# Back Pain by AZoMedical vs SpineRef

The clearest difference is update cadence: SpineRef at every 10 days against Back Pain by AZoMedical's every 4 months. Back Pain by AZoMedical's advantage is iOS requirement (11.0 vs 15.1). On price, ads, in-app purchases and device support there is nothing between them.

Both are free to download. Neither carries in-app purchases, so what you see is what you pay.

Back Pain by AZoMedical ships an update every 4 months, SpineRef every 10 days. The most recent releases landed on November 1, 2026 and November 10, 2026 respectively.

## The numbers

| Metric | Back Pain by AZoMedical | SpineRef |
| --- | --- | --- |
| Price | Free | Free |
| Rating | — | **[1.0 (1 ratings)](https://appshunter.io/ios/app/spineref/id6777927922/reviews)** |
| Number of ratings | — | **1** |
| Positive reviews | 0.0% of reviews | — |
| In-app purchases | No | No |
| Ads | No | No |
| Update frequency | Every 4 months | **Every 10 days** |
| Monetization | Free | — |
| Size | 42 MB | 61 MB |
| Requires iOS | **11.0** | 15.1 |
| Devices | iPhone, iPad, iPod | iPhone, iPad, iPod |
| Age rating | 4+ | 17+ |
| Developer | [AZoNetwork](https://appshunter.io/developer/336360747) | [Platform.AI Inc](https://appshunter.io/developer/1895482359) |

## What reviewers say

### Back Pain by AZoMedical

[App page](https://appshunter.io/ios/app/back-pain-by-azomedical/id718218014)

Access regularly updated information and news about back pain. This free resource provides details on causes, symptoms, and duration of back discomfort. An internet connection is not required for core functionality.

**Highlights:** Regularly updated information, News on back pain, Details on causes and symptoms, Offline access, Free to use

**Features:** macOS Compatibility

**In-app purchases:** none


### SpineRef

[App page](https://appshunter.io/ios/app/spineref/id6777927922)

**Features:** macOS Compatibility

**In-app purchases:** none


## Frequently asked questions

### Is Back Pain by AZoMedical free?

Back Pain by AZoMedical is free to download, with no in-app purchases.

### Is SpineRef free?

SpineRef is free to download, with no in-app purchases.

### Do Back Pain by AZoMedical or SpineRef have ads?

Neither Back Pain by AZoMedical nor SpineRef shows ads.

### Which is updated more often, Back Pain by AZoMedical or SpineRef?

Back Pain by AZoMedical ships an update every 4 months, and SpineRef every 10 days. Most recently, Back Pain by AZoMedical was updated on November 1, 2026 and SpineRef on November 10, 2026.

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*Compared by [AppsHunter](https://appshunter.io/) from daily US App Store data. Review summaries are generated from verbatim App Store reviews.*