May 27, 2011

Dr. Christine Rini uses technology to help people manage pain.

Dr. Christine Rini uses technology to help people manage pain.

Coping with chronic pain is possible but challenging. Evidence shows that many patients report uncontrolled pain and that this is a source of distress for patients and their families. An important part of managing pain involves particular skills, including controlling thought patterns and learning to recognize tense muscles and relax them on demand.

Christine Rini, PhD, research assistant professor of health behavior and health education, has helped demonstrate that cognitive behavioral therapy offered via telephone is effective in reducing post-traumatic stress in cancer survivors. (Cognitive behavioral therapy aims to address dysfunctional thoughts, emotions and behaviors in a systematic, goal-oriented way.) Now, Rini leads a team to provide similar training through the Internet — with no therapists required — to help people manage pain.

“Some people would like to receive this type of training but don’t live near a place that offers it, or they prefer to do it in the privacy of their own home,” Rini says. She is developing the initial training program to help osteoarthritis patients. If it is effective, she plans to use it to help cancer survivors, as well.

The training is based on an in-person program devised by collaborator Francis J. Keefe, PhD, professor of psychology and neuroscience at Duke University. Translating in-person training to the Internet requires a system that can respond to patients’ questions, successes and challenges with a library of possible responses. Once code is written, patients can log on to a computer program that provides information and feedback appropriate to individual patients. While the development process can be laborious, such a system ultimately could be deployed for millions of patients, anywhere in the world. Patients in low-resource situations and countries could gain important skills that would help them manage pain.

The project, now in its first year, is funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Angela Spivey

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit