Study: Digital MSK Program Improves Chronic Shoulder Pain, Disability

A digital musculoskeletal care program improved chronic shoulder pain and function, according to a study published in the Journal of Pain Research

The study used SWORD Health’s digital MSK tool and some of the authors are SWORD contributors.

“This study supports the utility of telerehabilitation — namely, of digital care programs — in the management of shoulder disease, showing results comparable to those reported for in-person care,” the authors wrote.


Researchers found a 51.6% reduction in disability-level QuickDASH scores after 12 weeks of the digital MSK care program.

They also noted improvements in secondary measures, including a 54.8% decrease in pain, a 55.5% decrease in surgery intention, a 37.7% decrease in beliefs to avoid anxiety, a 66.5% decrease in job productivity loss, 50.3% decrease in anxiety and 63.6% decrease in depression. Of those who took painkillers at the start of the study, 44.1% had stopped taking them by the end of the program.

The researchers also noted that older users were more likely to adhere to the program, compared with younger participants.

“This study reported some interesting findings, the most notable of which is that people who completed are older than non-completers, and with a much higher proportion of patients over 60 years of age. Also, highly engaged patients were older,” they wrote.

“These two facts challenge the idea of ​​lower digital health adoption by an older population. As expected, early completers matched a less-disabled population.”


The study included 296 patients who started the digital MSK program, of whom 234 completed the intervention. The program included homeschooling and exercises guided by an app on a tablet and measured via motion sensors. A physical therapist monitored remotely and asynchronously, chatting or calling participants at least once a week. They also had monthly video calls.

The participants were asked to exercise at least three times a week for 12 weeks, although they could be discharged earlier if a physical therapist determined it was appropriate.

Researchers rated success based on the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, the Numeric Pain Rating Scale, analgesic consumption, intention to undergo surgery, the GAD-7 survey for anxiety , the PHQ-9 Survey for Depression, the Anxiety Avoidance Beliefs Questionnaire, and the Job Productivity and Reduced Activity Questionnaire.


Several digital MSK companies landed major funding rounds last year, including SWORD Health’s $163 million Series D. The startup also raised a $25 million Series B and an $85 million Series C in January.

But SWORD isn’t alone in the space. Others include: Kaia Health, RecoveryOne, SpineZone, DarioHealth, and Hinge Health. Hinge, which also raised its own hefty funding rounds last year, recently released results from a study evaluating the long-term effects of its program on pain.


Researchers said some of the benefits of the study were the larger sample size and geographically diverse population, as the participants came from 43 different states. However, there was no control group or long-term follow-up.

For future research, they recommend randomized controlled trials comparing digital programs with each other or with personal therapy, ideally with a longer follow-up period.

“Significant changes in disability, pain intensity, medication intake, surgical intent, mental health and productivity were achieved at the same level as those of RCTs with conventional physical therapy,” the authors wrote. “We believe digital modalities hold great promise for delivering accessible and effective rehabilitation, addressing the global burden of chronic pain.”