361: Randomized controlled trial assessing digital gamified pain management for adults with chronic pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Non-pharmacological treatments, Digital Health Technologies

Background and Aims: Chronic pain is a leading cause of disability worldwide. While digital interventions offer accessible and cost-effective management, their efficacy is often limited by low engagement and adherence. Gamification, which applies game-design principles to non-game contexts, presents a promising strategy to enhance user motivation and therapeutic outcomes. This randomized controlled trial (RCT) evaluated the feasibility and preliminary effectiveness of a Gamified Pain Management (GPM) program for individuals with chronic pain.

Methods: This two-arm RCT randomly assigned participants to either a 10-week web-based GPM intervention or a control group receiving routine online pain management materials. The GPM program, uniquely framed as an 'escape room,' integrated educational materials, physical activities, and psychological therapy with multiple gamified elements. Outcomes including pain intensity, pain-related disability, pain beliefs, and emotional status were collected at baseline and post-intervention (10 weeks). Data were analyzed using repeated-measures ANOVA and Quantile Mixed-effects models to assess treatment effects over time.

Results: A total of 45 participants were enrolled, with no significant differences in baseline characteristics. Patient satisfaction and adherence were high in both groups, though the control group reported higher adverse events including eye strain, more pain or muscle sprain. While both groups experienced significant improvements over time (p< 0.05), a significant time-by-group interaction effect favored the GPM group for the primary outcome of pain intensity (p = 0.034) and for secondary outcome of pain catastrophizing (p = 0.037). No significant interaction effects were found for the secondary outcomes of disability, anxiety, depression, exercise adherence or quality of life.

Conclusions: This RCT provides preliminary evidence that a GPM program is a feasible, safe, and effective approach for chronic pain management. The improvement in pain intensity and catastrophizing suggests gamification can enhance the therapeutic process, likely by fostering deeper engagement. The absence of effects on secondary outcomes is potentially attributable to the short intervention duration and small sample size. Importantly, this pattern aligns with theoretical rehabilitation models where cognitive shifts precede behavioral recovery. Therefore, our future study will conduct larger-scale trials to confirm these results and evaluate long-term functional changes.

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Saragih, I. D., Suarilah, I., Saragih, I. S., et al. (2024). Efficacy of serious games for chronic pain management in older adults: A systematic review and meta‐analysis. Journal of Clinical Nursing, 33(3), 1185–1194. https://doi.org/10.1111/jocn.17012

Presenting Author: Jiafan He
Submitting Author: Jiafan He

Senior Author: Jiafan He

IASP 2026 Global Year theme of Neuropathic Pain: No

• Mimi Mun Yee Tse: PhD - Hong Kong Metropolitan University
• Tyrone Tai On Kwok: PhD - Hong Kong Metropolitan University