A killer app for back pain patients

So I had a thought the other day that just might turn into a great product. Here’s the tl;dr version:

 Wearable devices for back pain patients can help them monitor what movements hurt and what don’t throughout the day, giving them useful personal metrics about their condition. These metrics will help patients stay mobile by reducing the fear of ‘overdoing it’, make them more informed for visits to the doctor or physiotherapist, and help to set and track rehabilitation goals.

Here’s the slightly longer case for why I think this would be a killer product:

If you were to make a list of chronic conditions that are extremely debilitating to a very large number of people and are underserved by the medical device market, you could start with low back pain. Back pain is the leading cause of work-related disability, the second-greatest reason for doctor visits, and the leading cause of reduced physical function in Americans under age 45. Back pain can range from annoying to crippling, and over 20% of adults will experience back pain at least one day a month. This is an enormous market of patients who have a problem they want solved, and are highly motivated to solve it. 

A low back pain patient (from Google Images).
A low back pain patient (from Google Images).

In the last decade, there has been a significant shift in the way back pain patients are treated. Historically, patients with hurt backs were told to get bed rest, take it easy, and avoid straining anything. This made sense; if something hurts, you don’t want to aggravate it further. Unfortunately, as it turns out, bed rest and inactivity is one of the worst things to do for acute back pain. Clinicians are now slowly but steadily embracing a new paradigm of active recovery, where patients are encouraged to stay moving, pursue active rehabilitation, and change their daily routines as little as possible. Patients usually agree with these instructions in the clinic, often enthusiastically- but then fail to follow these instructions at home. They remain inactive, and fail to improve. The overwhelming reason why back pain patients do not move around is not laziness or indifference; it is fear of overdoing it and reinjuring themselves.

This fear of re-injury reinforcing inactivity is well known to back pain researchers and therapists, who refer to it as the ‘fear/avoidance paradigm’. Fear/avoidance behaviour not only reinforces the existing back pain through inactivity, it also obstructs future therapeutic progress: if patients are too afraid to follow instructions and stay active, then periodic meetings with a doctor or physiotherapist will be less useful. There is surely enormous demand for a medical device that can help patients address this problem.

There has to be some sort of product that fits here.
There has to be some sort of product that fits here.

The product I propose here is fairly simple. Imagine a wearable patch, let’s say 3×5 inches, worn on the lower back (like a large band-aid) that can record basic motions: standing, sitting, bending, reaching, walking, etc. The other feature on this patch is a small tab on one side that a patient can touch (basically a functional button) any time a movement hurts. The patch simply keeps track of motion throughout the day, as well as which ones were accompanied by a button-push indicating pain. (You could get fancy and have one button for sharp pain and one for dull pain, or whatever, but let’s keep it simple for now.) At the end of the day, the data is uploaded to the patient’s computer or smartphone and displayed in an app that shows what motions hurt and which ones didn’t, and when, over the past day. The value for the patient is both a) gathering actual data about what movements hurt, as opposed to relying on recall and association, and b) getting data on what movements don’t hurt, which may not have been obvious before.

back patch mockup Now imagine that the patient can easily compile and compare these data over days, weeks or months. This will give real, actionable data about what movements remain painful, what movements are ok, and where improvements or deteriorations have occurred. This will empower the patient with the confidence to move around more, removing much of the uncertainty around re-injury and ‘overdoing it’. It will also give the patient data to bring into the clinic for their scheduled doctor or physiotherapist appointment, to show what hurts and when, what feels okay, and where they have improved. Doctors will have more confidence in their advice if they can see day-to-day patient data. Physiotherapists will be able to prescribe home rehabilitation exercises more confidently, knowing that patients have a way of self-monitoring their pain levels and what motions the pain may be associated with. Patients will be empowered by this data to take control over their back pain, rather than remain a victim. It’s a win-win-win situation. I’m really surprised that nothing like this exists yet.

There are already a few entrants to the back pain-wearables space right now, which is unsurprising given that wearables are pretty trendy right now and it’s hard not to notice the untapped back pain patient market. I’ll write about them in a later post, and why I don’t think any of them address the back pain problem correctly and why I don’t buy their value propositions. But what they do offer is market validation. Hopefully soon I will have a better idea of whether this is a viable business opportunity or not, and whether patients will actually use this device or not. But in order to find that out, I’m about to get out of the building and see what people think. I’ll check back in soon with a progress report.

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