Research Updates

Self-managing pain — websites and other tools for healthcare and RTW practitioners

Lauren Finestone

Not everyone with persistent pain conditions can access specialised pain services. How effective are websites as a tool to help them manage their pain?

Persistent pain is a common long-term condition that affects 1 in 5 people around the world. But there are barriers to people accessing and using specialised pain services — particularly for culturally and linguistically diverse communities. 

Online resources such as websites are promoted as a patient education tool to complement face-to-face services and to give people information and support to manage their persistent pain. But how do we know if those sites are of good quality and meet existing evidence-based guidelines? 

A New Zealand study used Google, Bing, and Yahoo to search for websites that that were freely available to the public and provided information on self-managing pain to see if they:

  • had information that matched current best practices
  • had information tailored to different cultures
  • were of good quality.

They included 27 websites in the study and evaluated the contents using a checklist. They assessed website quality using the Health On the Net code (HONcode) certification.

What the study found
  • Most websites had some information that matched best practices, but only one (ACI Pain Management Network) had information tailored to different cultures.
  • LivePlanBe, ACI Pain Management Network and MyJointPain scored the highest for enabling self-management skills.
  • LivePlanBe, MyJointPain, ACI Pain Management Network, American Chronic Pain Association, Action on Pain, and Pain HEALTH met all the 7 content items of self-efficacy building strategies.
  • 6 websites were certified as health information that has been reviewed externally and is both reliable and credible 
  • 17 websites provided information tailored to individual user needs.
  • The websites mostly talked about how pain works, ways to relax and breathe and strategies based on cognitive-behavioural therapy.
  • The top-scored websites let users complete validated instruments that measure pain intensity, stress and anxiety and provided tailored self-efficacy building strategies and features to set, monitor and review goals over time.
  • Other websites had only generic information on all the self-efficacy building strategies with not many opportunities for users to make personalised action plans.
  • Just over half of the websites had some form of social support, such as online forums or telephone support. Studies have shown that peer support can provide a sense of community and role-modelling for people with persistent pain. But there is a lack of research comparing the different ways peer support can be provided — such as face-to-face, online or over the phone, and the type of moderation that is needed (such as by a healthcare provider or a peer volunteer).
  • The text on the all websites may be too complex and difficult for a person with less than a high school education to understand. (Examples of websites that do provide easily readable, culturally tailored information to users include ACI Pain Management Network, Beyond Blue and Depression New Zealand).
The takeaways

Some of the websites may be helpful to complement face-to-face services to reinforce day-to-day use of strategies commonly learnt with clinicians. They can also be used when it's hard to access services.

It's important to keep in mind that most websites don't have information tailored to different cultures and there's no evidence that the information on these websites is effective. 

Clinicians and users should be aware of these limitations when recommending or using online resources as a pain self-management tool.

Self-management websites may not be very helpful for people in vulnerable communities, and there are currently no guidelines for tailoring information to various culturally and linguistically diverse communities.

Original research

Devan, H., Perry, M. A., van Hattem, A., Thurlow, G., Shepherd, S., Muchemwa, C., & Grainger, R. (2019). Do pain management websites foster self-management support for people with persistent pain? A scoping review. Patient Education and Counseling, 102(9), 1590-1601.

Published 20 January, 2023