Why you need one holistic clinical care team to address your members’ MSK needs

May 25th, 2021  by  Dr. Claire Morrow, DPT – Staff Physical Therapist

As a full-time Doctor of Physical Therapy at Hinge Health, I spend my days working to help our participants tackle the complex issues involved with chronic musculoskeletal (MSK) pain and help them return to the quality of life they deserve. But I don’t work in isolation; instead, I work with an integrated care team that surrounds each member with a dedicated team of physicians, Doctors of Physical Therapy, Board-certified health coaches, and other specialists, such as nutritionists. All my colleagues are full-time clinicians at Hinge Health, which allows each of us to commit to offering quality care for your members 24/7. We don’t rely on contractors or part-time clinicians, as we believe your members’ care deserves 100% of our attention.

Why you need a whole-body approach

At Hinge Health, we recognize that a physical injury is connected to a member’s whole body, including mental health, diet, and stress. For example, eating inflammatory foods like sugars can increase joint inflammation and pain. Stress also can increase cortisol levels in the body, which, in turn, hinder the growth hormone production that is essential for tissue repair. Pain and depression have similar pathways in the brain. As a result, depression or anxiety can amplify how the brain perceives pain.

Those who suffer from chronic pain have been shown to be three times more likely to develop depression or anxiety and twice as likely to be at risk for suicide. These statistics show that chronic pain goes deeper than the diagnosis, creating a toll that is not only physically difficult but also emotionally exhausting.

These psycho-emotional stressors can lead to our creating coping strategies that include seeking unnecessary care. Studies have shown that people suffering from chronic pain tend to use the healthcare system 3x more if they develop a passive coping strategy versus an active one. This means that on top of the physical symptoms that I treat daily as an expert in MSK care are deep psychological barriers that need to be overcome to start seeing improvement.

The biopsychosocial approach to MSK pain

Here at Hinge Health, we take a biopsychosocial approach to pain, which research has validated as the gold standard for treatment. The biopsychosocial approach emphasizes that health risks/conditions are due not only to physical factors but also to psychological, social/cultural, lifestyle, environmental, educational, economic, and other factors in combinations that are unique to each individual. The biological component focuses on the physiology underlying your body's health. For example, exercise has been shown to reduce pain sensitivity in people with chronic pain by up to 60%. The psychological component focuses on thoughts, feelings, and behaviors influencing health. For example, a high belief in yourself, or can-do attitude, leads to lower pain levels, even at 1 to 2 years after intervention, according to research published in the Journal of Pain Research. And finally, the social component focuses on the ways that society can influence how people view their health. The support offered by a personal health coach or family member can make a big difference in helping a member stick with their treatment and recover.

This need for physical movement coupled with the need for encouragement and lifestyle change, such as in regard to diet or mental health, led us to think more holistically about treating MSK. As a clinician, I find it is much more effective to treat members with one integrated care team across specialities, as opposed to members seeing specialists piecemeal. That way, we can work together and share information on how to support your members’ recovery. Our digital delivery model enables us to work together virtually and support your members, removing the friction caused by brick-and-mortar specialists who are usually not co-located or in communication with each other.

Our health coaches work to keep participants accountable and help them find time to do the exercise that will get them back on track. Working with other specialists, our health coaches also help participants make key lifestyle and behavior changes necessary to their MSK recovery, whether it’s an anti-inflammatory diet, weight loss, or mental health care. When you combine the clinical expertise of our physical therapists with the behavioral know-how of our health coaches and the comorbidity expertise of our specialists, the sum is clearly greater than its parts.

That's why participants complete our program 3x more than the industry average, make the necessary lifestyle changes to recover, and enjoy on average a 69% reduction in pain per participant, according to a study published in JMIR by researchers from Stanford, UCSF, and Vanderbilt. In fact, two years later, 70% of Hinge Health participants continued to do their exercise therapy and experience lasting pain relief and behavior change.

Hinge Health’s thoughtfully designed holistic care team includes the following specialists

Physicians and clinicians - Physicians and clinicians design your members’ MSK care plan and guide their recovery, including Expert Medical Opinion to determine whether surgery is necessary or if conservative care is more appropriate.

Doctors of physical therapy (PTs) - Hinge Health’s doctors of physical therapy (myself included) are full-time employees dedicated to our participants 100% and involved in supporting participants throughout their MSK journey. We do this through our work with our health coaches, participants, and wearable sensor technology. Together we create a personalized exercise therapy plan and strategies to get people back to what they love to do. Every unique exercise plan is designed and reviewed by our physical therapists.

Board-certified health coaches - Our holistic approach goes beyond physical therapy and adds in an extra layer of behavioral health support. Our health coaches are trained in behavioral health techniques and provide the motivational support to help participants adhere to the program and implement lasting behavioral and lifestyle changes. In fact, our entire program and digital app are designed by our director of behavior change with the latest behavior change science in mind. Through one-on-one virtual coaching and behavior change tactics, our coaches help support and empower participants every step of the way, resulting in better outcomes. For example, one of our users said to his coach, “It's so helpful when you check in because it gives me that accountability and little nudge I need sometimes!” In short, they are experts in helping participants make the mindset shift from “what can I do?” to “I can do it!” After feeling pain relief from the Hinge Health program, the user said, “Thank you for this. I’ll never forget you.”

Key specialists - Our clinical care team also includes other key specialists like nutritionists or mental health support to help your members make diet or lifestyle changes necessary for their MSK recovery, guided by their personal health coach.

Advanced wearable technology - Using our motion sensors, our participants are guided through an exercise program and receive feedback in real time, which helps them create the habit of daily movement. Our technology also allows our health coaches and PTs to monitor and track the progress of our participants. Our new Enso wearable technology for pain management also offers a noninvasive and nonaddictive alternative to opioids, allowing members with severe pain to get immediate relief, start doing their exercise therapy, and get on a better path toward recovery.

The Hinge Health model: putting our focus on your member

Finally, Hinge Health’s clinical model uses a team approach to not only help our participants with their physical ailments but also support and empower them to make key lifestyle and behavior changes. Our team of health coaches and physical therapists work together with these core values in mind:

  • We treat the whole person. We want to understand your members’ whole body and lifestyle, not just their physical pain.
  • We know movement is medicine. Exercise has been shown to reduce pain sensitivity by 60%. That’s why our physical therapists work directly with both our health coaches and participants to find the best way for members to move—and move well.
  • We know members are busy. Between work, family, and their busy life, it can be a challenge to fit in exercise. Our health coaches work with your members to find solutions that make sense given their hectic lifestyle.
  • We teach members about pain. We understand that knowledge can change the way members look at the world and help reduce their pain. Through education, we’re able to gradually change your members’ mindset and awareness of how to overcome their pain.
  • We feel your members deserve a team behind them. Chronic pain is complex and we feel your members need an integrated care team of specialists who can take a whole-body and lifestyle approach to their care.

Leading the way

Chronic pain is an epidemic that continues to grow in our country. As the market leader in MSK care, our team is committed to continuously innovating and evolving best-practice MSK care to serve our participants so they can get back to doing what they love most.

Dr. Claire Morrow, DPT

About the Author

Claire Morrow is a Doctor of Physical Therapy at Hiinge Health. She has been practicing physical therapy for eight years. She is a Board-certified orthopedic clinical specialist and fellow of the American Academy of Orthopaedic Manual Physical Therapy. In addition to being a PT at Hinge Health full time, she is also a clinical faculty member in an orthopedic residency and fellowship program in the Bay Area, where she mentors and teaches new physical therapists. Her professional mission is to empower individuals to take control of their pain for improved function and overall quality of life.

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