Examining the Impact of a Digital Health Program and TENS Device for Patients With Chronic Low Back Pain

Inclusion Criteria: * Age 18 or over * United Healthcare (UHC) is primary health plan * Mechanical (myofascial), axial back pain (focused around the spine) * Experiencing pain primarily in the low back area * Radicular component of pain has minimal effect on functionality, medication, quality of life * Experiencing low back pain for at least 3 months * Subject able to understand and provide informed consent * Comfortable and willing to accept random assignment to one of two study conditions (intervention or standard care condition) * Has an email account Exclusion Criteria: * Patients that do not own or have access to a smartphone or tablet * Has spinal instability, joint instability, or grade 2 or greater spondylolisthesis with instability * Primary symptoms due to spinal stenosis as evidenced by pseudoclaudication, leg weakness or numbness * Source of back pain related to an acute nerve impingement * Diagnosis of cancer/malignant tumors in the last 5 years * Source of back pain is an infection * History of spinal fusion surgery * Has a cardiac pacemaker, implanted defibrillator, spinal cord stimulator, pain pump, or any other implanted electronic device * Has had myocardial infarction within the past 6 months * Has had a coronary stent in the past 3 months * Has radicular pain symptoms that affect functionality, quality of life or medication intake * Has undergone surgery to solve pain related to the study indication in the past 12 months * Is scheduled for upcoming surgery to solve pain related to the study indication * History of opioid or drug use, or excessive alcohol use (excessive alcohol use defined as greater than 3 drinks a day on average), per investigator discretion * History of rheumatological or other inflammatory conditions such as rheumatoid arthritis, systemic lupus, erythematosus, etc. * Any psychiatric condition that may interfere with the study assessments or prevent the subject from complying with the requirements of the protocol, in investigator's judgment * Pregnant women (as determined by self-report) * Has a heart condition that limits the ability to do mild exercise due to symptoms such as fatigue, palpitations, shortness of breath, or chest pain * Has any health condition that limits the ability to do light-intensity exercise such as slow walking or light household chores * Diagnosed with dementia or a similar memory disorder * Has had a fall in the past three months * Unable to move from sitting to standing without help from another person * Unable to stand without assistance from another person or device * Any other disease, condition, or habit(s) that in the opinion of the Principal Investigator would interfere with study compliance or adversely affect study outcomes * Inability to complete data collection as required * No secondary/coinsurance or plans to change insurance from UHC in the next 3 months * Patients who were recommended spine surgery from a spine surgeon in the 3 months prior to the index month