Systematic ReviewTreatment: Exercise & MovementSystematic Reviews & Meta-analysesClinical Guidelines & Best PracticesClinical RelevanceDOI
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Patient-friendly summary

If you read nothing else

Apps and online programmes offered through your workplace - mostly short exercise routines - may help reduce chronic pain and improve quality of life, but the evidence so far is limited and not yet conclusive.

Bottom line

Workplace-delivered digital self-management tools show promise for easing chronic pain and improving quality of life in working adults, but the small number of moderate-to-low quality studies means no firm conclusions or 'best' approach can yet be recommended.

Preliminary evidence

Published

2024
2 years ago
Current

Evidence hierarchy

Meta-analysis
Systematic Review ◀ this study
RCT
Cohort
Case-Control
Case Report
Expert Opinion

Study participants

1522 participants across 8 studiesNot reportedNot reported

Vocationally active adults with chronic pain recruited via their workplace, predominantly office/white-collar workers, in France, Spain, Japan, Jordan, South Korea and the USA

Full research — for clinicians and curious readers

Study Summary

This systematic review examined whether digital interventions (mobile apps, computer- or web-based programmes) delivered through the workplace can help vocationally active adults self-manage chronic pain. Seven articles reporting eight intervention studies (1522 participants total, mostly office workers across six countries) met inclusion criteria. The authors found that such workplace-delivered digital interventions may improve pain and health-related quality of life, but the evidence was moderate-to-low quality and too heterogeneous to pool in a meta-analysis. Most interventions focused narrowly on short exercise routines, and very few addressed psychological support, broader self-management strategies, or work-related adjustments and outcomes.

55/100
Evidence StrengthModerate
Study Quality
Sample Size
Replication

Key Findings

Workplace digital interventions may improve painHigh

All eight included studies measured at least one pain outcome, and most showed a statistically significant improvement in pain at follow-up.

Quality of life improved across studies that measured itHigh

Five studies included a measure of health-related quality of life; despite using different instruments, all reported a significant improvement following the intervention.

Interventions were dominated by exercise, neglecting other self-management aspectsHigh

Six of eight studies used interventions that included exercise (usually short 1-7 minute stretching/mobilization routines); few considered psychological support, behavioural strategies, or other facets of pain self-management.

Work-related adjustments and outcomes were largely absentMedium

No interventions included advice on work-related adjustments or support, and few studies measured workplace outcomes such as absenteeism or presenteeism, despite chronic pain's known impact on work.

Psychological outcomes rarely improvedMedium

Seven studies included a psychological outcome measure, but only two reported improvements (one in work-related fear avoidance, one on the STarT Back psychological subscale).

Evidence quality limited conclusionsHigh

Studies were moderate-to-low quality with high heterogeneity in design, interventions and outcomes, preventing meta-analysis; only two studies had low risk of bias and the remainder were moderate risk.

Study Methodology
Study Design
Systematic review with narrative synthesis (no meta-analysis possible due to heterogeneity); pre-registered with PROSPERO (CRD42023463484); reported per PRISMA 2020
Sample Size
7 articles reporting 8 intervention studies; 1522 participants total (range 20 to 645 per study)
Duration
Intervention durations in included studies ranged from 6 weeks to 9 months; literature searched January 2001 to December 2023, searches conducted October-December 2023
Population
Vocationally active adults with chronic pain recruited via their workplace (mostly office/white-collar workers); studies conducted in France, Spain, Japan, Jordan, South Korea and the USA
Outcome Measures
Pain outcomes · Health-related quality of life · Psychological outcomes (e.g. work-related fear avoidance, STarT Back psychological subscale) · Physical activity (International Physical Activity Questionnaire; Stages of Change readiness) · Work-related outcomes (Work Productivity and Activity Impairment questionnaire, job satisfaction, work stress) · Risk of bias via JBI critical appraisal tools for RCTs and quasi-experimental studies

Strengths

  • Pre-registered with PROSPERO and conducted according to PRISMA 2020 reporting standards
  • Comprehensive search across nine databases plus grey literature and hand-searching of reference lists
  • Dual independent screening, data extraction checks, and dual independent risk-of-bias assessment (86.96% initial agreement)
  • Addresses an under-researched but high-burden topic - work-related self-management of chronic pain
  • Transparent narrative synthesis reporting between-group differences for each study

Limitations

  • Only seven articles (eight studies) met inclusion criteria, limiting the strength of conclusions
  • Included studies were moderate-to-low quality, with only two at low risk of bias
  • High heterogeneity in study design, interventions and outcome measures meant a meta-analysis could not be performed
  • Interventions were heavily focused on exercise, with little coverage of psychological, behavioural or work-specific self-management
  • Few studies measured work-related outcomes (e.g. absenteeism, presenteeism), and no interventions addressed workplace adjustments
  • Restricted to English-language publications and no studies from UK employment settings were found
  • Participants were predominantly office/white-collar workers, limiting generalizability to other occupations

Key Takeaways for Patients

What This Means for You

  1. 01If you have ongoing pain while working, digital tools delivered through your workplace - like phone apps or web programmes with short stretching and mobilization routines - may help reduce pain and improve quality of life.
  2. 02Most of these programmes focus mainly on brief exercise (often just 1-7 minutes), so they may not address the emotional or psychological side of living with chronic pain.
  3. 03These tools could be a useful extra source of support, especially if you are waiting for or cannot easily access clinical services such as occupational therapy.
  4. 04The research is still early and of limited quality, so there is no clear 'best' programme yet, and results may vary from person to person.
  5. 05Almost none of these programmes covered practical workplace adjustments, so you may still need to discuss accommodations directly with your employer or occupational health service.

Read the Full Paper

Access the complete peer-reviewed study from British Medical Bulletin

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