The Science

Knee and back pain are incredibly common, affecting almost all of us at some point in our lives. When these problems keep returning, they can have a severe impact on your quality of life.

The good news is, it is possible to dramatically reduce pain, and return to a more active and normal life without the need for surgery or potent drugs. [1,2]

In fact, all major medical bodies recommend a thorough programme of such non-invasive or “conservative” treatment before surgery is ever contemplated. In addition to this, there is very little disagreement in the medical community about what this conservative care needs to consist of:  [3,4]

  • Information, to allow you as the patient to better understand the condition, and how to manage it.
  • Frequent stretching and strengthening exercises, combined with more general physical activity.
  • Help with weight loss, where this may help unload the knee or back.
  • Support to address the mental and social difficulties almost always associated with chronic pain.

Results from an effective programme that contains all of the above can be extremely positive: Different studies have shown pain reduction as good as, or even better than that achieved by opioids (strong, addictive painkillers), a four-times smaller likelihood of needing knee surgery, and twice the increase in physical activity and rate of return to work seen through less sophisticated care. [1,2]

At Hinge Health we regularly see our remotely delivered programmes achieve results as good as the expensive and inconvenient in-person care that these studies involved.

[1] Deyle, G. D. Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee. Ann Intern Med 132, 173–181 (2000).

[2] Gatchel, R. J. & Okifuji, A. Evidence-Based Scientific Data Documenting the Treatment and Cost-Effectiveness of Comprehensive Pain Programs for Chronic Nonmalignant Pain. The Journal of Pain 7, 779–793 (2006).

[3] ACR OA Guidelines Non-pharmacological - Knee and Hip. American College of Rheumatologists (2009).

[4] ADULT BEST PRACTICE FLASH CARD: Low Back Pain. Intermountain Healthcare at <>