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Pain is generally undertreated and there is a need to differentiate and improve access to appropriate pain care. The growing Field of telehealth offers a novel opportunity for pain care, exploiting mainly communicative and pharmacological therapeutic principles. Rationale for telemedicine for the management of chronic pain are the potential to overcome timely, economical, and structural barriers for the access to specialized pain care as well as the general open mindedness of physicians and patients towards this technology. The general usability and effectiveness of telemedicine in pain care has been described. The most prominent applications of telemedicine in pain care are store-and-forward applications and direct consultations. Smartphone applications are easily accessible and inexpensive. The quality and effectiveness of smartphone applications has not been evaluated thoroughly due to a lack of regulatory objectives. Estimations of the cost-effectiveness of telemedicine in pain care are limited due to a lack of data regarding long-term outcome and healthcare utilization after treatment. Telemedicine offers new approaches to improve pain care for the treatment of acute postoperative pain as well. Future challenges will be to start a collaborative effort between developers and health-care professionals to implement evidence-based clinical protocols into telemedicine applications and to evaluate the effectiveness and safety of existing telemedicine programmes.