The economics of MSK pain

If you’re an HR or Benefits leader, you already feel the pressure: healthcare costs are rising fast, and musculoskeletal (MSK) pain is a top driver year after year. The cost of inaction is no longer neutral—it compounds. MSK conditions now cost the U.S. healthcare system an estimated $661B annually.¹ That spend isn’t just big—it’s growing.

Below, we break down three realities shaping your 2026 benefits strategy—and the practical moves that keep members healthier and budgets in check.

The inflation multiplier: Status quo is the most expensive option

Doing nothing about MSK isn’t neutral—it’s letting your costs compound. In a recent analysis by Aon published in the Wall Street Journal, Healthcare costs are expected to rise 9.5% per employee in 2026.²

Even more telling: a small cohort (about the top 6% of members) drives roughly 85% of MSK costs,³ which means precision targeting isn’t a nice-to-have, it’s the strategy. Traditional approaches wait for a claim to appear; a modern MSK model flags risk sooner and engages proactively—before the cost curve spikes.

The P&L impact: Delaying care doesn’t defer cost

Delaying care doesn’t defer cost—it transforms manageable pain into high-cost utilization (imaging, injections, surgery). Early, high-value MSK care shifts members to conservative pathways and away from avoidable procedures.

• Across independent, claims-based analyses, Hinge Health delivers a 2.4x hard-dollar ROI by reducing MSK medical claims—especially surgery and imaging.⁴

• In peer-reviewed claims studies of people with spine and joint pain, Hinge Health members saw fewer high-cost interventions, including a documented reduction in spinal fusions and joint replacements.

Most utilization management touches the case when it’s too late—after costly interventions have already started. Hinge Health’s proactive engagement flags risk before it reaches the surgical table (e.g., via targeted enrollment informed by claims, authorizations, and high-risk signals).

What this means for your plan? Early digital physical therapy is not a “nice-to-have”—it’s the single most effective hedge against downstream MSK claims this year.

If you don’t intervene upstream, you’re effectively financing tomorrow’s surgery pipeline today.

The hidden cost: Pain costs more than just medical claims

Pain erodes productivity (absenteeism and presenteeism), amplifies mental health comorbidities, and drives medication reliance that can introduce additional costs. Addressing pain holistically is a workforce resilience strategy as much as a medical one.

• Among Hinge Health participants, 59% report taking less pain medication after one year, and participants use prescription opioids 62% less than non-participants.⁵

• Hinge Health’s whole-person model—combining exercise therapy, clinical expertise, and behavioral support—has been associated with meaningful improvements in pain, function, and mental health in large-scale studies.

Integrating exercise therapy, clinical guidance, and behavioral support—across digital and in-person settings—addresses the real drivers that prolong pain and drive indirect costs. 

What leading teams are doing now

1) Target the few who drive the most. Use claims- and auth-informed “targeted enrollment” to identify high-risk members early (the 5–6% driving ~85% of spend) and redirect them into conservative care before costs escalate.

2) Make high-value, conservative care the default. Stand up digital physical therapy as the first line for back, knee, hip, shoulder, and neck—supported by rapid access to MSK specialists or in-person physical therapy when needed. Expect fewer surgeries and lower imaging.

3) Measure both ROI and VOI (value on investment). Account for claims savings plus improvements in productivity and employee retention—they reflect real dollars and real risk.

Bottom line: “Do nothing” is not neutral

“Do nothing” is not neutral—it’s a decision to absorb accelerating MSK claims and all the hidden costs that come with them. A proactive MSK strategy is one of the rare levers that can reduce claims in-year while improving care. Learn more by reading the largest-ever medical claims analysis of a digital MSK solution demonstrated that Hinge Health reduces medical claims by $2,387 per participant compared to a control group.

Let’s turn MSK from an inflation engine into a savings strategy—while helping your people move beyond pain.