The word “pain” comes from the Latin word poena, meaning a fine or penalty. For anyone living with pain, it certainly can feel like some kind of punishment. However, pain isn’t completely out of your control. Statistics show only 50% of people follow their medication schedule correctly, resulting in unnecessary levels of pain. Fortunately, smart technology is here to help people stick to their schedules and to live a relatively pain-free life.
A Generation of “Quantifiers”
Saleen Ong, senior director of clinical sciences at Pfizer, has discussed the phenomenon of the “quantified self” movement, explaining that, “A generation of people are quantifying everything about themselves.” A host of apps and devices can measure your every move—from steps taken to calories burned—and some devices even help alleviate pain for people with both chronic diseases and short-term pain induced by injuries. They also give pharmaceutical companies access to a wealth of data, giving them a better understanding of the patient experience and how to proceed in developing devices, treatments and medications to provide pain relief.
One example is Medisafe, founded by two brothers, Omri and Rotem Shor, who were spurred into action when their father’s accidental intake of an extra dose of insulin landed him in serious condition. They soon realized their experience was far too common, and they embarked on the journey to create Medisafe to assist people in taking their medications on time and in the correct doses.
Omri Shor said, “One of the most important questions health professionals ask patients suffering from chronic pain is, ‘Are your medications alleviating the pain?’ Medisafe makes answering this question easier with the integration of biofeedback into its platform.” This feature allows you to track and correlate your adherence directly with health outcomes. It also allows you to assess whether your medications are diminishing your pain, providing doctors with real-time data that can inform their decisions in adjusting pain medication.
For those living with rheumatoid arthritis or any type of chronic pain, it is advisable to take medications on schedule—not after pain has set in. Once the pain has begun, it takes longer to obtain relief. That’s why apps to help remind you—such as Life-txt, Apple’s PillReminder, Mango Health’s app, and Medisafe, to name just a few—can assist in pain relief.
Apps for Lifestyle Management
These apps also can help with lifestyle management, an important aspect of managing pain. For example, they can offer reminders to exercise and to take time out to relax. Although arthritic pain may make you want to just sit on the couch and nurse your pain, it’s important to remain physically active. Health-care professionals can recommend beneficial exercises that don’t put too much strain on the joints. Wearable devices such as the Apple Watch tell you how many steps you have taken in a day and what exercise you have done. The app can tell whether you have been cycling, running or walking to ensure you meet your daily quota or that recommended by a health-care professional.
There are times when just getting to the doctor’s office can be excruciating. This is when apps such as TouchCare are invaluable. TouchCare allows you to connect with your physician through a video call from your home and receive a personal consultation. The app also includes features such as appointment reminders and push notifications for incoming calls, so you don’t miss face time with your doctor. This app is incorporated easily into the normal billing, charting and scheduling of the physician, so the video calls are integrated seamlessly into the normal practice. This app currently is being used in both the U.S. and U.K. extensively for follow-up appointments, going over test results, refilling prescriptions and providing after-hour care.
Let’s not forget the role of diet in pain management. Apps such as Shopwell help with food choices that can reduce pain, although many people already know which foods make their pain worse and which provide relief. Shopwell, a community partner of the USDA, is an app created by registered dietitians that allows you to scan the barcodes of items either in-store or at home to check if they match your dietary requirements. The app can recommend food better suited to your health needs and supports people looking for foods to relieve the pain of osteoporosis and achieve a host of other health-related goals.
With Shopwell, it is possible to earn rewards by giving feedback via “missions” that enable you to share your experience using the app with its creators. In return for your input, which enables the developers to keep improving the product, you earn Tango Cards that can be exchanged for gift cards from top name brands in the U.S. and abroad.
A similar app called Substitutions on the Apple iPhone or iPad suggests alternatives to the foods you know trigger your pain or discomfort. Fooducate, available on both the Apple iPhone and Android devices, also allows you to scan barcodes. It then unlocks the various elements of the food and delivers a health score. So although a product may be fat-free, the app will tell you if it is loaded with sugar. You also can type in the name of a food such as tomato, and it will score that, too.
Advice abounds regarding which foods to eat and which cause pain flare ups; yet, there is disagreement between proponents of alternative and mainstream science on what should or should not be consumed. One proven pain-causing culprit has been isolated by Jaime Uribarri, M.D., and associates: dietary advanced glycation end products (dAGEs), which contribute to increased oxidant stress and inflammation and can be reduced significantly by cooking with moist heat, using shorter cooking times, cooking at lower temperatures and using acidic ingredients such as lemon juice or vinegar. Many apps can suggest suitable meals incorporating these methods.
Adherence is Key
Non-adherence to medication and lifestyle advice is a key culprit for pain. Health-care professionals, patient-care companies and caregivers all agree—you must adhere to medication schedules if you want relief from pain. Omri Shor said, “The Medisafe app is designed to understand the personal causes of non-adherence and to use this information in real time to create better patient engagement and raise medication adherence. Once patients have downloaded the app, they create a profile, adding in the medications they are taking and at what time they need to take them, setting a unique alarm for each medication.” You also can elect to use the Medfriend feature, which allows you to have caretakers or loved ones receive alerts if you miss a medication dose.
Apps can be used for various chronic conditions. According to Omri Shor, “The Medisafe app is designed to address the needs of patients with different and varied chronic conditions including diabetes, heart failure, hypertension, pain, high cholesterol, epilepsy and depression.”
Miniature Implants to Combat Pain
Apps aren’t the only smart technology to achieve medication adherence and pain relief. A team of 10 engineers, software developers and biomedical experts at Sydney-based National Information Communication and Technology Australia (NICTA) have been working on smart chip implants. One of these implants, Implantable Neuro-Sensing and Stimulation (INS2), was created to relieve chronic pain by being placed close to the spinal cord to block the pathways for pain signals to reach the brain, thus providing pain relief.
John Parker, Ph.D., chief technology officer of NICTA, said although implants to block pain have been around for some time, they tend to be large and inconvenient. However, the device they are working on is only the size of a match head, making it more efficient because it can be implanted closer to the spine.
In terms of how the device has fared in clinical trials, Parker said, “We have recently conducted an FDA Investigational Device Exemption study in the U.S. for a temporary form of the system, in which 81% of patients preferred this therapy over the more traditional therapy of spinal cord stimulation.” In addition, more than 70% reported fewer side effects.
Pain Relief for Children
Approximately 70 million people in the U.S. alone suffer from arthritis, and among these are over three million children. This prompted Muhammad Mustafa Hussain, associate professor of electrical engineering at King Abdullah University of Science and Technology, to conduct research into a new patch for pain relief using nanotechnology.
Together with his team of researchers, Hussain has devised a silicon-based smart thermal patch that is both flexible and stretchable to combat the problems experienced by thermal patch wearers of typical off-the-shelf chemical-based products. Those are mostly not re-usable and have a limited time frame (around eight hours) and a limited temperature range. Using complementary metal oxide-semiconductor technology in the construction of integrated circuits, the new smart patch can be used for pain management in an interactive way. It is particularly effective for children.
This Feeling, an iPad app for children, is an exciting innovation that was presented at the European League against Rheumatism Annual Congress. Through a variety of tools such as adjustable pain icons and an interactive manikin, the app helps children with juvenile idiopathic arthritis (JIA) describe their pain location, intensity and its emotional impact. Children ranging from ages 5 to 16 recruited to test the app at an outpatient clinic as part of the Childhood Arthritis Prospective Study reported a preference for the app over other methods (95%). Traditionally, it has been difficult to monitor exactly how much pain children with JIA experience. This Feeling, however, allows health-care professionals to gauge pain intensity more accurately.
Robots are another novel pain relief option for children. A robot developed by Tanya Beran, professor of community health sciences at the University of Calgary, has been delighting children visiting various hospitals in Canada. Her company, RxRobots, built a robot specifically to interact with children. “When working in hospitals and seeing children screaming, struggling and pleading not to have a needle,” said Beran, “I realized these procedures need to be easier, faster and far less painful. I put two and two together and thought that maybe children would respond to a friendly looking robot who helps them face medical procedures.”
In 2011, Beran conducted a randomized control trial that involved such a robot—MEDiTM. There was a 50% pain reduction in children receiving the influenza vaccination and positive feedback from parents, who requested MEDi for future medical procedures. “Our first thought was to use MEDi to provide coaching and distraction during medical procedures involving needles,” said Beran, “but providing comfort to children in pain from arthritis is certainly one of the applications.”
Advances in technology have facilitated the development of smart apps and devices that can help you live relatively pain-free. At present, there are apps to encourage medication adherence and facilitate pain relieving lifestyles, as well as wearable devices to help you eat better and stay more physically active. And exciting innovations—from smart patches to alleviate pain and robots to help calm children in pain—are just around the corner.