Currently submitted to: Journal of Medical Internet Research
Date Submitted: Apr 8, 2026
Open Peer Review Period: Apr 9, 2026 - Jun 4, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of Digital Therapeutics for Pain Reduction in Patients with Chronic Pain: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Chronic pain is a prevalent and complex condition requiring long-term, multidimensional management. Digital therapeutics (DTx) have emerged as a promising nonpharmacological intervention; however, evidence regarding their effectiveness remains inconsistent due to heterogeneity in intervention types and study designs.
Objective:
This study aimed to systematically review and meta-analyze the effectiveness of digital therapeutics in reducing pain among patients with chronic pain.
Methods:
A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Electronic databases, including PubMed, Embase, CINAHL, and the Cochrane Library, were searched from inception to December 10, 2025. Randomized controlled trials evaluating DTx interventions in adults with chronic pain were included. The primary outcome was pain intensity, and secondary outcomes included physical function and psychological outcomes (quality of life, anxiety, depression, and pain catastrophizing). Effect sizes were calculated as standardized mean differences using a random-effects model, and risk of bias was assessed using the Cochrane Risk of Bias tool.
Results:
A total of 7 studies were included in the meta-analysis. Digital therapeutics demonstrated a statistically significant reduction in pain intensity (SMD = -0.87, 95% CI: -1.70 to -0.03, p = 0.04); however, heterogeneity was substantial (I² = 97%). No significant effects were observed for physical function (SMD = 0.62, 95% CI: -1.57 to 2.80, p = 0.58) or overall psychological outcomes (SMD = -0.92, 95% CI: -2.01 to 0.17, p = 0.10). Among psychological outcomes, quality of life showed a trend toward improvement (SMD = 0.28, p = 0.07), whereas anxiety, depression, and pain catastrophizing showed no significant effects and substantial heterogeneity.
Conclusions:
Digital therapeutics may contribute to reductions in pain intensity in patients with chronic pain; however, the effects on physical function and psychological outcomes remain inconsistent. The high level of heterogeneity suggests that the effectiveness of DTx varies considerably depending on intervention characteristics and study design. Further high-quality and standardized trials are needed to establish the clinical effectiveness of DTx. Clinical Trial: PROSPERO CRD 420261355510; https://www.crd.york.ac.uk/PROSPERO/view/CRD420261355510
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