of an internet-based pain self-management intervention for individuals living with chronic pain

Abstract

Background: Chronic pain is a prevalent healthcare problem which influences each aspect of an individual's life. A biopsychosocial approach is the dominant one to be taken in the understanding and treatment of chronic pain as not only physical but also psychological factors influence the pain experience. Multi-disciplinary interventions based on a biopsychosocial approach provide an effective treatment strategy for the management of chronic pain. However, the availability of these interventions is limited. Research indicates that internet-based self-management interventions can address this limitation. Aim: The aim of this study was to assess the effectiveness of an internet-based pain self-management intervention, for individuals with chronic pain that were recruited from various clinical settings. The intervention is a well-known pain self-management website known as the 'pain toolkit'. This is the first study that we are aware of which examines the effectiveness of the 'pain toolkit' intervention in a 'real-world' clinical context. It was hypothesised that the participants' fear of movement/(re)injury, pain-related anxiety, pain catastrophizing, pain (intensity and interference) and passive coping strategies (i.e. diverting attention, catastrophizing, praying/hoping) would decrease after engagement with the 'pain toolkit' website.Moreover, it was hypothesised that the participants' self-efficacy and active coping strategies (i.e. reinterpreting pain sensations, coping self-statements, ignoring pain sensations, increasing activity level, the ability to decrease pain and to control pain) would increase after engagement with the 'pain toolkit' website. Finally, it was hypothesised that the participants' readiness to engage in pain self-management would increase from the onset to the completion of the intervention. Specifically, engagement with the 'pain toolkit' intervention would facilitate participants' movement into a more advanced stage of pain self-management. Methodology: Self-report questionnaires, including: Pain Stage of Change Questionnaire (PSOCQ), Tampa Scale for Kinesiophobia (TSK), Pain Anxiety Symptoms Scale (PASS), Brief Pain Inventory (Short-Form: BPI), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ) and Coping Strategies Questionnaire (CSQ) were completed by the participants - both before and after the intervention. Participants engaged with the intervention for 6 weeks.Results: Forty-eight chronic pain patients (27 females and 21 males) aged 22 to 77 completed the study. Participants showed significant reductions in pain related anxiety, fear of movement/(re)injury, and pain catastrophizing and there was significant improvement in their ability to decrease pain. Conclusion: These findings indicate that internet-based, pain self-management intervention, such as the 'pain toolkit' is an effective intervention on a variety of measures for individuals living with chronic pain.