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What to Know 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. You may be hopeful you won't need surgery. Still, it's normal to have questions about when surgery might be recommended, especially if your healthcare providers have previously mentioned or suggested it. 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:

  • Most people improve with exercise therapy. Clinical studies show that Hinge Health members on average experience a 70% reduction in pain within 12 weeks. Other studies show no difference in long-term pain levels between people who do exercise therapy regularly and those who have had surgery for common MSK conditions.

  • 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 delaying surgery, which is why, generally speaking, it makes sense to put it off as long as you can. If a conservative approach doesn’t work, you can always opt for a more invasive option — no harm done.

Step 2: Get a First Opinion From Your Surgeon

It often takes six weeks or more to start seeing pain improvements from exercise therapy. If you don’t improve by eight weeks and wonder if you’re a candidate for surgery, 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. When it comes to a decision as big as surgery, it’s always worthwhile to get a second opinion. This helps you fully understand all your treatment options and weigh the pros and cons against alternatives to the surgery. 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:

  • 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 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.

  • 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 EMO.

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

Surgery is a big decision, and Hinge Health is here to support you each step of the way. What you’re doing right now — exercise therapy — is the best first step. If you haven’t been able to do your ET consistently yet, lean on your Hinge Health care team for support. Research shows that consistency is the best way to maximize your results.

If you don’t see improvement after eight weeks or your pain escalates and you think surgery might be an option for you, consider speaking to a surgeon. Then your Hinge Health EMO team can help you make an informed decision on your next steps. If surgery isn’t the right decision for you at this time, there are always other steps you can take, and we’re there to support you every step of the way. You’re here to manage your pain. We’re here to help.

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, whether that’s surgery or something else.

References

  1. Digital Musculoskeletal Impact on Medical Claims: 136 Employer Study. (n.d.). Hinge Health. Retrieved from https://www.hingehealth.com/outcomes/?active=clinicalStudies&_ga=2.79868759.1315969191.1655826209-1521343927.1647351281

  2. 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

  3. 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

  4. Kaushal, N. & Rhodes, R. E. (2015). Exercise habit formation in new gym members: a longitudinal study. Journal of Behavioral Medicine, 38(4), 652-663. doi: 10.1007/s10865-015-9640-7 PMID: 25851609