Smartphone applications for chronic pain management: A critical appraisal

Abstract

Chronic pain is a common condition with significant detrimental physical, psychological, social, and economic impact.The Institute of Medicine estimates that >100 million Americans suffer from chronic pain, 1 representing approximately one-third of the entire population of the US. 2 Conservative estimates suggest that well over US $500 billion per year is spent in the treatment of these pain conditions, not to mention the lost productivity of these individuals or the burden that their suffering engenders for patients and their families.Despite tremendous efforts, chronic pain continues to be a major societal problem. 1 Smartphones have become one of the most rapidly adopted technologies in the modern history of mankind allowing for previously unimaginable opportunities for communication and access to information.3 Powering this societal revolution is not so much the onboard or attachable hardware for smartphones, but the dizzying array of software programs that use the hardware to add novel functions; we call the unifying software programs "applications" or, more commonly, "apps".While each phone comes with onboard technologies, such as Wi-Fi, Bluetooth, lights, microphones, cameras, accelerometers, and even barometers, it is the development of the app that combines these functionalities to create new and innovative uses for the same hardware for everything from Skype 4 to Pokémon GO. 5 The use of such applications within the health care industry continues to grow, and it is estimated that the market for mobile health apps will grow to US$26 billion in 2017.6 The immense size of this market is due to the functional flexibility that apps can provide.These emerging technologies also provide new opportunities to engage with patients and improve health care outcomes.Studies have shown that mobile phone messaging helps to improve patient engagement outside the clinic or hospital and facilitates self-management of chronic diseases such as hypertension, diabetes, and asthma, 7 and app-based systems may also be of use in this regard.While the overall market for apps in health care is robust, the market segment for pain management is less than impressive.It is clear that pain is a complex phenomenon and thus requires a multifaceted and multidisciplinary approach to achieve optimal outcomes.Of the several pain management approaches, the biopsychosocial components to the pain experience have been shown to be the most effective means of treating chronic pain, yet they are underutilized.8 New technologies such as the smartphone apps that have come