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So You’re Thinking About Surgery?

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You signed up for Hinge Health because you want to reduce your pain. Maybe your exercise therapy is going great, or maybe it hasn’t done the trick yet. Maybe you’re wondering if surgery is the best next step. No matter which way you’re leaning, it’s normal to have questions about the long-term effects of exercise therapy versus surgery. Here, you’ll get all the information you need to take the next steps in making an informed surgery decision for yourself.

Step 1: Exercise Therapy

You’ve already taken the most important step in long-term musculoskeletal (MSK) pain management: exercise therapy (ET). Hinge Health experts recommend trying exercise therapy and nonsurgical options before surgery because:

  • A nonsurgical approach is less risky. “A nonsurgical approach is inherently less invasive and less risky,” says orthopedic surgeon Jonathan Lee, MD, senior expert physician at Hinge Health. “While surgery can sometimes be a reasonable option, for the majority of chronic MSK conditions it is considered elective, which means that surgery is not required. Bear in mind that every surgery is a major decision, regardless of the size of the incision or type of procedure."

  • There’s no harm in delaying surgery. You won’t do irreparable damage by putting it off. If you start with a conservative approach and eventually need a more invasive solution, there’s no harm done.

  • Many people improve with exercise therapy. Clinical studies show that many people see the same results from exercise therapy as they do from surgery.

Step 2: Get a First Opinion from a Surgeon

It often takes six weeks or more to start seeing pain improvements from exercise therapy. If you’ve only been at it a few weeks, stick with it. But if your pain is affecting your quality of life, you’re not confident in your exercise therapy plan, or feel that surgery is a good option, set up an appointment with a surgeon.

“You may encounter conflicting information about the effectiveness of surgery,” says orthopedic surgeon Raymond Hwang, MD, Senior Medical Director at Hinge Health. “While your symptoms may sound similar to a friend or family member’s, everyone’s situation is different. What worked for your friend may not be appropriate for you. It’s important to pursue treatments that are specific to your situation.” That’s why it’s important to talk to a surgeon about all the factors that influence your pain and the treatment options that are right for you. Doing so helps ensure you fully understand the trade-offs between different options (and even between different surgeries) before deciding on a particular treatment.

Preparing for Your First Opinion

Let’s be honest. Appointments can sometimes feel overwhelming and rushed. It’s important that you feel all your questions have been answered and that you understand why surgery may or may not be the right choice for you at this time. Start with our Top 10 Questions to Ask Your Surgeon below. For more guidance, ask your coach for our Your Surgery Decision resource.

Top 10 Questions to Ask Your Surgeon

  1. Is surgery the best path for me? Why or why not?

  2. What else can I try before moving forward with surgery?

  3. Are there activities I should be doing or avoiding right now?

  4. What will happen if I delay or don’t have surgery?

  5. How will the surgery be performed (i.e., technique)? What other surgical options are there?

  6. What are the risks, benefits, and potential complications of surgery?

  7. What will my recovery look like?

  8. What are the expected outcomes of surgery for me?

  9. How long will the effects last? Should I expect to need a follow-up surgery at any point?

  10. What about my situation makes you think surgery will be a success?

Step 3: Get a Second Opinion from Hinge Health

We at Hinge Health believe that knowledge is power. No matter how your first appointment with a surgeon went, it’s always worthwhile to get a second opinion to ensure you fully understand all your treatment options. In fact, second opinions are so important, a lot of health insurance plans actually require one before certain procedures.

You can get a second opinion through Hinge Health at no cost to you. Here’s what you should know about the program:

  • If you've (1) seen an orthopedic surgeon or neurosurgeon and (2) had imaging for your condition in the last 12 months, you may be eligible for a Hinge Health Expert Medical Opinion (EMO).

  • Our Expert Medical Opinion (EMO) team includes orthopedic surgeons, nurse practitioners, and care coordinators. They work with you after you’ve met with a surgeon to help you choose the best treatment, whether that’s surgery or something else.

  • Hinge Health experts can offer a different perspective on surgery technique. Different procedures can often be used to treat the same condition, some being less invasive, each with pros and cons. Your EMO team can discuss alternatives that might be better for your body and your goals.

  • Hinge Health surgeons are impartial, unbiased experts. They don’t have any “skin in the game.” They do not perform surgery at Hinge Health, nor do they get paid to help you avoid surgery. Their priority is truly to help you make the best decision for you.

  • Even if you have surgery scheduled, you can still receive an EMO if your surgery is more than four weeks away from when you apply.

Surgery is a big decision, which is why Hinge Health is here to support you each step of the way. If surgery is on the table for you, start by talking to a surgeon. Then your Hinge Health EMO team can help you make an informed decision on your next steps. You’re here to manage your pain. We’re here to help.

For questions about our EMO service, contact us at emo@hingehealth.com.

Key Takeaways

  1. Experts recommend starting with exercise therapy and nonsurgical treatments for pain management before considering surgery.

  2. If you don’t see results from consistent ET after eight weeks, consider speaking to a surgeon for a first opinion on whether you’re a good candidate for surgery.

  3. If you've seen an orthopedic or neurosurgeon and had imaging for your condition in the last 12 months, you may be eligible for a Hinge Health EMO (second opinion). Our EMO team will help you decide what the best treatment is for you.

References

  1. Gugliotta, M., da Costa, B. R., Dabis, E., Theiler, R., Jüni, P., Reichenbach, S., Landolt, H., & Hasler, P. (2016). Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ Open, 6(12), e012938. doi: 10.1136/bmjopen-2016-012938

  2. Katz, J. N., Brophy, R. H., Chaisson, C. E., de Chaves, L., Cole, B. J., Dahm, D. L., Donnell-Fink, L. A., Guermazi, A., Haas, A. K., Jones, M. H., Levy, B. A., Mandl, L. A., Martin, S. D., Marx, R. G., Miniaci, A., Matava, M. J., Palmisano, J., Reinke, E. K., Richardson, B. E., Rome, B. Safran-Norton, C. E., Skoniecki, D. J., Solomon, D. H., Smith, M. V., Spindler, K. P., Stuart, M. J., Wright, J., Wright, R. W., & Losina, E. (2013). Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. New England Journal of Medicine, 368, 1675-1684. doi: 10.1056/NEJMoa1301408