Pain is generally undertreated in the United States, owing to a number of 
barriers including geographic distance from specialty treatment providers; 
functional disability that limits mobility; treatment-related stigma; economic 
limitations; and educational barriers. Pain undertreatment exacerbates pain 
chronicity and emotional disruption that can significantly erode a pain 
patient's quality of life, and there is widespread agreement that pain care must 
evolve to address this significant problem. The growing field of telehealth 
(defined for the purposes of this paper as technology that allows for distance 
interaction between providers and/or patients) offers a novel opportunity to 
expand pain assessment, consultation, and treatment services beyond the walls of 
the specialty pain clinic, but there is limited availability of resources 
describing how to best use this technology to improve access to care. A recent 
literature review (September 2011) using universally endorsed MeSH search 
criteria revealed only 32 MEDLINE references focusing on telehealth for pain. 
This is surprising in light of the very large number of references covering 
telehealth (14,164 references) and pain (104,564 references), respectively. Of 
the studies available, there are very few randomized trials of telehealth pain 
care and only one general overview of e-health and chronic pain, which dedicates 
just a few paragraphs to telehealth. This manuscript represents one of the first 
comprehensive reviews of the current state of telehealth and pain management 
research and practice. The goals are to provide a rationale for the potential 
benefit of telehealth-based pain management services; describe the various 
applications of telehealth technology for pain management; orient the reader to 
cost models for telehealth; present examples of services in place; and offer 
recommendations for future research based on the current state of knowledge.