Evaluating the Impact on Pain Perceptions, Pain Intensity, and Physical Activity of a Mobile App to Empower Employees With Musculoskeletal Pain: Mixed Methods Pilot Study.

Background: Mobile apps present opportunities to empower employees with musculoskeletal pain and reduce long-term absenteeism. However, adoption remains limited because of a lack of empirical evidence and challenges in user-friendly design.

Objective: This pilot study aimed to evaluate the potential effects of a fully automated, app-based pain management intervention tailored for employees. Specifically, the study aimed to (1) assess the effect of the intervention on maladaptive pain perceptions, pain intensity, and physical activity and (2) identify factors influencing its effectiveness.

Methods: A total of 66 employees from a Belgian university hospital who had been experiencing musculoskeletal pain for at least 6 weeks participated in a 24-week intervention. The app-based intervention focused on reducing maladaptive pain perceptions, providing work-related guidance, and promoting healthy activity habits through interactive modules, real-time recommendations, and goal-setting features. Every 6 weeks, participants completed a questionnaire measuring maladaptive pain perceptions (pain catastrophizing and fear-avoidance beliefs). Pain intensity was recorded daily using a visual analog scale, and step count was tracked daily using an activity tracker. In addition, semistructured interviews were conducted with 12 participants to explore how they engaged with the intervention and perceived its impact.

Results: Quantitative analysis showed a significant reduction in pain catastrophizing (B=-0.83, P<.001, d=-0.27), with greater decreases observed among participants with higher baseline scores (σ=-0.38; P=.09). No significant overall change was found in fear-avoidance beliefs (B=-0.35; P=.15), although individual trajectories varied (σ²=1.34; P=.04). Pain intensity also showed significant variability across participants (σ²=17.29; P=.03) despite no overall effect (B=-0.37; P=.67). No significant change was observed in the daily step count (B=107.50; P=.23). Qualitative analysis revealed that the effectiveness of the intervention was hindered by content and design choices that did not adequately account for diverse work settings and the busy lives of employees. Cognitive biases and nonsupportive work environments further complicated the successful implementation of the intervention in the workplace.

Conclusions: This pilot study demonstrates the potential of an app-based intervention to support employees with musculoskeletal pain by reducing pain-related fear and promoting active coping strategies. While promising for some, digital interventions alone may be insufficient for employees with more complex needs. Blended approaches and integration within supportive workplace environments are likely essential to enhance effectiveness and promote sustainable work participation.