An app for your back to keep you on track

Low back pain is a common cause of disability and costs billions in annual health care bills. But we can minimize the damage to our backs and in our wallets, says Professor Paul Jarle Mork.

Mork (Norwegian University of Science and Technology) is the coordinator of selfBACK, an international project that improves how lower back pain is managed. The team use a hi-tech wristband, a mobile app, and state-of-the-art technology to help patients care for, and improve, their own condition.

ResearchGate: Why is it important to tackle low back pain, and what’s the best way to do it?

Mork: The recent global burden of disease study showed that low back pain is the most significant contributor to years lived with disability in Europe. It’s the fourth most common diagnosis in primary care, and a common reason for sick leave and work disability. It’s also an enormous burden on the economy. The total annual cost of low back pain in Europe is somewhere between 85 and 291 billion euros, and is expected to rise as the population ages. It’s a huge challenge for the future of European health care systems.

Around 85% of low back pain patients have what’s called non-specific pain. That’s when it cannot reliably be attributed to a specific disease or pathology. It is best treated by the individuals themselves; so-called self-management. However, patients’ adherence to self-management programs is poor. Lifestyle modifications are difficult with little or no additional support, but that’s what it takes.

RG: What results do you expect to see with selfBACK?

Mork: We envisage that patients who use selfBACK will have 20% reduction in pain-related disability after 9 months compared to patients receiving treatment as usual. The presentation of self-management advice, and the way in which it’s followed-up and reinforced, significantly impacts whether a patient sticks to their plan. We offer patients an evidence-based system with personalised advice and follow-up.

RG: How will selfBACK do this? What’s the technology behind it?

Mork: We’re developing an easy-to-use decision support system for patients with non-specific low back pain. This is essentially a computer model that generates customised advice based on the patient’s characteristics, and successful cases of similar patients. It will run on a smartphone app and promote actions that help patients to better self-manage their low back pain.

The prediction quality of selfBACK will increase over time because the advice is grounded in the system’s growing experience. The more people use it, the smarter it becomes and the better advice it can give. To do all of this, we’re working with state-of-the-art technology to capture and analyze the data and give pro-active decision support.

RG: How should low back pain be treated (and self-managed)?

Mork: Move around and only use over-the-counter pain killers in if necessary (if the patient cannot sleep, for example). Don’t lay in bed. That’s the most well-documented and effective approach to manage low back pain. To promote activity the selfBACK system includes an activity-detecting wristband and an app that will give the patients instant feedback on how they are doing. It’s also important to reassure the patient about the favourable prognosis and recommend they stay active both on and off work. Build strength and stretch – that’s advice that helps prevent relapse.

RG: A number of pain related apps are currently available – what sets yours apart?

Mork: Nearly 300 pain-related apps are available in the main app shops (App Store, Blackberry App World, Google Play, Nokia Store and Windows Phone Store). To the best of our knowledge, none of these apps have documented effects by scientific publications, and none include a decision support system.

Interested in the selfBACK project? One of the collaborating institutions, Robert Gordon University, is hiring a Data Scientist to join the team. Check it out here.

Feature image courtesy of Rachel.