Decades ago, advances in pharmacology gave chronic pain patients hope with increasingly strong drugs that the medical community and patients alike thought could alleviate their suffering.

The reality has been much different. The drugs, including opioids, resulted in a widespread epidemic of prescription drug abuse that has wrecked lives through overdose and addiction.

Today, advances of a different kind are infusing the chronic pain community with newfound hope–telemedicine for chronic pain.

Telemedicine, which harnesses technology to bridge geographical distance, promises to connect primary care doctors and chronic pain specialists as they jointly seek to help patients in a more effective, holistic way. Virtual medicine has also been shown to improve patients’ response to care, namely because of its ability to more closely track progress.

Primary care doctors bear the brunt of chronic pain epidemic

Primary care doctors are usually the first to see patients experiencing chronic pain. However, these physicians often lack the time necessary to dig into a patient’s case history and symptoms to uncover the true cause of pain.

Doctors are often left helpless against the complexity of chronic pain, trying to unravel its many mysteries amidst a health care model that requires doctors to limit patient appointment times in order to make ends meet. Still, they must help patients and reduce their suffering.

Since the powerful painkiller Oxycontin first came on the market in 1995, doctors have increasingly turned to writing prescriptions for potentially dangerous opioids to help patients who were running out of hope. Unfortunately, taking these drugs leads to physical dependence, long-term health impacts, and sometimes overdose and death.

Tides are turning against opioids, however, as reports increasingly underscore their dangers. Despite the dangers, rates of opioid use have steadily risen over the past two decades, spurred along in part by patient advocacy groups who fought for increased use of pain medicine to alleviate people’s suffering, according to NJ Spotlight.

Today, Arizona’s rates of prescription drug abuse are the sixth highest in the nation, and more people die from overdose than from car crashes, according to a report by the nonprofit Trust for America’s Health. Prescription opioids represent some of the more commonly misused drugs.

With the epidemic, however, has come the growing awareness that a new solution must be found. Enter telemedicine.

What is telemedicine?

Telemedicine is when doctors and patients communicate through various forms of technology, often video, instead of in-person office visits. This form of practicing medicine can be used in several ways: doctors from across the country can use technology to talk about patients, or patients can use video and the Internet to meet with doctors for follow-up visits or other consultations.

Using technology to bridge distance allows primary care specialists to recruit the best pain doctors to help in patients’ cases, no matter where they’re located. It also encourages what’s known as collaborative medicine—when all of a patient’s doctors communicate on any given case.

Collaborative telemedicine for chronic pain helps patients since it brings together multiple medical minds to prescribe medical solutions to health challenges. It also reduces the likelihood of gaps or redundancies in care.

How common is telemedicine for chronic pain?

This phenomenon is growing worldwide, with millions of patients using technology to take charge of their health, according to the American Telemedicine Association.

More than 50% of U.S. hospitals use the care in some form, and the trend is growing.

How does telemedicine for chronic pain work?

Telemedicine offers a variety of ways to connect patients and doctors like never before.

Primary care doctors in New Jersey, for instance, began a telemedicine initiative that involves weekly meetings with West Coast pain specialists. During the meetings, the general medicine practitioners detail a patient’s case, and then the pain specialists help them determine a course of treatment.

Pain specialists have in their arsenal a variety of non-pharmacological tools to manage chronic pain. These include special injections, such as nerve blocks that interfere with pain signals at the source, and cutting-edge procedures, such as stem cell treatments, that may give hope to patients who have tried other options without success.

Additionally, pain doctors have experience with alternative treatments, including acupuncture, chiropractic, and stress reduction techniques, that primary care doctors may not immediately think of to treat pain. Combined, these interventions offer hope to patients who previously would have been given a prescription for opioids.

Dr. Daren Anderson, a Connecticut physician involved in the New Jersey effort says:

“We devalue all the effective alternatives that are out there. We treat pain, but we don’t treat addiction—or we ignore it.”

Another option for telemedicine for chronic pain involves patients visiting directly with their doctor. This option may help save time for patients and doctors, making it easier to meet for follow-up visits, or help patients who live in an underserved area.

A study published in the Clinical Journal of Pain reviewed eight Canadian patients who each lived about 200 miles from their respective doctors. Researchers found that both patients and doctors saved time and money by meeting virtually instead of in-person. The visits were follow-ups to review patient progress, change medication, or offer counseling.

Doctors and patients using telemedicine for chronic pain follow-up care may also save time and money, one study found.

Telemedicine may also in some cases be more effective than standard care, according to researchers at Indiana University School of Medicine, particularly when all the potential of technology is harnessed for tracking patient well-being. A study of 250 patients compared those receiving telemedicine to those receiving traditional care from a general practitioner.

The telemedicine group was asked to record their levels of pain by phone or online. Doctors used a special algorithm to adjust medication based on the patients’ responses. After one year, patients in the telemedicine group said their pain improved by 30% while patients receiving standard care said their pain worsened.

What are the risks of telemedicine for chronic pain?

No form of medicine is perfect, and telemedicine does have risks.

One risk involves patient security. All medical information is confidential under federal law, however, telemedicine frequently involves transferring patient files over wireless Internet connections. This opens the door for hackers and other unscrupulous individuals to access the information, according to insurance company Zurich.

There is also room for error if medical professionals on either side of the telemedicine connection lack necessary credentials or licenses. Technicians could end up completing tasks or giving medical advice on subjects outside their area of expertise, according to Zurich.

As telemedicine becomes more popular, protocols and protections are increasing in scope and complexity to ensure a safe environment for patients. Nevertheless, it’s always a good idea to ask your doctor about any concerns you have to ensure the best possible medical care.

Would you ever try telemedicine for chronic pain management?

Image by Intel Free Press via Flickr

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