High demand for musculoskeletal pain treatment benefits

Muscle, joint and bone pain represent some of the most common ailments that people of all ages experience, yet these conditions often go untreated. From not knowing if their pain is a real problem, to fear of hearing a diagnosis that requires surgery, to simply being unaware of where to look for help, people often live in pain longer than they should.

In addition to struggling with pain, many are unsure if their health benefits cover musculoskeletal (MSK) care and delay treatment for fear of expensive bills.

According to “The State of MSK” 2022 report by Sword, a leader in virtual physical therapy and musculoskeletal pain management, MSK conditions impact 50% of Americans age 19 and older, and nearly three in four among those is over age 65.

The report found nearly 80% of employed Americans experience some form of MSK pain, with 70% specifically dealing with low back pain, and many often just push through without seeking care.

Economic impact of growing MSK Conditions

Addressing the need for enhanced health benefits related to MSK-related treatment and physical therapy is becoming increasingly important. Direct treatment costs for MSK injuries have doubled over the past decade. Annually, MSK conditions incur approximately $600 billion in costs, including health care expenditures and lost worker productivity, surpassing the annual costs of heart disease ($309 billion), cancer ($243 billion) and diabetes ($188 billion).

According to the World Health Organization, employers are spending up to $103,000 annually on musculoskeletal (MSK) treatment costs, excluding expenses related to disability and workers’ compensation. MSK claims are one of the top cost drivers for employer health plans.

With an innovative plan design and coverage that encourages members to seek effective MSK treatment, rather than waiting or pushing through the pain, our industry can reverse some of these trends. This approach can help more employees stay productive on the job and give employers more opportunities to support workers who may be silently battling joint pain, back strain, hip soreness and other MSK conditions.

Gender disparities in MSK health

Research shows women are walking around with more MSK-related aches and pains. According to a 2023 MDLinx article, women have a 22% higher prevalence to MSK conditions than men, especially starting at middle age.

Women are more likely to experience compression fractures, vertebral changes and osteoporosis, which can increase their risk of breaking bones. Other factors that make women more susceptible to MSK pain than men include hormonal fluctuations, lower muscle mass, bone structure differences and physical household demands.

For both women and men, millions of surgeries and more invasive treatments were postponed during the pandemic and in their place, digital physical therapy sessions and less invasive procedures were undertaken. In many cases, the outcomes were positive for patients and the results started to pave the path for an uptick in digital care options.

Overcoming barriers with digital and virtual physical therapy

Physical therapy is often recommended for MSK conditions. Many individuals may not realize they can start with virtual physical therapy before seeing a specialized physician. This option is particularly beneficial for those who have limited time, transportation, finances or other barriers. Additionally, remote physical therapy is helping improve care equity, and mirroring the growth in the adoption of virtual fitness programs over the past decade.

Steeped in research insights, Sword is one company immersed in this space. The company’s certified physical therapists provide participants with personalized care at their convenience, eliminating the need to physically travel to a clinic. Over 60% of Sword’s sessions occur after traditional work hours to accommodate member’s busy schedules.

Sword’s sensor technology provides real-time feedback and regular communications to assist patients in performing and completing their customized MSK physical therapy programs. Sword’s 1:1 approach is highly focused on bringing pain relief and better mobility to individuals.

Read more: Managing chronic conditions is key to reducing high-cost claims

Addressing MSK conditions through innovative care

Care navigation programs have been on the rise in the health care industry to offer personalized support to high-risk individuals earlier in their diagnoses and to help steer them toward the right treatment path that matches their specific health needs. These programs focus on increasing awareness of available resources, providing health education and enhancing communication between members, payers and providers.

With MSK conditions expected to continue increasing among Americans, new care navigation programs are emerging to address this issue. These programs, managed by licensed health professionals and experienced nurses, assist with treatment options, provider referrals for second opinions, cost estimates for appointments and more. Care navigation teams are helping people make tough decisions, streamline their health journeys and provide supportive resources during difficult times.

Creative solutions such as care navigation programs and value-added point solutions are enabling employers to address holistic health needs, remove roadblocks and allow more people to affordably optimize their health plans. This “wrap-around” approach to comprehensive health benefits shows employees that their employers are truly looking out for them. As employers consider impactful solutions for their staff while keeping their budgets under control, MSK solutions are certainly worth investing in for a healthier and happier workforce.

Jessica Hennessey, Senior Vice President of Clinical Programs, Gravie