Does your organization embrace a proactive approach to musculoskeletal pain and injury?

Why Proactive?



Identify the Pain Problem Early & Address It
Proactive management increases chances for full recovery and cost containment. Employees can be guided in low cost self care while high risk employees with barriers to recovery are identified and managed.


Ignore The Pain Problem As Long As Possible
Delayed reactive care leads to poorer outcomes and more expensive care.  Barriers to recovery are not identified until it’s too late.





H&D proactive begins with a brief online musculoskeletal pain-injury assessment. We simplify data collection with a time efficient and user friendly process that can be done from anywhere within just 2 minutes


2. Analytics based on cutting edge research in occupational medicine

Every month, hundreds of new research papers are published about musculoskeletal pain and injury.  We stay on top of the research, and continually integrate new research into the proactive analytics algorithm.



Learn about employees with MSK pain as early as possible. Assess risk and barriers to recovery, and empower employees on recovery strategies and pathways of care that are the most clinically effective and cost efficient.


MSK pain and injury is more than just Biomechanics


Integration of biomechanics & psychosocial factors

H&D's proactive approach stands out by incorporating the wide range of biopsychosocial factors that influence pain recovery, work related disability, and cost of care.

“There is increasing evidence that no single risk factor has predominant prognostic value, but that several factors may combine to form a reasonably good prognostic model”


Many of These commonly overlooked prognostic factors are modifiable and can be easily assessed

+Predictive Psychosocial Factors ...

"Findings from this study confirm the requirement for measurement of ‘depression and maladaptive cognitions’ in screening tools for patients at risk of developing persistent low back pain. • Psychological factors at baseline correlated with a progression to persistent low back pain up to 6 months. • The benefit of including factors such as ‘depression and maladaptive cognitions’ in screening tools is that these factors can be addressed in primary and secondary prevention"

+Multi-Site Pain ...

"The number of pain sites predicted poor work ability after 4 years of follow-up with a dose–response manner. Those with widespread pain had almost a 3-fold risk of developing poor work ability at follow-up. The associations were stronger for younger and white-collar workers....Counting the number of concurrent pain sites may be a simple method of identifying workers with high risk of work disability in occupational health practice."

"The number of pain sites independently predicted DP retirement. Employees with multisite pain may need specific support to maintain their work ability"

+Fear & Fear-Avoidance ...

"Individuals who had reported greater levels of fear avoidance beliefs when pain was acute also reported greater scores of disability six months later"

"Fear-avoidance beliefs have been shown to be associated with delayed return to work and increased sickness absence in longitudinal cohort studies"*

*"Mental health, work-related fear-avoidance beliefs and catastrophizing are all predictors of chronic work disability."

+Lifestyle Factors ...

Aerobic Exericse: "The performance of regular aerobic activities seems to reduce sickness absence and the recurrence of LBP whereas infrequent aerobic exercise leads to increased sickness absence"

Sleep: *"Those with sleep disturbances at baseline had a 2.4-fold risk of elonging to the new pain or chronic radiating pain cluster compared to pain-free participants."

Occupational health and safety personnel, as well as the [employees] themselves, should recognize sleep problems early enough in order to prevent back pain and its development into chronic pain.

Self-reported restorative sleep was independently associated with the resolution of chronic widespread pain and return to musculoskeletal health"

"Insomnia symptoms was associated with a 1.40-fold increased risk of back pain"

+Social Support ...

"Job satisfaction and social support at work minimized the influence of sickness absence at baseline and at 1-year follow-up" "A correlation was observed between delayed workplace injury recovery and poor perceived workplace social support" "Workplace support was a significant moderate-to-strong predictor of days until to return to full capacity."

Social support was predictive of multi-site pain developing in all age groups except for the age group 60-64 years

+References ...

  • Resources for preventing sickness absence due to low back pain, Occupational Medicine 2012
  • Predicting the transition from acute to persistent low back pain, Occupational Medicine 2011
  • Multi-site pain and work ability among an industrial population, Occupational Medicine 2011
  • Sleep disturbances predict long-term changes in low back pain among Finnish firefighters: 13-year follow-up study, International Archives of Occupational and Environmental Health 2015
  • Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study, Rheumatology 2008*
  • Increased insomnia symptoms predict the onset of back pain among employed adults, PLoS 2014
  • *Multisite musculoskeletal pain predicts medically certified disability retirement among Finns, European Journal of Pain 2015
  • Resilience and Vulnerability Factors When Pain is Acute as Predictors of Disability: Findings From a Two-Year Longitudinal Study, Pain Medicine 2017
  • Psychosocial Factors Impacting Workplace Injury Rehabilitation: Evaluation of a Concise Screening Tool, Journal of Occupational Rehabilitation, 2017

Customized for the needs of your organization


Multiple Use Cases & Flexible Options


Organizational Snapshot

PROACTIVE surveys assess the prevalence of high risk musculoskeletal pain within your workforce. Survey can be delivered at a single point across the organization, or made available at repeated time points to engage employees at the right time, just as MSK problems are starting to develop.



Targeted Services & pRograms

PROACTIVE data gives decision makers the tools they need to decide on what health services and wellness offerings will have the greatest impact on their unique employee population, and which sub-sections of the organization require services.


Promote Cost Efficient Care Pathways

The PROACTIVE platform identifies which employees will benefit from different service offerings, and provides automated follow up to guide employees into evidence based pathways of care that are clinically effective and cost efficient.  

12 month cost of care for back pain using evidence based vs. non-evidence based care pathway

Data Source: The cascade of medical services and associated longitudinal costs due to non adherent magnetic resonance imaging for low back pain, SPINE 2014

“Your pain lessons have been instrumental in helping me get off all meds”
— Unsolicted feedback from H&D's self management recovery course


Self Treatment

An ideal strategy for addressing the burden of muscuolsektal pain, is to empower employees with the knowledge to treat themselves.  This low cost approach provides targets MSK problems during the "warning sign" stage, rather than waiting until MSK pain is preventing work ability.

PROACTIVE identifies specific factors relevant to each employee, and creates a customized self treatment plan involving symptom specific advice such as simple exercises, ergonomics, lifestyle (e.g. sleep improvement), or mind-body techniques including mindfulness meditation.  This online intervention is delivered slowly (in small sections) so that the employee can realistically implement the strategies into their daily routine. 

The PROACTIVE platform also identifies which employees need regular follow up and tracks symptom and risk level changes over time.

H&D’s online training content has been studied in randomized controlled trials, with results published in a peer reviewed medical journal. 95% of users reported being highly satisfied with our content and >90% would recommend to all people with pain


Contact us to learn more about how H&D's PROACTIVE platform can benefit your organization.

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