People with non-specific low back pain could benefit from a range of digital technologies evaluated by the National Institute for Health and Care Excellence (NICE).
Seven apps and digital platforms could be used by NHS patients in England aged 16 and over while evidence is generated on their clinical and cost-effectiveness, the regulator said in draft guidance. This will include the length of time people use the apps before they are sufficiently improved to return to normal activities.
The recommendations aimed to reduce inequalities in accessing musculoskeletal services across England.
According to the NHS, low back pain affects 2.68 million people each year in England, accounts for 25% of GP consultations, and is the biggest cause of disability.
Technologies Aimed at Cutting Waiting Lists
Mark Chapman, interim director of medical technology and digital evaluation at NICE, said there were "considerable pressures" on NHS services as a result, and that the digital platforms could provide "extra capacity to get those affected off waiting lists" and "offer value for money for the taxpayer".
The recommendations means the technologies could be used in the NHS once they have appropriate regulatory approval and meet standards within NHS England's digital technology assessment criteria.
The approved technologies are:
- ACTForPAIN (Pain Medicine Specialist Ltd) - a chronic pain psychological self-management program supported by pain specialists and psychologists, who provide email advice and guidance
- getUBetter (getUBetter) - a digital platform integrated with GP systems, using questionnaires, nudges, video content, and risk stratification to aid self-managing recovery from common musculoskeletal injuries and conditions
- Hinge Health Digital MSK Clinic (Hinge Health) - a digital therapeutic aiming to reduce musculoskeletal pain by pairing advanced wearable sensors and computer vision technology with a clinical care team of physiotherapists, physicians, and health coaches to monitor engagement and adherence to program activity
- Kaia App (Kaia Health) - for people with chronic musculoskeletal pain including back, hip, and knee pain, offering education, physiotherapy, exercises adapted to an individual's fitness level, and mindfulness techniques delivered as audio content
- Pathway through pain (Wellmind Health) - an intensive web-based pain management programme delivered by pre-recorded videos from physiotherapists and clinical psychologists, with real-time detailed user progress and outcomes data accessible to healthcare providers and commissioners
- selfBACK (SelfBack Consortium) – an app for self-management of non-specific low back pain as a supplement usual care, providing participants with educational material and weekly tailored recommendations on step counts, strength, and flexibility exercises, along with a physical activity-detecting wristband
- SupportBack (University of Southampton) - an internet-based intervention offering self-management for both acute and persistent low back pain, following consultation in primary care, either as stand-alone support or in combination with telephone support from a physiotherapist
Health Minister Will Quince said that the apps were an example of how technology can be used "[to] help patients get the care they need, when they need it". The range of services offered would allow patients to manage lower back pain "from the comfort of their homes", improving access to musculoskeletal services and helping to reduce pressures on the NHS and cut waiting lists.
Apps "A Huge Step Forward"
Denice Logan Rose, executive director of BackCare, the National Back Pain Association, said: "Very many people living with non-specific low back pain feel that they have nowhere to turn for help. They are desperate and are at a complete loss about what they can do to help themselves.
"Apps form a significant part of the technology-driven world we live in, and if they can be used to help people living with back pain to lead more pain-free and active lives, this is a huge step forward."
NICE early value assessment guidance is applicable in England only. A consultation on the recommendations is open until 25 October.