Patient perspectives on non‑traumatic painful upper‑extremity conditions, co-occurring risky substance use, and an integrated web-based mind-body intervention addressing both conditions.

OBJECTIVE

This study explored patient experiences with non-traumatic painful upper-extremity conditions (NPUCs) and co-occurring risky substance use and assessed perspectives on the acceptability and usability of Web-TIRELESS, an integrated web-based mind-body intervention addressing both conditions concurrently.

METHODS

Nineteen adults with NPUCs and risky substance use completed individual semi-structured interviews. Data were analyzed using a hybrid deductive-inductive thematic analysis approach.

RESULTS

Four themes emerged: (1) Challenges managing pain: Patients reported functional deterioration, emotional distress, and frustration with limited symptom relief, often associated with maladaptive coping strategies, including substance use. (2) Motivations for substance use and change: Alcohol, cannabis, and tobacco were commonly used to manage pain, stress, or sleep difficulties. Participants had limited awareness of the reciprocal relationship between pain and substance use and expressed low motivation to change. (3) Intervention preferences: Web-TIRELESS was viewed positively for its flexibility, privacy, and accessibility. Participants preferred credible, evidence-based, and practical pain-coping content. (4) Barriers and facilitators: Barriers included skepticism about efficacy, low motivation, and technological accessibility. Facilitators included live-human support, streamlined content, and accountability reminders.

CONCLUSION

Patients prefer flexible, accessible, and evidence-based psychosocial interventions addressing pain and substance use simultaneously. Upon integrating patient suggestions, Web-TIRELESS may effectively bridge gaps in integrated orthopedic care.