PT Alone Won’t Eliminate Musculoskeletal Pain: 3 Tips for Implementing a Whole-Person Approach to Care

October 20th, 2021  by  Dr. Jeff Krauss, MD – Chief Medical Officer

When it comes to musculoskeletal or MSK pain, there’s a common misconception that pain is generated from one particular part of the body and that remedies should be directed at that location. In reality, however, pain is multi-dimensional. Diet, lifestyle, and a person’s mental or emotional state can influence how an individual experiences pain.

The link between pain and depression is well studied. Emotional pain has the same neural pathways as physical pain. As a result, it’s not surprising that many people experience cycles of depression and pain. In fact, around two-thirds of the depressed population report also having chronic pain. Depression, anxiety, and stress can over-excite the nervous system, intensifying how people perceive pain. In addition, excess weight can overburden the joints, while eating too much sugar can increase inflammation and MSK pain.

The Need for a Whole Person Approach to Addressing MSK Pain

Given the complex nature of MSK pain, physical therapy or surgery alone won’t solve the problem. Since biological, psychological, and social factors all play a role in a person’s pain experience, experts believe that a more holistic approach is necessary.

In fact, studies show a holistic whole body or lifestyle medicine approach improves MSK outcomes:

  • The Agency for Health Research and Quality recently reviewed 202 non-drug clinical trials and found that mind-body approaches were more effective than body-focused treatments on their own. Examples of mind-body techniques for pain relief include exercise therapy, stress reduction, deep breathing, lifestyle changes, patient education, and more.
  • A study published in JAMA in March 2016 led by Daniel Cherkin, Senior Investigator Emeritus Kaiser Permanente Washington Health Research Institute, found that patients who received mind-body therapies along with their usual medical care had less pain, fewer physical limitations, and improved mental health compared to patients who did not receive them.
  • Furthermore, behavior changes—among them, quitting smoking, losing weight, and improving nutrition—have been found to improve bone health, reduce chronic musculoskeletal pain, and reduce the risk from other chronic diseases, according to a 2015 study published in BMC Musculoskeletal Disorders.

These studies underscore the need to take a more integrated and whole-body approach to MSK care.

3 Ways to Implement a Whole-Person Approach to Resolving MSK Pain

Because MSK is closely related to a range of comorbidities, here are three recommendations for launching an effective MSK program based on whole person, mind-body principles:

1. Offer physical therapy plus an integrated care team to personalize care.

People with chronic musculoskeletal pain often also have comorbidities like depression or obesity. However, the traditional approach to MSK pain is narrowly focused on the physical aspects of MSK pain. Members have to navigate multiple providers and a siloed healthcare system to address MSK and related conditions like depression or obesity, even though it’s critical for their MSK recovery. A more integrated care team approach is required to effectively address MSK and its related comorbidities. According to the World Health Organization, “integrated care is a continuum of services delivered by a system organized around the health needs of people rather than diseases.”

Partnering with a solution like Hinge Health, members have one-on-one access to a comprehensive integrated care team including doctors of physical therapy, board-certified health coaches, and physicians. Care is personalized for each member, based on their unique needs. Physical therapists create a tailored plan of stretching and exercise for every individual. Nutritionists may get involved to aid members with weight loss or transitioning to an anti-inflammatory diet. Throughout the journey, health coaches help members create new habits with proven behavior change tactics and keep them on track with constructive nudges.

2. Leverage advanced technology to deliver better outcomes.

Real-time interventions and member feedback make the difference when it comes to addressing MSK pain. Hinge Health’s Digital MSK Clinic is built on several innovations to ensure that members get the most out of their exercise therapy, while managing their pain without drugs or surgery. Thanks to wearable sensors and computer vision technology, participants receive real-time feedback about their movement which builds confidence and care teams have additional opportunities to monitor and personalize care. In addition, Hinge Health Enso is a wearable technology that provides pain relief that is both non-addictive and non-invasive. It uses high-frequency electrical nerve stimulation that delivers long-lasting relief within seconds. Hinge Health program participants benefit from both reduced pain and reduced usage of opioids.

3. Close the data gap between in-person and digital health care providers.

For many MSK patients, their health care and medical data is fragmented across multiple providers. For personalized care, providers need a holistic view that includes a patients’ broader medical history, medications, and encounter data. Hinge Health is the first digital MSK solution to bridge the digital and in-person care divide with HingeConnect which allows bi-directional medical information exchange with Hinge Health and 750,000+ in-person providers. Additionally, HingeConnect monitors medical records for escalations of care to empower a member’s care team to appropriately intervene in real-time.

The traditional approach to musculoskeletal pain remains narrowly focused on physical injury, despite the complex health needs of members. Looking at the whole person and his or her unique needs is key to resolving MSK pain. By offering an integrated approach to MSK care, health plans and employers can ultimately drive better member outcomes and reduced MSK spend.

To learn more about treating the whole person and taking a holistic approach to musculoskeletal care, download our white paper.

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Dr. Jeff Krauss, MD
About the Author

Dr. Krauss is Hinge Health’s Chief Medical Officer. He graduated from Harvard College, earned his Medical degree from UC San Francisco School of Medicine, and completed his residency in Physical Medicine & Rehabilitation at Stanford University. He is a Clinical Assistant Professor at Stanford University in the Department of Orthopedics, and he continues to practice as a part-time Staff Physician at the VA Palo Alto Health Care System.

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