Chronic pain is reported by over 20 percent of the global population but there is no scientific determination of what that even means.

There are metrics but standard 0-to-10 scales and questionnaires are subjective and basically only useful for justifying treatments to insurance companies, they are clinically not much help.

Pain patients were demonized by the Obama administration in their war on Big Pharma and "opiods" that many in Congress now claim to support and that may be why both doctors and patients minimize their symptoms on official forms. No patient wants to be told their pain is just recreational desire while doctors are the easy targets for government. That plus general recall bias and confusion about what a pain scale really means clouds the issue.



And, notes Vanessa Nirode, doctors are defining pain in purely physiological terms, while patients may view it through the lens of identity and functional loss. Which ignores "biophysical" reality but that may be how wearables, AI-driven trackers, and ecological momentary assessments can help. Nirode discusses app-integrated virtual care that sends journaling and tracking data directly to patient charts and how AI-driven transcription can record and summarize doctor-patient conversations to provide long-term context while digital tools may analyze facial microexpressions to detect pain in patients who may not be able to verbalize their distress.

Citation: Nirode V., The Need for Continued Investment in Digital Pain Assessment, J Med Internet Res 2026;28:e97777 https://www.jmir.org/2026/1/e97777