When the pain hurts so bad you can’t stand up
Sometimes work gets busy, and stressful, and that back pain that flares up every now and then, all of a sudden, leaves you flat on the floor. That’s what happened to Shelly, a barber at Vail Resorts whose pain was so bad she couldn’t stay on her feet. Shelly grew tired of living in pain, tired of saying no to her friends, and tired of missing out on the things she loves. When Vail Resorts partnered with Hinge Health, Shelly enrolled in the program looking for a solution to her chronic pain.
After completing Hinge Health’s 12-week digital coach-led program, Shelly went from living a life controlled by pain to living her life. Shelly avoided surgery and addictive drugs and now she’s back at work, on her feet all day, and transforming her clients with new hairstyles.
Shelly is one of the participants in our randomized control outcomes published this month in collaboration with UCSF researchers in Nature journal of Digital Medicine. Like Shelly, participants in the clinical study had lower back pain and 81% experienced pain improvement after completing Hinge Health’s digital MSK program which combines the three pillars of best practice care — exercise therapy, behavioral health, and education. Across 177 participants, the average pain reduction was 62% and nearly all participants (97%) reported the Hinge Health program could help them avoid surgery altogether. When participants feel better, they engage, which is why Hinge Health has unmatched weekly engagement averaging 90% for those that completed the program.
An overview of low back pain
Lower back pain is the leading cause of disability throughout the world, affecting 4 in 5 individuals in their lifetime. Although we know it is prevalent, determining the etiology of lower back pain is especially difficult because there are so many causes. As a result 90% of cases have no clear underlying cause. Best practice care recommends treating multiple aspects of pain, including physical, psychological, and social, before relying on drugs, imaging, and surgery. However, with no clear cause, a variety of interventions are used to treat the pain and if symptoms don’t improve, surgery and opioids are often recommended.
What we did
We conducted a randomized control trial, consisting of 177 employees and their dependents across 12 locations in the U.S. with low back pain. Participants were highly diverse with jobs ranging from data analysts and drivers to catering staff and outdoor instructors. Participants were randomly divided into two groups, a control group and a Hinge Health treatment group. The Hinge Health treatment group received a program consisting of exercise therapy, education articles, cognitive behavioral therapy, team discussions, activity tracking, symptom tracking, and 1-on-1 coaching, all accessed from home through a dedicated app on a complementary tablet computer. The control group received education articles. Both groups were free to pursue usual treatment.
What we found
By digitally delivering the 3 pillars of best practice care — exercise therapy, behavioral health, and education — Hinge Health was able to engage participants and improve outcomes. Compared to the control group, participants who completed the Hinge Health program saw statistically significant improvement in pain, disability, interest in surgery, and daily life activities.
Outcomes of participants who completed the Hinge Health program:
- 62% reduction in pain (vs. 3% in control group)
- 55% reduction in disability (vs. 9% in control)
- 64% improvement in daily life activities (vs. 9% in control)
- 52% decrease in interest in surgery (vs. 52% increase in control)
- 90% average weekly engagement among participants who completed program
What this means
The positive results from this study suggest digital care programs combining exercise therapy, behavioral health, and education are a scalable solution for treating chronic low back pain without surgery and drugs. As the opioid crisis continues to prevail, the impact of this study also shows promise for mitigating the use of harmful opioids for coping with low back pain.
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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.