Study: Lower back pain patients using digital program report significant reduction in pain

The study found that high-risk patients who used the telehealth consultation feature also had better outcomes than their peers who did not.
By Laura Lovett
03:26 pm

New research demonstrated that patients using a digital treatment for nonspecific low back pain report significantly stronger pain reduction compared to their peers receiving the standard of care. 

The cluster-randomized study, published in the Journal of Pain Research, compared patients using traditional treatment methods to those using a digital program called Rise-uP, which combined electronic case reports, a telehealth consultation aspect, a treatment algorithm for guideline-based clinical decision-making and digital health company Kaia’s app.

The study was funded by a German Innovation Fund grant and took place in Southern Germany. 


In the study the intervention group reported a 33.3% reduction in pain, whereas the control group reported a 14.3% reduction in pain.

The study also found that high-risk patients who had a telehealth consultation demonstrated larger decreases in pain intensity (−43.5%) compared to the control group (−14.3%).

While the study found no correlation between the level of pain improvement and the frequency of Kaia app use, in an analysis, researchers found that the impact of “teleconsultation was mediated by an increased training activity in the Kaia App.” 

“Taken together, analysis of pain intensity revealed an overall superiority of the Rise-uP approach compared to the standard of care procedures in the control group, a strong impact of teleconsultations on symptom development in patients at risk, which was fully mediated by a significantly higher Kaia App usage in high risk patients,” the researchers wrote. 


In order to be included in the clinical trial patients needed to report NLPB in an acute state or sub-acute state. Patients who had more than six recurrent episodes of lower back pain or those who had it for more than 12 weeks were excluded. All subjects were between the ages of 18 and 65 years. 

Patients were recruited through their general practitioner's office or through Facebook advertisements. 

A total of 111 GPs and 1,245 patients participated in the program. The GPs were randomized to the investigative or control group in a 2:1 ratio, resulting in 933 affiliated patients in the former and 312 patients in the latter.

Pain ratings were on a numeric rating scale, and all patients were assessed at the beginning of treatment and at the three-month mark. 


Digital health for the physical therapy space is gaining steam. Recently a report by digital health company Ascenti captured data on patients’ openness to virtual treatment, pain improvements on a 10-point Numerical Rating Scale (NRS) and satisfaction with outcomes. Results showed that it is just as effective as and, in some cases more effective than, in-person treatment.

This isn’t the first time Kaia has been studied. In May of 2019, npj Digital Medicine published a randomized control study that found Kaia Health’s app-based exercise therapy for lower back pain (LBP) to be an effective treatment for multidisciplinary patients, and could be more effective than a standard strategy of individual physiotherapy sessions paired with online education.

App-based physical therapy platforms have also seen some movement within the market. Omada purchased Physera in May to expand into virtual musculoskeletal therapy, while Hinge Health brought in a $90 million Series C back in February.


“Our results show the superiority of the innovative digital treatment algorithm realized in Rise-uP, even though the [control group] also received relevant active treatment by their GPs. This provides clear evidence that digital treatment may be a promising tool to improve the quality of treatment of non-specific back pain,” the authors of the study wrote. 


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