545: Smartphone Apps for Pain Reduction in People with Low Back Pain: An Umbrella Review

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Non-pharmacological treatments, Physiotherapy (e.g. exercise, rehab), Digital Health Technologies

Background and Aims: Low back pain (LBP) is the leading contributor to the need for rehabilitation services in at least 134 countries (1). Besides revolutionising healthcare, digital breakthroughs also catalysed a mismatch between the widespread deployment of mobile health applications (apps) and the prevailing lack of scientific and regulatory endorsement (2). The purpose of this umbrella review was to provide an overview of the effectiveness of mobile health applications in reducing pain intensity in people with LBP.

Methods: Prospectively registered umbrella review (CRD42023432585). Nine medical, health-related and information technology databases were searched from inception to June 2023 combining keywords and medical subject headings related to LBP, mobile applications, and systematic reviews (SRs). SRs investigating the effect of mobile apps compared to any other intervention on adults with back pain were included. The primary outcome was pain intensity at immediate post-intervention follow-up. Two reviewers independently performed screening, data extraction, and methodological quality appraisal using the Assessment of Multiple Systematic Reviews 2 (3).

Results: A total of 2382 records were retrieved from the search strategy and nine SRs were included. Published over three years (2020 to 2023), the SRs investigated 18 primary studies and involved 11262 participants. Only five SRs (56%) were prospectively registered, and industry ties were identified in eight (44%) primary studies. The summary effect estimates of apps compared to control on pain intensity at immediate post-intervention were generally small, and the certainty of evidence was low to moderate. The SRs’ methodological quality was generally low or critically low.

Conclusions: Despite mobile apps’ potential to reshape traditional models of healthcare delivery for people with LBP, low to moderate certainty evidence only showed a small effect of apps in reducing pain intensity at immediate follow-up, when compared to control. Higher quality clinical trials are crucial to unveil the potentially pivotal role of mobile health technologies in LBP care.

References: 1. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. THE LANCET. 2020;396(10267):2006-2017.

2. Bates DW, Landman A, Levine DM. Health apps and health policy: what is needed? JAMA. 2018;320(19):1975-1976.

3. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.

Presenting Author: Anelise Moreti Cabral Silveira
Submitting Author: Anelise Moreti Cabral Silveira

Senior Author: Paulo Ferreira

IASP 2026 Global Year theme of Neuropathic Pain: No

• Anelise Moreti Cabral Silveira - 1Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; 2Musculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia; 3The George Institute for Global Health, UNSW Sydney, Sydney, Australia
• Cheuk Him Curtis Yu - 4The Hong Kong Polytechnic University, Hong Kong, China
• Tsz Pan Law - 4The Hong Kong Polytechnic University, Hong Kong, China
• Paula R Beckenkamp - 1Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; 2Musculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia
• Paulo Ferreira - 1Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, Australia; 2Musculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia