Can We Measure Pain? How Digital Biomarkers Are Reshaping the Most Subjective Vital Sign

Pain has long been considered one of the most subjective vital signs, often described as "what the patient says it is." While tools such as pain scales (0–10) or visual analog charts have been used for decades, these methods remain imprecise and highly dependent on individual perception and communication. Inconsistent pain reporting complicates diagnosis, treatment, and clinical research, leaving a major gap in healthcare. However, the rise of digital biomarkers is beginning to transform how we measure, understand, and manage pain.

Digital biomarkers are objective, quantifiable data collected through wearable sensors, mobile devices, or digital platforms that can provide continuous insights into physiological and behavioral responses linked to pain. By analyzing heart rate variability, movement patterns, sleep quality, skin conductance, and even facial micro-expressions, digital tools are opening a pathway to making the invisible visible.

We have already covered which biomarkers are the most important for health app integration. In this article, we will explore how pain is traditionally measured and why it matters, the promise of digital biomarkers and examples of the most relevant signals, the opportunities and benefits they offer, as well as the challenges and ethical considerations that remain. 

Why Pain Measurement Matters

Pain is not only a personal experience but also a massive economic and healthcare burden. According to the International Association for the Study of Pain (IASP), chronic pain affects more than 20% of adults globally, contributing to lost productivity, mental health struggles, and rising healthcare costs. Accurate and detailed measurement is therefore critical not only for understanding individual patient needs but also for improving system-wide efficiency and outcomes. More specifically, pain measurement plays an important role in several areas:

• Diagnosis: Differentiating between types of pain (neuropathic, inflammatory, musculoskeletal) for proper treatment, while also helping clinicians avoid misdiagnosis that could delay recovery.
• Treatment optimization: Monitoring whether therapies, from medications to physiotherapy to digital interventions, are effective or need adjustment, ensuring patients receive timely and tailored support.
• Clinical trials: Providing reliable, standardized endpoints for testing pain management drugs or devices, which strengthens research quality and accelerates the development of new therapies.
• Patient empowerment: Giving individuals real-time insights into their pain patterns, triggers, and improvements over time so they can better self-manage symptoms and actively participate in their care plan.

Digital Biomarkers in Pain Tracking

Digital biomarkers, unlike traditional ones, capture indirect but highly relevant indicators of pain by measuring physiological stress and behavioral changes. These biomarkers move beyond subjective self-reports to provide objective, continuous, and quantifiable data that reflect how pain impacts the body and behavior. Key examples include:

1. Heart Rate Variability (HRV): Pain activates the autonomic nervous system, reducing HRV. Continuous HRV tracking offers objective insights into stress, pain intensity, and recovery patterns over time. Learn more about HRV here! 
2. Sleep Disruption: Chronic pain often leads to poor sleep quality. Smartwatches and sleep trackers can quantify disturbances in sleep stages, duration, and restfulness, creating a fuller picture of pain’s impact on daily life. We have covered how vital sleep regularity is here! 
3. Movement Patterns: Wearables and smartphones track activity levels, gait, and posture changes, often altered by acute or chronic pain conditions. Reduced mobility or irregular motion can signal flare-ups or treatment needs.
4. Skin Conductance & Temperature: Sudden spikes in stress or discomfort can be detected through galvanic skin response sensors and thermal changes, offering real-time indicators of acute pain episodes. For more information, read our electrodermal activity blog post! 
5. Facial Recognition & Voice Analysis: AI-based tools are being developed to recognize pain-related micro-expressions or vocal stress patterns. These approaches are particularly helpful for patients unable to self-report, such as infants, older adults with cognitive decline, or nonverbal patients.

Together, these indicators provide a multidimensional view of pain that is more consistent, trackable, and actionable than traditional scales.

Opportunities and Benefits

The integration of digital biomarkers into pain assessment offers wide-ranging opportunities and benefits that extend across clinical practice, research, and patient engagement:

1. Objective Measurement: By capturing physiological signals and behavioral changes, digital biomarkers reduce reliance on subjective self-reported scales, resulting in more accurate, reproducible assessments.
2. Personalized Insights: Data can be used to tailor pain management strategies to each patient’s unique physiological and lifestyle profile, enabling adaptive, individualized care plans.
3. Remote Monitoring: Clinicians can continuously track pain progression outside of clinical settings, allowing timely interventions, reduced hospital visits, and better management of chronic conditions. Check our blog post on remote healthcare work here! 
4. Enhanced Research: Quantifiable biomarkers create robust endpoints for clinical trials, helping researchers detect subtle treatment effects, stratify patient groups, and accelerate drug and therapy development.
5. Healthcare System Efficiency: By improving accuracy and reducing unnecessary visits or treatments, digital biomarkers can help lower overall healthcare costs while enhancing patient outcomes.

How Thryve Drives the Future of Measuring Pain

Looking ahead, biomarker systems that combine wearable sensors, AI algorithms, and patient-reported outcomes could evolve into the gold standard for pain assessment. Beyond improving accuracy, these systems will be able to anticipate flare-ups, evaluate treatment effectiveness in real time, and provide tailored, actionable insights for both clinicians and patients. They may even help personalize therapy choices by learning individual pain patterns and adapting recommendations accordingly.

At Thryve, our API makes complex health signals accessible and usable for healthcare providers, insurers, and digital health innovators. When it comes to pain, our platform helps businesses transform fragmented sensor data into actionable insights. We offer:

• Seamless Device Integration: Thryve connects with over 500 wearables and biosensors, enabling you to capture continuous data on movement, sleep, stress responses, and heart rate without the burden of multiple integrations.
  
  
• Data Harmonization: Pain-related signals such as HRV, activity levels, and sleep disruptions are automatically standardized into consistent, clinically relevant formats. This allows researchers and clinicians to build more reliable pain-tracking frameworks without worrying about device differences.
  
  
• Scalable Infrastructure: Instead of investing in costly infrastructure to process billions of daily data points, Thryve distills this into the core metrics you need — whether it’s daily activity summaries, peak heart rate under stress, or custom biomarkers tied to pain triggers.
  
  
• GDPR & HIPAA Compliance: All data is managed securely, encrypted end-to-end, and compliant with the highest international standards, ensuring patient trust and regulatory safety.

With Thryve, health organizations can move beyond subjective pain scales and start integrating objective, digital pain biomarkers into their products, services, or research. This not only enhances clinical accuracy but also creates new opportunities for proactive care, personalized treatment pathways, and patient engagement.

Book a demo with Thryve and discover how we can help you turn the challenge of measuring pain into a competitive advantage for your organization.