Musculoskeletal Disorders

Why understanding pain leads to better recovery

Pain is an evergreen topic when talking about musculoskeletal conditions. Although every person sees and feels pain differently, it plays the main character in their daily life. But pain can be demoted to a lesser, supporting role.


By understanding pain, what it entails, and how we should behave towards it. Then, recovery won’t seem as difficult and unattainable as before.

Pain is not just pain

Pain is the way our body responds to a threat by prompting protective behaviors, which includes focusing attention on pain sources and avoidance. However, these protective behaviors may persist beyond the healing time, and this is when pain turns chronic, leading to pain-related disability.

So, pain is more than just pain. It’s the fear of pain and movement, the loss of function, and the inability to do the things we used to do out of the fear of them being harmful — even though most times they are not. However, feeling pain does not mean we have serious damage, nor it means we are doing further damage. The same applies to exercise therapy.

Exercise-induced pain is common and to be expected

When people struggling with a musculoskeletal condition are about to start their treatment, they often fear that physical therapy is painful. The answer is quite straightforward: yes, it is painful – at first. But this pain is normal, bearable, and nothing to be worried about.

As the body gets used to the therapeutic exercises, the higher loads patients can tolerate, and the less and less pain they feel. In other words, there’s a dose-response to exercise for musculoskeletal pain. Over time, people learn to expect increasingly challenging exercises while knowing they can tolerate them.

Moderately painful exercises are actually beneficial

Research has shown that doing moderately painful exercises offers better outcomes than doing exercises with no pain at all. It has also proved that exercising into pain has no apparent adverse effect when the aim is to manage chronic musculoskeletal pain.

One of the discussed reasons for this response to exercise into pain was the positive impact on central pain processes, the immune system, and affective aspects of pain.

In short, moderately painful exercises challenge the body’s threat response to pain, helping “reconceptualize” pain as safe and non-threatening.

Consequently, people no longer perceive pain as equal to harm, being then able to reintroduce the same movements they were avoiding before. They learn how to cope with pain — and conquer it.

Being a coper, not an avoider, is the best way to conquer pain

During a painful event, it’s better to cope with pain and not give in to paralyzing pain-related fear.

Changing the perception about pain is a tipping point between having a coping over an avoidance behavior. It includes challenging the attention bias, which happens when we focus our attention on how painful a particular movement is and end up feeling it more strongly. In other words, we end up catastrophizing pain.

Exercising, as mentioned before, is a way of challenging this bias and reframing pain as not harmful. Another one is making a valued life goal a priority over pain.

Focusing our attention on what really matters to us outweighs our pain-related fear. When we set goals and are optimistic about them, it becomes easier to hold back our fear-related protective behaviors.

After the pain, the recovery

SWORD Health team took all critical aspects of pain management into account when developing our solution for musculoskeletal care.

  • We promote exercise as the first-line approach to MSK management;
  • We make goal-setting a priority, enabling participants to divert their attention from pain to their more objective, valued goals;
  • We foster continuous education as a way of empowering people to put pain into perspective and go through with the program despite it.

At the end of the day, our Digital Therapist yields undisputed results, with a reported 74% decrease in pain after only eight weeks — all while helping people stay away from opioids and surgeries, too.

After we overcome the pain obstacle, the path to recovery becomes clearer. Pain is no longer a barrier to treatment, so people can set their minds into a more relevant thing: getting better, faster.

Musculoskeletal Disorders

How staying active helps manage back and joint pain

How sedentary is the U.S. population? According to the U.S. National Health and Nutrition Examination Survey, Americans spend “the majority of their waking time in sedentary behaviors.”

Sedentary behavior is a matter of public health. Not only does it have a negative impact on overall health, it has also been associated with a proneness to suffer from musculoskeletal disorders – also known as MSDs, a set of diseases that includes chronic back and joint pain, and affects 1 in every 2 adults in the U.S.

Exercise, a central player in preventing and treating MSDs

The correlation between exercise and health is obvious. We know how relevant a role physical activity plays in preventing heart diseases and fostering mental health, for instance.

Indeed, exercise is seen as “an economic and safe way to prevent and treat diseases” when compared with the cost of opioids and other drugs on families and society. Yet, what people sometimes overlook is that exercise can help prevent and treat musculoskeletal disorders, too.

The 2018 Physical Activity Guidelines Advisory Committee of the Office of Disease Prevention and Health Promotion published a scientific report that showed “a relationship between greater amounts of physical activity with decreased pain and improved physical function in adults with osteoarthritis of the knee and hip.” What is more, an active lifestyle also led to reports of “overall improvement in their quality of life.”

As for low back pain, a recent systematic review stated that exercise, along with patient education, is the only clinically proven way to prevent it. The study goes as far as saying “exercise alone may reduce the risk of an episode of LBP [low back pain] and sick leave due to LBP, at least for the short-term.”

People with medical conditions, however, should be cautious when engaging in physical activity.

MSD patients should follow an exercise program customized to their specific case and prescribed by certified physical therapists. A tailored exercise program will provide the guidance they need to engage in suitable physical activities that promote their rehabilitation and physical function.

More physical activity, more pain relief and self-confidence

The piece that people usually miss in understanding why physical activity is so important is exactly how it can change the way their bodies behave and adapt.

First, exercise improves overall physical ability as well as muscular strength and flexibility, reducing stiffness and improving mobility and range of motion. Secondly, exercise promotes the release of endorphins, which act like opioids in our system and lead to a decreased perception of pain.

All in all, exercise helps surpass the fear of movement, regaining confidence in movement, self-esteem, and self-efficacy.

It’s fairly simple to recognize why these factors may contribute to an improvement in quality of life and overall health.

The missing factor: compliance

By this time, the association between physical activity and effective back and joint pain management is well-established. However, there’s another critical factor for this equation to work: compliance.

In research, studies showing greater compliance with exercise programs also reported more positive outcomes. But how do we promote compliance?

According to the report mentioned above, individual-level interventions may be an effective way to “increase the volume of physical activity (…), especially when the interventions are based on behavioral change theories and techniques.”

Moreover, “information and communication technologies (…) can be used to enable self-monitoring, deliver messages, and provide support”, which can help promote regular physical activity.

Why SWORD is the go-to solution for pain management

Summing up what we have discussed so far, there are three key ideas to take away:

  • physical activity is an effective strategy for the management of back and joint pain;
  • exercise programs should be customized to the individual needs of MSD patients;
  • exercise is more effective when there is compliance, which can be achieved through one-on-one interventions, patient education, and remote support.

SWORD covers all three aspects for the successful management of MSDs: we promote physical therapy as the first-line treatment for joint and back pain, we prescribe tailored exercise programs that address the specific needs of our patients, and we enable our patients to perform their programs at home while receiving real-time feedback.

The result? A faster and better way to treat MSDs.

And when it comes to relieving pain, our program’s positive impact is best described with one of our patient’s words: “Sometimes I couldn’t sleep because of the pain, so I got up at ungodly hours and started exercising (…) The best part of my day was the therapy; it actually relieved my pain”.

Musculoskeletal Disorders

Round-up on the Opioid Epidemic: Musculoskeletal Disorders and Opioids

A few weeks ago, we discussed the current state of affairs regarding the opioid epidemic. At that time, we shared some grim numbers along with some hopeful steps being taken to tackle it.

This time, we’re addressing the connection between musculoskeletal disorders and opioids.

Musculoskeletal pain and opioids: the hows and whys

Musculoskeletal disorders (or MSKs) are injuries or disorders that affect the human body’s movement or musculoskeletal system, causing recurring pain, stiffness or swelling. The most commonly affected areas of the body are the back, neck, shoulders, hip, and knees. When we talk about chronic low back pain or chronic shoulder pain, we’re usually talking about an MSK. Many MSKs are work-related or at least worsened by work.

Opioids have long been a standard, go-to option to treat MSK. But given the current circumstances, doctors are becoming increasingly cautious when prescribing them. Even the Center for Disease Control and Prevention has issued guidelines to help Health professionals decide whether or not chronic pain patients might require opioid treatment. Given opioids’ high addiction rates, keeping people from beginning to take them unless absolutely mandatory may prevent many future deaths. This sounds like a good strategy since their very real toll on populations has been unraveling before our eyes for years now.

However, the most baffling piece of information regarding opioids and its use to treat chronic pain is that opioids are not even a recommended approach to hand these affections. In fact, specialists recently came to the conclusion that “NSAIDs and opioids reduce pain in the short-term, but the effect size is modest, and the potential for adverse effects need careful consideration.”. What this study does recommend as the best way to address back and joint pain is a combination of physical therapy and behavioral intervention.

Sorting what’s wrong with conventional physical therapy

Being the favored solution to treat MSK, it may come as odd that under 10% of people engage in physical therapy when their doctors prescribe it. But it’s fairly easy to understand why: the hassle to get to a physical therapy center, most likely at inconvenient times, and the time spent in the waiting room make most people opt out.

To solve the inconvenience associated with MSK care, we at SWORD Health have developed a new approach to it: the Digital Therapist.

By bringing MSK care to people’s home, we have eliminated the hassle factor that causes them to reject physical therapy.

By allowing for real-time remote monitoring, assessment, and communication via a human clinical team comprised of doctors and physical therapists, we make understanding the participants’ evolution and troubleshooting seamless and immediate.

But, most importantly, by delivering a MSK solution that is clinically proven to be even more effective than conventional physical therapy, we are ensuring people reduce pain by 74%, enabling people to have a better quality of life while keeping opioids at bay.

If you would like more information on how we can help you reduce your workforce’s burden with MSK, reach out to our Strategic Business Development team.

Musculoskeletal Disorders

A Round-Up on the Opioid Epidemic

The growing awareness of the toll opioid consumption is taking on the US population had a substantial boost last week with accusations of failure to address the public health problem coming from within the FDA. The head of the agency’s opioid advisory committee stated it had failed to learn its lessons and keeps approving strong opioid painkillers, thus putting the interests of big pharma ahead of public health.

In the meantime, concern comes from every side of public life: from the Senate, who sent a letter to the FDA’s commissioner showing atonement towards the fact they keep approving new medication, to Walgreen’s board of investors, who required the company to show how it’s monitoring and managing risks related to the opioid crisis. The world is starting to acknowledge how big a problem we have between our hands.

Terrifying Numbers

The most recent CDC report stated that 18% of the general population reports illicit drug use or prescription drug misuse somewhere in the past year. Add to this a baffling recent update from the National Safety Council showing that people are now more likely to die from a drug overdose than in a car accident.

With 4.3% of the general population being prescribed opioids and a 33% addiction rate associated with them, this easily ends up translating into 130 people dying from overdoses in the US every day.
Furthermore, if we assume that the most regular users of prescribed opioids are people with arthritis and back pain (63% of prescribed opioids users report the first and 59% report the latter) and add to that the recent studies showing that physical therapy combined with behavioral intervention can substitute opioid intake in many cases, it becomes very apparent that physical therapy plays a very relevant role in tackling the opioid epidemic.

Finding new solutions is crucial

Expert entities including the American College of Physicians are advocating for exercise programs and patient education as a first-line treatment option for chronic muscle and joint pain.

At SWORD Health, we have conducted clinical studies that demonstrated our novel MSK care intervention can reduce pain levels by 33% in just four weeks, all the while keeping people away from prescription opioids.

We know that addressing this problem requires a multifold approach that comprises local, immediate action as much as systematic prevention. By creating cost-effective digital physical therapy at home and combining it with behavioral intervention and continuous education, we are helping people stay away from opioids in the very first place.

If you need more information about SWORD Health or need help in making this change happen in your workforce or your population, our team is here to help.

About SWORD Health:

SWORD Health is a tech-enabled musculoskeletal (MSK) care provider. We pair licensed physical therapists with innovative technology to help people overcome their chronic and post-surgical pain faster and more cost-effectively. We’re on a mission to reduce U.S. healthcare costs by $70B by making it simple for people to recover at home, without resorting to imaging, surgeries or opioids.