A recent study[1] referenced in The Journal of Pain (a US publication) caught my attention. It is entitled “Mobile App Use among Persons with Fibromyalgia: A Cross-Sectional Survey”. 

As a member of the Clyde & Co Chronic Pain Group and having dealt with many claims where the injured party has been diagnosed with fibromyalgia (either as a result of the accident or as an underlying condition), I am all too aware of the difficulties that can be found in seeking to manage and resolve the symptoms that are complained of. As the study notes, fibromyalgia sufferers experience a diverse and potentially debilitating set of symptoms. Personal agency in managing those symptoms is also often an important factor for such individuals. So any tool, especially one that come at little to no cost, should always be given consideration.

We are used to seeing the management of fibromyalgia involving a costly multidisciplinary approach, but the prevalence of smart phones in the general population (and consequent familiarity among most with the use of “apps”) means that most of us are walking around with a useful tool for self-management of symptoms in our pocket. The study ostensibly looks at how useful apps can be for those with fibromyalgia and what the common strengths and weaknesses with apps are when it comes to helping to manage symptoms.

The mean age of survey respondents was 56.4 years and the sample were predominantly white and female; with 27.9% said to be employed full-time, 9.7% part-time, 30% retired and 10% unemployed. Somewhat surprisingly, the vast majority of respondents (nearly 82%) reported their health as being either good or fair. 

Interestingly, two-thirds of the sample used for the study described themselves as mobile app users; whereas the remaining one-third did not[2]. I suspect amongst the wider population, in the UK at least, we might see a higher proportions of app users, but whether or not that says anything about the profile of fibromyalgia sufferers is perhaps another study altogether. The study also says that over 50% of mobile phone users in the United States have downloaded a health-related mobile app; and that “there has been substantial interest in using mobile technologies to support chronic disease management”[3]. Such interest may be higher where there is no free at the point of entry healthcare system, or indeed where the prospect of private treatment funded by a compensation award is not present.

The study found that apps were generally used to assist with scheduling / time management, notetaking, fitness, and wellness. The top five apps reported as being used were Fitbit, MyFitnessPal, Calm, YouTube and WebMD. None of those are specific to fibromyalgia, nor indeed chronic pain and it is difficult to discern to what extent the respondents my have used these apps for reasons not strictly related to management of fibromyalgia / chronic pain symptoms. 

Ease of use of the app was said to be the key factor in the continued and frequent use. That is no surprise given fatigue and problems with cognition (often described as brain fog) are symptoms often associated with fibromyalgia, though one would assume that in the wider population as well it will be the apps that make tasks easier that we stick with; as opposed to those that add an administrative layer to our lives. Reasons for discontinuing app use included issues with privacy, the effort required, lack of interest, and lack of perceived quality. Lack of awareness and how-to knowledge were additional reasons, though those are evidently problems that can be overcome more easily with initial support. 

The use of data gathered through apps to treat fibromyalgia is noted as being a valuable way to identify effective treatment strategies for what is a condition that has a lack of clinically meaningful improvement over time. One of the most surprising aspects that comes out of the study is the apparent lack of apps (or lack of prevalence) specific to managing fibromyalgia symptoms / chronic pain that are used. The study details the use of alarms, timers, notes etc., but those are common apps we all use. One would not tend to view them as being designed to greatly assist an individual who may be struggling with depression, fatigue, pain and/or brain fog. The difficulty, as the study notes, is that more complex apps fulfilling multiple needs are simply not as user-friendly, which seems to be a significant barrier to entry for many fibromyalgia sufferers. Migraines from app/phone use are also flagged as being an issue in this regard. 

Moving forward the greater use of tech and increased amounts of AI within the tech we use on a daily basis is likely to mean that those who have fibromyalgia (and indeed all of us) will have an increasingly greater number (and one would suspect simpler ways) of managing daily tasks. For those with fibromyalgia that could well make it easier to manage the difficulties they face because of their symptoms and the collection of more data would logically lead to more effective treatments being identified. In the claims sphere, that might well mean a reduced need for direct care, but for that to be effective it is going to need the buy in of the individual in every case. The instruction of a good care/OT expert with tried and tested strategies for managing symptoms, including the effective use of apps, will always remain key as well.

[1] Jiaxin An, Wei Fan, Anant Mittal, Yan Zhang and Annie T. Chen, Mobile App Use among Persons with Fibromyalgia: A Cross- Sectional Survey, The Journal of Pain, (2024) doi:https://doi.org/10.1016/j.jpain.2024.03.011 

[2] I also note that the study involved participants who self-identify as having fibromyalgia and there was a $25 gift card lottery available for entrants as well. That said, it is also noted that of 1,400 responses collected, 562 were excluded as being suspicious/unreliable and 175 were excluded for being incomplete, which leaves a hopefully reliable albeit quite small data set.

[3] Fan K, Zhao Y. Mobile health technology: a novel tool in chronic disease management. Intelligent Medicine. 2022;2(1):41-47. doi:10.1016/j.imed.2021.06.003