Multidisciplinary back pain app improves pain and sleep symptoms in individuals suffering from back pain – retrospective study.
Janosch A Priebe, Daniel Utpadel-Fischler, Thomas R Toelle

Medical apps seem to be promising treatment measures for patients with unspecific lower back pain (LBP). Yet, in the previous studies, especially pain intensity and functional parameters, but not sleep quality, were investigated. Since pain symptoms and sleep quality affect each other we investigated how the use of a multidisciplinary back pain app (Kaia) affects both symptoms.
User data of two user cohorts (using different Kaia app versions) with LBP were collected (cohort 1: N = 180; cohort 2: N = 159). Pain intensity and sleep quality were assessed on a 11-points numeric ratings scale (NRS; 0-10) at the beginning of use (baseline: BL) and at the last day of use (follow-up: LU) within a 3-month training program. 
Substantial pain reduction was found in both cohorts (cohort 1: MBL = 4.80; SD = 1.59 to  MLU = 3.75; SD = 1.76/cohort 2: MBL = 3.65; SD = 1.98 to  MLU = 3.65; SD = 1.78). Additionally, sleep quality improved (cohort 1: MBL = 5.76; SD = 2.12 to  MLU = 6.56; SD = 1.72/cohort 2: MBL = 6.08; SD = 2.08 to  MLU = 6.76; SD = 1.55). Interestingly, improvement of sleep quality was not fully mediated by pain reduction in both cohorts (ANCOVA). 
The relationship of pain (relief) and sleep (improvement) is well established. Improvement of sleep quality comes along with pain reduction and vice versa. Since the effect of the app use on sleep could not be explained solely by pain reduction, multidisciplinary elements of the app, probably especially relaxation (mindfulness) and the education units, may facilitate sleep quality.

MULTIDISCIPLINARY BACK PAIN APP IMPROVES PAIN AND SLEEP SYMPTOMS IN INDIVIDUALS SUFFERING FROM BACK PAIN - RETROSPECTIVE STUDY