Digital health · Chronic pain and anxiety
Flowly
A Los Angeles company that mails subscribers a VR headset and a heart rate sensor, then teaches them to calm their own nervous system to manage chronic pain. It has NIH backing and a completed federal trial. The trial's own posted results do not match the company's headline claims.
A kit in the mail
A Flowly subscriber gets a small box: a fold flat mobile VR headset that a phone slides into, and a heart rate sensor that clips onto a finger or an ear. The app walks the user into a virtual world, a beach or a bamboo forest, and puts their live heart rate on screen, guiding breathing patterns meant to slow that number down.
The pitch: chronic pain keeps a person's nervous system stuck in fight or flight, where pain signals get amplified, and biofeedback teaches a way out of that state. Founder and CEO Celine Tien has described the goal as helping people "downshift" into rest and relaxation mode on command.
What began in 2020 as a direct to consumer subscription, sold in Basic and Pro tiers with the VR kit included, has since become something closer to telehealth. By 2024 and 2026 the company describes itself as a "virtual clinic," pairing the app with a 14 week program run by licensed human therapists, and says it takes certain health insurance plans in select states.
The gap it says it is aimed at
Flowly's own materials put the number of Americans with chronic pain at 100 million and frame pain as what it calls a "bio psycho social" condition: physical, psychological and social at once. Its argument is that most treatment, medication especially, only touches the physical piece. The company has leaned hard into the opioid angle, arguing biofeedback and VR can help people taper opioids they have been on for months or years, a claim its NIH grant exists specifically to test.
Three founders, a personal reason
Celine Tien grew up around family members with pancreatic cancer. "I grew up around cancer, which is a very painful, anxiety-ridden experience, especially in the terminal stages," she has said of what drew her to pain management. She acted as a child, studied at Yale, then did interactive content and VR work at DreamWorks, where she says she learned VR had been studied for pain management since the 1980s.
She brought in Julien Soros, a Yale classmate with an electrical engineering background who had worked on control systems at Hyperloop One, as CTO. Narae Kim, an award winning art and creative director Tien met through a VR film project selected for the 2017 Cannes Film Festival VR showcase, joined as chief creative officer.
Public trackers disagree on the founding date. Crunchbase and CB Insights both list 2017, matching that Cannes and CES project. Flowly's own launch release and the YC page instead say 2019. The likely reading: 2017 is the founders' first joint VR project, 2019 is Flowly becoming its own company, but neither side says so directly.
Grants, an accelerator batch, and a small trial
Flowly's most substantiated capital is federal. Its operating entity, Tamade LLC of Pasadena, holds an NIDA SBIR Fast Track award, project R44DA049630, PI Celine Tien: $225,000 in fiscal 2019 for Phase I and $989,571 in fiscal 2022 for Phase II, combined $1,214,571. In April 2021 Tien told Inc. the company had raised $2.5 million to date, including "a $1.2 million grant from the National Institutes of Health and National Institute of Drug Abuse," a figure lining up with the federal total. The company also joined Y Combinator's Summer 2021 batch; aggregator data adds names, Sazze Partners, Healthworx Accelerator and 500 Global among them, this page could not independently confirm.
The grant funded a real trial. NCT04236804, VANISH for Chronic Low Back Pain, tested a device the registry calls "Flowly (TMC-CP01)" against standard opioid tapering alone, in 20 patients on high dose opioids, split ten and ten. It ran at the University of Pittsburgh under Ajay Wasan, unblinded, from June 2020 to primary completion in January 2024, with results posted in April 2025.
What is proven, and what is still claimed
| Evidence | What the record shows | Source type |
|---|---|---|
| NIH SBIR grant | NIDA award R44DA049630 to Tamade LLC, PI Celine Tien. Phase I $225,000 (FY2019), Phase II $989,571 (FY2022). Total $1,214,571. | Public record |
| Registered trial, design | NCT04236804: 20 patients on more than 50mg morphine equivalent daily, randomized to Flowly (TMC-CP01) plus tapering, or tapering alone. No masking. Completed Jan 2024. | Public record |
| Registered trial, opioid outcome | Daily opioid dose in MME: Flowly arm 47.5 at baseline, 47.27 at week 8. Standard of care arm 21.75 at baseline, 10.62 at week 8. Dose fell only in the no-device arm. | Differs from claim |
| Registered trial, pain outcome | Change in PROMIS Pain Interference, baseline to week 8: negative 1.47 (Flowly) versus negative 1.75 (standard of care), a slightly larger improvement for the comparison group. | Differs from claim |
| Registered trial, anxiety outcome | Change in PROMIS Anxiety at week 8: negative 4.05 (Flowly) versus negative 2.62 (standard of care), favoring the Flowly arm. | Public record |
| "40% reduction in opioid use," "reduces pain by 46%" | Repeated in company interviews and on the website and app listing. The registered trial these figures are said to rest on shows the opposite direction on opioid dose, and a smaller pain gain than the comparison arm. | Company-stated |
| Peer-reviewed publication | No paper by Tien, Flowly or Tamade found in PubMed as of Sep 25, 2026. | Not found |
| FDA status | No 510(k), PMA or registration listing found for Flowly, Tamade or Tamadé in FDA's device databases as of Sep 25, 2026. No FDA clearance is claimed. | Not found |
| Founding date | 2019 per the company's launch release and YC page. 2017 per Crunchbase and CB Insights, likely reflecting the founders' earlier joint VR project. | Differs from record |
Read plainly: the federal grant and trial registration are real and specific. What the trial measured, in a small, unblinded, 20 person study, does not back the marketing numbers the company has repeated for years. Opioid dose did not fall in the device group, and pain interference improved slightly less than in the group with no device at all. Anxiety is the one measure where the device arm did better. A small Phase I study is not a verdict, but it is not the source of a "40% reduction" claim either.
What to watch
- Whether the $989,571 Phase II NIDA award funded a second, larger registered trial. None beyond NCT04236804 was found as of September 2026.
- Any peer-reviewed publication of the VANISH trial data, which currently exists only as a registry results posting.
- Whether Flowly reconciles its marketing figures with its own posted trial results.
- Progress on insurance reimbursement, pursued since at least 2022 and described as partial, in select states, as of 2024.
In their words
“Flowly shows you your heart rate in VR and teaches you how to control it. This allows you to downshift your nervous system, on command, from that fight-or-flight mode, where pain signals are created and amplified, into your parasympathetic nervous system, which is your rest, digest and relaxation mode.”
Celine Tien, founder and CEO, AgeTech Collaborative interview, Oct 2022 · Interview
“I grew up around cancer, which is a very painful, anxiety-ridden experience, especially in the terminal stages. So pain management is something that has always been top of mind for me.”
Celine Tien, AgeTech Collaborative interview, Oct 2022 · Interview
“Covid hasn’t slowed us down. It’s made us work faster and harder to get the product out there.”
Celine Tien, quoted in Inc., Apr 16, 2021 · Interview
“We had one investor who wrote ‘I’m into out of the box ideas’ on his website bio and when we pitched, he said we were amazing but this was ‘just too out of the box’ for him.”
Celine Tien, Voyage LA, Aug 15, 2022 · Interview
“We are a YC-funded, NH-backed start-up using VR and biofeedback to help people manage their chronic pain, anxiety, and pain.”
Officialflowly, Reddit AMA, archived Nov 27, 2024 · Company account
“It was through SBIR! We received a Fast Track SBIR for Phase I and Phase II through NIH.”
Celine Tien, Reddit AMA, archived Nov 27, 2024 · Company account
“Flowly has developed a pain and anxiety management platform that is not only intelligent, but thoughtful as well.”
Aman Mahajan, MD, PhD, Chair of Perioperative Medicine, University of Pittsburgh Medical Center, Business Wire release, Jun 9, 2020 · Company release
“We believe everyone deserves a chance to live a life free from pain.”
Celine Tien, CEO and Founder, Pathways to Healing Fund announcement, Nov 20, 2024 · Company release
Related companies
Sources
- Public recordNIH RePORTER, project R44DA049630 (Tamade, LLC, PI Celine Tien)
- Public recordClinicalTrials.gov NCT04236804, VANISH for Chronic Low Back Pain, with posted results
- InterviewFlowly: Using VR and Biofeedback to Reduce Chronic Pain
- IndependentA Chinese American Entrepreneur on Anti-Asian Bias in the Pandemic
- InterviewHidden Gems: Meet Celine Tien of Flowly
- AggregatorFlowly company profile (legal name Tamadé)
- AggregatorFlowly company profile, legal name Tamadé Inc.
- AggregatorFlowly company and funding profile
- PlatformFlowly: relaxation training, developer Tamade LLC
- PlatformFlowly company page
- IndependentWe are the co-founders of Flowly, a YC-funded NIH-backed start-up, AMA
- CompanyFlowly Offers Relief to 100 Million Americans Living with Chronic Pain and Anxiety
- CompanyFlowly YC S21 launch post
- CompanyFlowly Launches Pathways to Healing Fund
- CompanyFlowly homepage and about page
- Public recordSEC EDGAR full text search for Flowly and Tamade, Form D
- Public recordopenFDA device databases, 510(k) and registration listing searches for Flowly and Tamade
Profile researched and written by Healthcare Discovery. Last updated September 29, 2026.
