Systematic review of digital health interventions to support self-management of low back pain in the workplace.

Background: Low back pain (LBP) is a prevalent condition in working populations, imposing significant individual, organisational, and societal burdens, including reduced quality of life, impaired work performance, and high healthcare costs. Digital health interventions (DHIs) offer scalable solutions for self-managing LBP in workplace settings, yet their tailoring, integration, and effectiveness remain unclear.

Objective: This systematic review evaluates the effectiveness of DHIs in supporting LBP self-management in workplace environments. It examines intervention components, tailoring methods, integration with occupational health (OH) pathways, and their impact on clinical and work-related outcomes.

Methods: A systematic search was conducted across PubMed, MEDLINE, EMBASE, CINAHL, the Cochrane Library, and Web of Science, following PRISMA guidelines. Randomised controlled trials evaluating DHIs for workplace LBP were included. Data extraction focused on intervention characteristics, tailoring approaches, and primary outcomes, including pain intensity, disability, and physical performance. The quality of evidence was assessed using the Cochrane risk-of-bias and GRADE frameworks.

Results: Five studies were included, featuring DHIs delivered via web-based platforms or mobile applications. Interventions incorporated exercise, ergonomics education, and work activity modification. Only one study used a tailored approach based on theoretical frameworks and individualised work classifications. Moderate-quality evidence supported improvements in pain, disability, and physical performance, but effects on quality of life, psychosocial factors, and work outcomes were inconsistent. Integration with occupational health pathways was absent in all studies.

Conclusions: The lack of tailoring and integration within occupational health systems limits the scalability and impact of DHIs for workplace LBP. Future research should focus on personalised, theory-driven interventions and systemic alignment with occupational health policies to enhance their feasibility, implementation, and long-term outcomes.