Pain assessment and determination methods with wearable sensors: a scoping review

Abstract

There is no gold standard for objectively measuring pain; wearable devices cannot claim to measure pain itself, but may offer correlational insights through physiological signals. This scoping review synthesizes current evidence on pain-related assessment methods using wearable sensors across pediatric and adult populations. This review followed the PRISMA-ScR guidelines. A systematic literature search was conducted across PubMed, Cochrane Library, Scopus, Web of Science, CINAHL, and Ovid MEDLINE for studies published up to December 2024. A total of 24 studies met the inclusion criteria. The most used wearable devices included commercially available smartwatches, wristbands, and multisensor platforms. Physiological indicators associated with pain responses included heart rate, heart rate variability, electrocardiography, electrodermal activity, electromyography, surface electromyography, photoplethysmography, skin temperature, and electroencephalography, reflecting autonomic, muscular, and neural system activity. Wearable sensors represent a promising, non-invasive tool for capturing physiological pain-related responses, particularly in contexts where verbal self-report is not feasible. While these devices may support more responsive and continuous pain monitoring, they cannot replace self-report measures and should not be interpreted as providing objective pain measurements.