How We Scaled an FDA-Certified Neck Pain Device to $2.4M in Annual Revenue
Through data-driven direct-to-consumer marketing, we scaled an FDA-certified neck traction device from zero to $2.4M peak annual revenue in ~3 years with sustainable unit economics.
Project Overview
Product
NTD 3000 – FDA-certified neck traction device for chronic neck pain and post-injury recovery
Region & Channel
DTC e-commerce, U.S., Canada, Australia & New Zealand
Timeframe Covered
Late 2020 → Late 2024 (36-40 months)
Starting Point
New product launch with limited brand recognition
Peak Performance
$300K monthly revenue at peak with 1,200 customers/month
Total Revenue Generated
$4.5-5M across full lifecycle with sustainable margins
Key Metrics at Peak Performance
Strategy Breakdown
1. Paid Media Strategy – Meta Ads (70% of Revenue)
What We Did
Launched comprehensive Facebook and Instagram ad campaigns with multiple audience targeting strategies. Started with small daily budgets ($20-50/day per campaign) and scaled winning campaigns to $100-200/day. Ran 20-30+ campaigns simultaneously at peak, testing broad audiences, narrow interests, and lookalike audiences.
Created product demonstration videos (15-30 seconds) showing device assembly and usage to reduce purchase anxiety. These product-led growth ads became our top performers.
Optimization Approach
- Tested 10-12+ different interest audiences per campaign
- Built 1%, 3%, and 5% lookalike audiences after reaching 500+ conversions
- Implemented layered retargeting for site visitors, video viewers, cart abandoners
- Refreshed creative every 2-3 weeks to combat ad fatigue
Outcome
- Scaled from $0 to $50K-$60K monthly ad spend at peak
- Achieved 4.2× blended ROAS during scaling phase (up from 1.5× in early testing)
- Peak ROAS of 4.8× during optimal efficiency period
- Product demo videos achieved 35% lower CPA than lifestyle/testimonial ads
- Best performing campaign: $35 CPA vs. $55-57 average
2. Conversion Rate Optimization
What We Did
Ran continuous A/B testing program with 130+ tests over 36-40 months (3-4 tests per month average). Optimized landing pages, product images, copy, social proof elements, and checkout flow. Focused heavily on page speed improvements and reducing friction in the buying process.
Key Optimizations
- Simplified product page layout with clear value proposition
- Added video demonstrations directly on landing pages
- Enhanced social proof with customer testimonials and reviews
- Streamlined checkout process to reduce abandonment
- Improved mobile experience and page load times
Outcome
- Increased site conversion rate from 1.5% to 3.1% (+107% improvement)
- Improved checkout completion rate from 35% to 68%
- Higher conversion rates led to lower effective CAC as more traffic converted
3. Email Marketing & Lifecycle Optimization
What We Did
Built automated email sequences in Klaviyo for the entire customer journey: welcome series, abandoned cart recovery, post-purchase upsells, replenishment reminders, and win-back campaigns. Segmented email list into three categories: completely disengaged (35%), passively engaged (40%), and highly engaged (25%).
Created educational content about neck pain management, device usage tips, and introduced complementary products (back pain devices from same manufacturer).
Key Email Flows
- Welcome Series: 3-4 emails over 7 days with product education and setup guides
- Abandoned Cart: 3-email sequence with escalating discounts (0% → 10% → 15%)
- Post-Purchase Upsell: 4 emails over 30 days introducing accessories and complementary devices
- Win-Back Campaign: 4-email sequence for customers with no purchase in 120 days (12% recovery rate)
- Replenishment: Timed reminders for device maintenance and replacement parts
Outcome
- Generated 20-30% of total revenue through email marketing (~$600K annually at peak)
- Increased repeat purchase rate from 15% to 45% (+200% improvement)
- Post-purchase upsell flow increased AOV from $140 to $180 (29% lift)
- Cleaned email list every 90 days, removing 30% of non-engaged subscribers to improve deliverability
4. Google Ads & YouTube Strategy (10% of Revenue)
What We Did
Launched Google Search campaigns targeting high-intent keywords like "neck traction device" and "neck pain relief." Used Performance Max campaigns with automated bidding to scale efficiently. Created YouTube video ads (15-30 second format) using same product demonstration content from Meta ads.
Outcome
- Generated ~$240K in annual revenue from Google/YouTube channels
- Google Search achieved 2.5× ROAS at $60 CPA
- YouTube ads used for awareness and retargeting, CPA of $75
- Targeted competitor channels (Chirp, Neck Hammock) and health/wellness content
5. Market Expansion – Australia & New Zealand
What We Did
Expanded into AU/NZ markets in 2023 with region-specific landing pages, local payment gateways (Afterpay), and optimized fulfillment for faster shipping times.
Outcome
- Generated 28% incremental revenue within 6 months of launch
- Demonstrated product-market fit beyond U.S. market
Key Learnings
- ✓Product-led content outperforms lifestyle content for complex products: Demo videos showing actual product usage achieved 35% lower CPA than testimonial-based ads. Customers needed to see how the device worked before buying.
- ✓Lifecycle marketing is essential for profitability in low-margin businesses: With 10-12% gross margins, we needed strong LTV to make unit economics work. Email marketing and post-purchase upsells increased LTV by 150% and made the business sustainable.
- ✓Early-stage testing is expensive but necessary: First 12-14 months with 1.5× ROAS were barely profitable, but this testing phase was critical to finding winning audiences, creatives, and offers that enabled 4.2× ROAS during scaling.
- ✓Platform diversification reduces risk: While Meta drove 70% of revenue, having Google (10%) and email (20-30%) channels protected against platform changes and provided multiple growth levers.
- ✓Creative refresh is mandatory for sustained performance: Even best-performing ads saw 20-30% CPM increases and 15-20% CTR drops after 30-60 days. Launching 3 new ad variations every week prevented creative fatigue.
- ✓International expansion extends growth runway: AU/NZ launch generated 28% incremental revenue when U.S. market started showing signs of saturation, demonstrating importance of geographic expansion for scaling.