Background Chronic low back pain (LBP) and neck pain (NP) are highly prevalent
conditions resulting in high economic costs. Treatment guidelines recommend
relaxation techniques, such as progressive muscle relaxation, as adjuvant
therapies. Self-care interventions could have the potential to reduce costs in
the health care system, but their effectiveness, especially in a usual care
setting, is unclear. The aim of these two pragmatic randomized studies is to
evaluate whether an additional app-delivered relaxation is more effective in
the reduction of chronic LBP or NP than usual care alone. Methods/design Each
pragmatic randomized two-armed study aims to include a total of 220 patients
aged 18 to 65 years with chronic (>12 weeks) LBP or NP and an average pain
intensity of ≥ 4 on a numeric rating scale (NRS) in the 7 days before
recruitment. The participants will be randomized into an intervention and a
usual care group. The intervention group will be instructed to practice one of
these 3 relaxation techniques on at least 5 days/week for 15 minutes/day over
a period of 6 months starting on the day of randomization: autogenic training,
mindfulness meditation, or guided imagery. Instructions and exercises will be
provided using a smartphone app, baseline information will be collected using
paper and pencil. Follow-up information (daily, weekly, and after 3 and 6
months) will be collected using electronic diaries and questionnaires included
in the app. The primary outcome measure will be the mean LBP or NP intensity
during the first 3 months of intervention based on daily pain intensity
measurements on a NRS (0 = no pain, 10 = worst possible pain). The secondary
outcome parameters will include the mean pain intensity during the first 6
months after randomization based on daily measurements, the mean pain
intensity measured weekly as the average pain intensity of the previous 7 days
over 3 and 6 months, pain acceptance, ‘LBP- and NP-related’ stress, sick leave
days, pain medication intake, adherence, suspected adverse reaction, and
serious adverse events. Discussion The designed studies reflect a usual self-
care setting and will provide evidence on a pragmatic self-care intervention
that is easy to combine with care provided by medical professionals
