Effects of using text message interventions for the management of musculoskeletal pain: a systematic review

Abstract

Musculoskeletal pain is the greatest cause of disability worldwide. Owing to its increasing prevalence and burden, the importance of affordable treatments has been highlighted. Text message interventions are accessible, low cost, and effective in promoting healthy behaviour and managing chronic diseases. However, little is known about their role in musculoskeletal pain. This systematic review was conducted to appraise the literature on the effects of text messages (as an intervention or a component of an intervention) compared with any control on pain and function in people with musculoskeletal pain (PROSPERO: CRD42018117371). MEDLINE, EMBASE, CINAHL, Cochrane, and PEDro databases were searched from inception to April 2020. Keywords relating to musculoskeletal pain, text messages, and randomised controlled trials were combined. Methodological quality was assessed using the PEDro score. Of the 12,022 studies identified, 11 were included, with a mean PEDro score of 5.4/10 points (SD 1.3). Pooled analyses were not performed because of heterogeneity of interventions and clinical characteristics. When text messages were added to and compared with usual care, some positive effects were found only on treatment adherence. Although small and inconsistent, some positive effects were reported for pain intensity, function, care-seeking behaviour, adherence, and quality of life when text messages were added to multicomponent interventions. Moreover, text message and telephone counselling interventions had similar effects on function. Overall included studies were of limited methodological quality and heterogeneous. However, our results indicate potential benefits of text messages in the treatment of musculoskeletal pain, which need to be confirmed in future trials.

Development and use of mobile messaging for individuals with musculoskeletal pain conditions: a scoping review protocol

“…49 Further, the quality of the evidence of relevant experimental studies has already recently been critically appraised. 33 Our study is limited to peer-reviewed studies published in the English language and indexed in four online databases. We anticipate that information of most relevance to our questions will be contained in the peer-reviewed literature.…”

“…The evidence from experimental studies of the effectiveness of text messaging interventions for managing MSK pain conditions has recently been comprehensively synthesised. 33 We will build on this work by describing studies relating to the design of messaging systems for MSK conditions, and by synthesising the results from both experimental and observational studies. Because we aim to map the literature, as is common practice with scoping reviews, we will not assess the methodological quality or risk of bias of included studies.…”

“…[28][29][30][31] A second review (11 RCTs; 1607), focused specifically on the effectiveness of text messaging for the management of MSK pain. 33 Five studies assessed text messaging as an adjunct to usual care, [34][35][36][37][38] with improvements found to treatment adherence. In a further five studies, text messaging was assessed as one component of a complex intervention [39][40][41][42][43] with small but inconsistent effects on pain, functioning, adherence, and quality-of-life.…”

mHealth Interventions to Support Prescription Opioid Tapering in Patients With Chronic Pain: Qualitative Study of Patients’ Perspectives

“…For example, in response to texting pain, the user might receive a message offering pain coping strategies (eg, "breathe in slowly to a count of four, breathe out for six") or informational reassurance (eg, "pain may flare up for many reasons-not necessarily due to tapering"). This functionality is common and feasible in mHealth technology [28,30].…”

“…mHealth interventions have been found to be effective in supporting people to manage a variety of complex chronic health conditions, including diabetes, cardiovascular disease, and obesity [21][22][23][24][25]. mHealth has also been used effectively to support the cessation of addictive substances [26][27][28], to improve people's ability to cope with chronic pain, and to enhance perceived quality of life [29][30][31][32]. One study found that a narrative (patient testimony) educational video about opioid tapering increased patients' tapering self-efficacy to a greater degree than a pamphlet with the same information [33].…”