Targeting Musculoskeletal Pain with Digital Therapeutics: A Cross-Sectional Analysis of ClinicalTrials.gov

Abstract

Musculoskeletal pain is a leading cause of disability worldwide and remains challenging to manage. Conventional pharmacological therapies usually provide partial long-term benefit and are associated with adverse effects, including opioid-related risks. Digital therapeutics have emerged as innovative, software-driven interventions that target pain mechanisms, rehabilitation processes, and psychosocial contributors to musculoskeletal pain. Methods: A cross-sectional search was conducted using ClinicalTrials.gov to identify clinical trials evaluating digital therapeutics targeting musculoskeletal pain. A structured search was performed in December 2025. Eligible studies included interventional or observational trials assessing digital therapeutic interventions for musculoskeletal pain conditions. Data extracted included study design, recruitment status, intervention strategies, outcomes, funding sources, and reporting practices. Descriptive analyses were performed using frequencies and percentages. Results: A total of 52 Clinical registered trials met the inclusion criteria. Most studies were interventional (94.2%) and focused on adult populations. Digital therapeutic strategies included virtual reality–based interventions, digital physical therapy and tele-rehabilitation platforms, multidisciplinary digital therapeutics, digital cognitive behavioral and exposure-based therapies, and mobile application–based rehabilitation tools. Pain intensity was the most frequently assessed outcome (≈96% of trials), followed by psychological outcomes and functional disability measures. Only 13% of studies evaluated opioid or analgesic use. While 40.4% of trials were completed, results were publicly available for only 9.6%, highlighting limited reporting transparency. Considerable heterogeneity in study design, outcome measures, and follow-up duration precluded quantitative meta-analysis. Conclusion: Digital therapeutics represent a rapidly expanding and diverse therapeutic approach for targeting musculoskeletal pain, addressing nociceptive, nociplastic, and biopsychosocial pain mechanisms. However, substantial gaps remain in outcome standardization, medication-related assessments, long-term evaluation, and result reporting. Future research should focus on harmonized outcome frameworks, integration with pharmacological strategies, and improved transparency to support the clinical implementation of digital therapeutics in musculoskeletal pain management.