Can Wearable Device Promote Physical Activity and Reduce Pain in People with Chronic Musculoskeletal Conditions?

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• Chronic musculoskeletal conditions may be associated with pain, functional limitations, emotional distress, and reduced quality of life.

• Wearable technologies (e.g., accelerometers, pedometers, fitness trackers, smartwatches, smartphones) provide objective, non-invasive monitoring of physical activity and related behaviour.

• Wearable technologies may enable users to track daily activity levels, thus supporting regular movement and healthier lifestyle habits.

• Intervention characteristics (duration, education support, and device type) may influence effectiveness and interpretation of findings.

Introduction

This study aimed to synthesise, identify, and appraise the evidence on the effectiveness of using wearable devices to promote physical activity and reduce pain in people with chronic musculoskeletal pain.

Methods

This was a systematic review conducted in accordance with PRISMA guidelines. Thirteen studies (n = 869 participants) were included, with mean participant ages ranging from 15.1 to 78.6 years. Twelve studies were randomised controlled trials and one was observational. All studies used wearable technology interventions. Among the RCTs, seven had parallel control groups, four had delayed control groups, and one included two intervention groups and one control group. Intervention durations ranged from 1–12 weeks to 24–52 weeks.

Results 

• Thirteen studies included osteoarthritis (46.2%), low back pain (23.1%), and inflammatory conditions (each 7.7%). Interventions included wearable activity trackers (WAT) alone or combined with counselling, exercise, education, or physiotherapist support.

• Step count increased more in intervention groups in 6/8 studies: e.g., +1148 vs. −843 steps/day (8 weeks), +2649 vs. −1585 (9 weeks), +1432 vs. −963 (21 weeks), and +773 vs. +214 (8 weeks). Significant increases occurred mainly when WAT was combined with behavioural components.

• Light physical activity improved significantly in intervention groups: +11.5 vs. +0.6 min and +46 vs. −58 min.

• Moderate-vigorous physical activity improved significantly in 4 studies, though 2 showed no significant change (−2.1 vs. −4.4 min; +6.9 vs. 0 min).

• Pain reduction occurred in most studies, but between-group differences were usually non-significant: e.g., 28% vs. 22% (25 weeks), 19% vs. 13% (6 weeks), 18% vs. −5% (9 weeks). Two studies showed greater intervention benefit (75% vs. 40%; 14% vs. 2%), while one favoured controls (37% vs. 56%).

• Participants showed good adherence, high satisfaction, and no adverse events attributable to wearable devices.

Conclusion

Wearable technology may improve physical activity in people with chronic musculoskeletal conditions; however, evidence for additional pain reduction compared with controls remains inconsistent.

• Physical activity is commonly recommended for improving quality of life in people with chronic musculoskeletal conditions and may contribute to pain management.

• Wearable devices may support behaviour change by promoting self-monitoring, goal setting, and increased physical activity when used appropriately.

• Combining wearable technologies with structured education, particularly when delivered by professional healthcare practitioners, may strengthen skill development, relapse management, and social support, enhancing long-term behaviour change.

• Wearables may be most effective when embedded within multicomponent programmes rather than used in isolation.

• Future studies should incorporate qualitative research to explore patients’ experiences and acceptability of wearable devices, as current evidence is limited to quantitative designs.

• Randomised controlled trials with standardised intervention protocols are needed to isolate the specific effects of wearable devices, either used alone or with minimal additional components.

• Further research should specifically investigate pain outcomes using standardised measures and longer follow-up periods to determine whether wearable-supported interventions provide clinically meaningful pain reduction.

• Longer intervention periods are required to assess long-term adherence, sustained physical activity, and delayed effects on pain outcomes.

• Standardised outcome measures and validated algorithms for objectively assessing physical activity are essential to improve comparability and support future meta-analyses.