The average user has more than 80 apps installed on their smartphone, with app downloads exceeding 200 billion annually as of 2019.1 And while only a small percentage of those apps relate to health care, mounting evidence suggests e-health self-management programs can help reduce both pain and disability in the management of chronic low-back pain (LBP).2
The Potential
A randomized clinical trial (RCT) published a few months ago explores how a recently developed app, specifically tailored to each patient's low-back pain symptoms and characteristics, might also reduce pain and disability. The study included 461 adults with a Roland-Morris Disability Questionnaire (RMDQ) score of at least six. In addition to usual care by a medical doctor, the app provided patients with "weekly recommendations for physical activity, strength and flexibility exercises, and daily educational messages."3
At the end of the trial, the "adjusted mean difference in RMDQ score between the 2 groups at 3 months was 0.79 (95% CI, 0.06-1.51; P = .03), favoring the SELFBACK intervention. The percentage of participants who reported a score improvement of at least 4 points on the RMDQ was 52% in the intervention group vs 39% in the control group (adjusted odds ratio, 1.76; 95% CI, 1.15-2.70; P = .01)." Researchers concluded that the app had reduced pain-related disability, although the improvement "was small and of uncertain clinical significance."
Why It's Needed
The is one of the first RCTs conducted on the effectiveness of an app for low back pain. Considering LBP accounts for 264 million lost workdays annually in the U.S. alone and is on the rise, there is an extremely large financial incentive to explore this potential adjunct. It is also likely that providers who administer an effective app to their patients as part of back pain management will be reimbursed for doing so.
Another factor that is most certainly driving the development of a back pain app is the inability of medical physicians to provide effective care for back pain. A systematic review and meta-analysis published last year revealed:
"Large numbers of patients who saw a physician for LBP received care that is inconsistent with evidence-based clinical practice guidelines. Usual care included overuse of imaging and opioid prescription and underuse of advice and information. Suboptimal care may contribute to the massive burden of the condition worldwide."4
All of the above begs the question: Who better to develop apps to improve care for back pain (not to mention neck pain and all other musculoskeletal pain) than the chiropractic profession? Clearly if we don't, another profession will.
References
- Mobile App Download and Usage Statistics (2021). Buildfire.com: https://buildfire.com/app-statistics/.
- Du S, Wen Liu W, Shining Cai S, et al. The efficacy of e-health in the self-management of chronic low back pain: a meta analysis. Int J Nurs Stud, December 2019;106(1):103507.
- Sandal LF, Bach K, Øverås CK, et al. Effectiveness of app-delivered, tailored self-management support for adults with lower back pain-related disability: a selfBACK randomized clinical trial. JAMA Intern Med; published online Aug. 2, 2021.
- Kamper SJ, Logan G, Copsey B, et al. What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments. Pain, April 2020;161(4):694-702.
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