Exploring Pain on Social Media: Observational Study on Perceptions and Discussions of Chronic Pain Conditions.

Background: Chronic pain, affecting 30.3% of the global population, constitutes a major public health and social challenge. It is associated with disability, emotional distress, and diminished quality of life. Conditions, such as fibromyalgia, headache, paraplegia, neuropathy, and multiple sclerosis are characterized by persistent pain and limited social and medical understanding. This contributes to patient isolation and increases mental health burden. In recent years, social media, particularly X (formerly Twitter), has emerged as a key space for analyzing health-related perceptions and experiences. Its massive use, spontaneity, and broad reach have made these platforms a valuable source for infodemiological research. Objective: This study aims to analyze posts on X concerning fibromyalgia, headache, paraplegia, neuropathy, and multiple sclerosis, as well as characterize the profile of users involved in these conversations, identify prevalent topics, measure public perception, evaluate treatment efficacy, and detect discussions related to the most frequent nonmedical issues. Methods: A total of 72,874 tweets in English and Spanish containing the selected keywords were collected between 2018 and 2022. A manual review of 2500 tweets was conducted, and the larger subset was automatically classified using natural language processing methods based on the BERTweet model, previously fine-tuned for content analysis on social media platforms. Subsequently, tweets related to chronic pain conditions were analyzed to examine user types, disease origin, and both medical and nonmedical content. Results: Of the total tweets collected, 55,451 (76.1%) were classifiable. The most active users were health care professionals and institutions. The primary perceived etiology was pharmacological, and higher treatment efficacy was noted in neuropathy, paraplegia, and multiple sclerosis. Regarding nonmedical content, there were more tweets related to the definition and understanding of the disease. Conclusions: Social media platforms, such as X, are playing a crucial role in the dissemination of information on chronic pain. Discussions largely focus on the available treatments and the need to enhance public education, using these platforms to correct misconceptions and provide better support to patients.