Women who have suffered from sexual or physical abuse often have residual muscle tension and pain, a symptom of extended stress and activity within the body. Now, two UK researchers are studying how a smartphone app could help these women manage chronic pain.
Charles Carlson, the Robert H. and Anna B. Culton Endowed Professor in the UK Center for Research on Violence Against Women, says a significant portion of the clinic’s female patients have suffered from sexual or physical abuse at some point in their lives, which often results in tension throughout the body that can lead to pain.
“Trauma often causes a prolonged state of increased sympathetic tone within the body,” Carlson said. “The chronic hypervigilance may be associated with scanning for danger around every corner. [This can lead] to a state of prolonged and unnecessary muscle tension and eventually, if unchecked, may contribute to muscle-based pain conditions such as myalgia. It is not surprising, therefore, that a significant number of our patients with chronic pain reported experience with physical or sexual abuse.”
Carlson, who is also a professor of psychology in the UK College of Arts and Sciences, and Matt Russell, a doctoral candidate in clinical psychology, want to help patients learn to calm their hypervigilance through strategies that can manage the excessive activation of muscle-based pain. Their previous research shows that patients with chronic pain can find relief through self-regulation strategies that include slow-paced, diaphragmatic breathing – a form of relaxation training.
App teaches self-guided breathing
With the help of a smartphone app that teaches users how to do diaphragmatic breathing, the researchers are currently conducting a clinical trial at the UK Orofacial Pain Clinic, working with patients experiencing myalgia and other chronic pain in the head and neck regions.
Diaphragmatic breathing is a practice most people can learn, so Carlson and Russell are exploring whether patients can help manage their pain by learning to breathe diaphragmatically without the use of a professional therapist. By providing patients with a mobile application that teaches the diaphragmatic breathing approach, the team hypothesizes patients will learn to self-regulate their body’s sympathetic tone to manage their pain.
“We designed the smartphone application to teach patients the basics of paced, diaphragmatic breathing with audio directions only,” Russell said. “Then, we use a visual aid to help pace their breathing, an important piece of strengthening the parasympathetic response.”
The current project will examine the effectiveness of the smartphone health intervention to improve treatment outcomes above standard dental care. The participants recruited through the Orofacial Pain Clinic will receive either standard dental care alone, or standard dental care plus the mobile application on their iPhone/iPad or a provided iPod Touch. Patients using the application will track their daily breathing practices and pain levels, while those receiving standard dental care alone will track only their pain levels. All participants will complete weekly assessments, and at each clinic follow-up visit, participants’ progress will be monitored by collecting measures of their current self-regulation skills.
While a quick iTunes search can result in hundreds of apps that promote breathing strategies to treat various ailments, Carlson emphasizes the importance of empirical evidence.
“To our knowledge, there are no published studies empirically validating that these applications can deliver on their promises,” he said. “As clinical scientists, we believe that before we tell our patients our application will help, we need evidence from a scientific study.”