Pain is a complex phenomenon, involving sensory and emotional experience, that is often poorly understood, especially in infants, anesthetized patients, and others who cannot speak. Technology supporting pain assessment has the potential to help reduce suffering; however, advances are needed before it can be adopted clinically. This survey paper assesses the state of the art and provides guidance for researchers to help make such advances. First, we overview pain's biological mechanisms, physiological and behavioral responses, emotional components, as well as assessment methods commonly used in the clinic. Next, we discuss the challenges hampering the development and validation of pain recognition technology, and we survey existing datasets together with evaluation methods. We then present an overview of all automated pain recognition publications indexed in the Web of Science as well as from the proceedings of the major conferences on biomedical informatics and artificial intelligence, to provide understanding of the current advances that have been made. We highlight progress in both non-contact and contact-based approaches, tools using face, voice, physiology, and multi-modal information, the importance of context, and discuss challenges that exist, including identification of ground truth. Finally, we identify underexplored areas such as chronic pain and connections to treatments, and describe promising opportunities for continued advances.

Pain is a complex and subjective experience that poses a number of measurement challenges. While self-report by the patient is viewed as the gold standard of pain assessment, this approach fails when patients cannot verbally communicate pain intensity or lack normal mental abilities. Here, we present a pain intensity measurement method based on physiological signals. Specifically, we implement a multi-task learning approach based on neural networks that accounts for individual differences in pain responses while still leveraging data from across the population. We test our method in a dataset containing multi-modal physiological responses to nociceptive pain.

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Currently there is no validated objective measure of pain. Recent neuroimaging studies have explored the feasibility of using functional near-infrared spectroscopy (fNIRS) to measure alterations in brain function in evoked and ongoing pain. In this study, we applied multi-task machine learning methods to derive a practical algorithm for pain detection derived from fNIRS signals in healthy volunteers exposed to a painful stimulus. Especially, we employed multi-task multiple kernel learning to account for the inter-subject variability in pain response. Our results support the use of fNIRS and machine learning techniques in developing objective pain detection, and also highlight the importance of adopting personalized analysis in the process.