A 12-week, 177-participant trial of Hinge Health’s at-home digital program for chronic pain relief significantly reduced users’ lower back pain, disability and interest in surgery. The study, led by employees of the company, was published last week in npj Digital Medicine.

Hinge Health’s digital care program (DCP) is designed for numerous musculoskeletal conditions, and consists of app-based exercise therapy using wearable sensors, virtual cognitive behavioral coaching, and interactive patient education.

Topline data

Roughly three quarters of participants who completed at least one exercise with the DCP (n = 91) finished the full program (n = 69). Average weekly engagement was greater among the latter group (75 percent versus 90 percent), with those finishing the DCP also participating in an average 3.8 workouts per week as opposed to the 3.0 recommended by the program.

The researchers found that, compared to controls, participants provided with the DCP achieved significantly greater improvements on all primary and secondary study outcomes. These included, as measured using a visual analog scale, a 62 percent improvement in pain and a 64 improvement in how much the pain impacted their daily lives, compared to a respective 3 percent and 9 percent gain among controls. The intervention group also saw a significant improvement in pain (52 percent versus 3 percent) and disability (55 percent versus 9 percent) measurements using the Modified Von Korff scale, as well as an increased understanding of their condition (55 percent versus 19 percent) and a decreased interest in pursuing surgery (52 percent decline versus 53 percent increase).

How it was done

Researchers conducted a randomized, controlled, unblinded trial that recruited adult participants from US employer health plans with persistent non-specific lower back pain. The researchers enrolled these participants into a treatment group (n = 113) and a control group (n = 64), the latter of which received an email with three educational articles.

All but one of the study’s authors are employed by or hold equity at Hinge Health.

What’s the history

A range of digital pain management approaches have cropped up over the past few years, and several tout data supporting their efficacy. In September, a pilot of Kiio’s app-based digital back pain therapy demonstrated some success in a one-year pilot, while the beginning of that year saw the deployment of ManagingLife’s Manage My Pain app at four Ontario clinics. Other recent approaches to tech-driven pain management include peripheral nerve stimulation, virtual reality, and other pain relief wearables.

On the record

“Hinge Health is a rare digital health company to choose the higher hurdle of demonstrating statistically significant outcomes in a pre-registered randomized control trial,” Dr. Jeffery Krauss, Hinge Health’s chief medical officer, said in a statement. “The Hinge Health results published in Nature journal Digital Medicine is unique because there are few digital programs with randomized control trials and even fewer with conclusive evidence.”