Last updated on November 26th, 2020 at 01:10 am
In this article, we’ll review Dorsal Health to help you decide if they are the right treatment option to help you manage your back or arthritic pain compared to other alternatives.
The sad truth is: chronic pain will affect most of us at some point in our life. It seems the more fun we have out there–things like running, sports, outdoor adventures, yard work or even taking care of kids–the more it hurts as we age. Whether your job is at the computer or you’re on your feet all day everyday, both can cause back degeneration and pain. And that sprained ankle from trail running or untreated football injury from high school? Yeah, those can cause arthritis later on. Genetics play a part in both arthritis and back pain too: when some people hit a certain age, these things simply kick in.
And if you are someone who suffers from it, you know that chronic pain can be a confusing puzzle to solve. What works for one person may not work for another – and even the best doctors sometimes can only send you to the pharmacy and the physical therapist without solving the root cause of the pain. So the simple doctor’s office visit does not always provide clear answers or long term relief.
Something that can add to this frustration for lingering chronic pain sufferers is that health insurance often cuts off after a certain number of physical therapy visits. Or, your plan may refuse to cover ongoing pain prescriptions. This can be a frustrating and alienating (and painful) experience.
Thankfully, online healthcare is taking on all kinds of innovative new forms. What used to be limited to services you would receive only in person can now be achieved via telemedicine, subscription programs, and other web-based methods. It’s getting easier than ever to manage health issues like chronic pain, comfortably, conveniently and privately from home. And it’s not just limited to talking with a healthcare professional; online healthcare services like Dorsal Health offer prescriptions for Physical Therapy and pharmaceuticals, as well as medical devices… so basically everything a doctor’s office can offer, without the associated hassles.
The new online healthcare wave began years ago, but was propelled into greater popularity when the COVID-19 pandemic hit. Now, more money is being invested in online medicine innovation, and regulations have been changed to allow more flexibility with prescriptions and which doctors can see which patients.
So while telemedicine used to be pretty limited, today a person can sign up with a membership for a service like Dorsal Health, have visits with a licensed doctor, receive a customized treatment plan, and have check ins on your progress. For something as insidious as chronic pain, this can often go above and beyond in person doctor visits as far as solving your personal pain puzzle.
Instead of making in-person appointments to see a busy doctor with limited time, services like Dorsal health employ smart use of technology, like 24-7 messaging, to make the whole process more efficient and effective. You don’t have to leave your house (or take time off from your job) to see a qualified medical professional and begin your treatment plan.
In this piece, we’ll take a closer look at Dorsal Health, a comprehensive online pain clinic that is rising in popularity due to its convenient offerings and experts specifically focused on chronic pain.
Dorsal Health is for anyone with chronic pain
Dorsal has a focus on back pain, and works best for anyone with any kind of chronic pain or arthritis, whether it looks any of the following:
- Acute back pain: strains, accidents, or “throwing your back out”
- Chronic back pain: long-standing back aches
- Muscle Spasms: Can be a part of acute or chronic back pain
- Sciatica: Shooting pain down the leg with a stinging or burning quality
- Disc issues: The connecting tissue between vertebrae are torn or have slipped out of place
- Arthritis: Chronic inflammation in the joints causing stiffness and pain
Are Dorsal Health’s treatments safe?
Both the technology and live staff behind Dorsal are set up to make the entire experience as safe as an in person doctor visit, if not more so. All treatments and care management from Dorsal Health are supervised by experienced medical Doctors. According to Dorsal, each of them has about ten years of experience and in-depth expertise in musculoskeletal care, orthopedics, rehabilitation, and pain management. Here are some of the Medical team members:
- Dr. Joseph Tu, MD – Board Certified in Pain Management and Physical Medicine & Rehabilitation. Trained at Northwestern University Medical Center. Over 15 years of experience.
- Dr. Charles Kaplan, MD – Board Certified in Pain Management and Physical Medicine & Rehabilitation. Graduate of University of Pennsylvania and SUNY Downstate Medical Center. Over 32 years of experience.
- Dr. Alan Gonzalez-Cota, MD – Board Certified in Pain Medicine and Anesthesiology. Trained at University of Michigan Hospital. Over 15 years of experience.
And then behind the physician team is the Dorsal Medical Advisory board: a group of leaders in musculoskeletal fields and some of the world’s leading hospitals. So in summary, Dorsal’s protocols have been vetted by a group of well qualified medical professionals.
While it’s natural to feel trepidation about sharing medical information over the internet, especially when it’s for the first time, the Dorsal process feels and is completely safe and easy.
The intake forms, just like at any medical office visit, make sure to capture any serious condition you may have such as kidney disease, thyroid condition, or high blood pressure, so that any treatment protocol takes these safely into consideration. They are quite comprehensive — perhaps even more so than those used at an in person office visit.
As far as data security is concerned, Dorsal users can rest assured that the tech platform used is HIPAA compliant– meaning that all processes follow the American Health Information Portability and Privacy Act, as well as all other health data integrity laws and regulations. This is important for protecting the privacy of your health information.
And for medications, all those used by Dorsal have been thoroughly tested, FDA approved, and used safely by the greater medical community for years. The physical therapy exercises are part of the most cutting edge and accepted standard of care for each chronic pain condition.
What does Dorsal offer for back pain and arthritis?
Dorsal is not simply the result of moving a typical doctor’s office visit online. One of the things that makes it unique is an acknowledgement that chronic pain is a thorny, multi-pronged issue that isn’t often solved with a quick fix. Thus Dorsal Health offers several treatments at the same time for each patient to try and reduce pain from multiple angles.
Each patient’s treatment plan includes elements of the following:
- Targeted prescriptions
- Ten weeks of physical therapy
- Education sessions
- Research-based behavioral coaching
What medications does Dorsal Health offer for pain?
As far as medications go, Dorsal uses an approach called “combination therapy.” This is where the different aspects of pain are targeted with different drugs, sometimes using simultaneous courses of prescriptions. For example, a topical NSAID might be paired with a muscle relaxer or a nerve pain reducer for a patient with spasms and sciatica.
But Dorsal doesn’t just offer up the typical full suite of pain medications. Their 15 different prescriptions are handpicked based on the latest research on what is most effective for back pain, and of course, for safety. Here are the six categories that they fall into:
Dorsal Health Medications for Pain
|Description||Drug Name||Treats Pain?||Treats Inflammation?||Addiction Risk?|
|Oral NSAIDs||Short for Non Steroidal Anti Inflammatory Drugs – we’re talking about things like Aspirin and Ibuprofen– only stronger!||Celecoxib (Generic Celebrex)
Meloxicam (Generic Mobic)
Diclofenac Sodium (Generic Voltaren)
|Topical NSAIDs||You guessed it: these are simply anti-inflammatory creams and ointments you put directly on the affected area. These can be very effective and are great for folks who have conditions that don’t allow them to take internal NSAIDs, like acid reflux or kidney disease.||Diclofenac Gel (Generic Voltaren)
Diclofenac Epolamine patches (Generic Flector Patches)
|Muscle Relaxers||These are more for acute muscular pain, when muscles spasm or cramp severely. Examples include Flexeril, and some cause severe drowsiness.||Methocarbamol (Generic Robaxin)
Cyclobenzaprine (Generic Flexeril)
Metaxalone (Generic Skelaxin)
Baclofen (Generic Lioresal)
Tizanidine (Generic Zanaflax)
|Steroid dose packs||Steroids are the go-to for acute inflammation, but they are usually only for short-term and their use must always be tapered off slowly.||Prednisone (Generic Deltasone)
Methylprednisolone (Generic Medrol Dosepak)
|Anticonvulsants||Burning, stabbing, and shooting pains typical of nerve damage or pinching from disc issues.||Topiramate (Generic Tomamax)||✅||❌||❌|
|SNRIs and TCAs (antidepressants)||Prescribed for chronic depression, some Serotonin Norepinephrine Reuptake Inhibitors (SNRI’s) like Imipramine can help with pain. And TCAs, or Tricyclic Antidepressants, can help with nerve pain.||Duloxetine (Generic Cymbalta)
Venlafaxine (Generic Effexor)
Amitriptyline (Generic Elavil)
According to Dorsal, all medications have been reviewed and approved by the FDA, have proven effectiveness in treating chronic pain by peer reviewed studies, and are delivered to patients as part of their monthly service.
How does Dorsal Health deliver physical therapy?
Dorsal’s suite of Physical Therapy regimens include components of mobility, strength and stability, soft tissue release, adjunct mobility, and adjunct strength. They are all offered by computer or even smartphone, and — this might be the best part– you choose when and where you hold your sessions. No more appointments cutting into your work, home or family time- these modules can just be incorporated into your routine in whatever way is natural.
Each regimen is 10 weeks, and focuses on both stretching and strengthening for stability and alignment.
The pillars include use of the very popular and well proven McKenzie method, which uses flexibility movements to remove pain.
Additionally, soft tissue mobilization is used to relax areas of tension or adhesion, and bring blood flow in to restore function.
And of course, the classic core strength exercises are also a major part of the program to protect the spine and provide stability during daily life.
What causes back pain?
Back pain and joint problems are two of the most common reasons we visit the doctor’s office, only behind skin problems. When we overdo it working out, or slip and fall, or worse, get into a car accident, many of us get better with rest and over time. However, over half of all people with back pain still have lingering problems after three months to a year.
What is behind this? Well, like many things having to do with the human body, the answer to that is pretty complicated. Generally, back pain falls into one of these categories: nerve pain, inflammation, and strained and spasming muscles, or strained ligaments. When we have an injury, or even the kind of back pain that seems to come out of nowhere, one type of pain can set off a secondary pain pathway. So even if you’ve healed the original injury, you are now in a cycle of inflammation and muscle dysfunction that can’t be fixed with the typical rest and pain management.
For example, say someone takes a slip on some nasty ice during winter, resulting in the very common herniated disc injury. The sudden combination jerking-twisting movement caused one of the “jelly donut” like cushions in between the vertebrae to have a microtear. As the body works to heal the tear, it may bulge into the spinal column, which is tightly packed with nerves. Needless to say, the nerves don’t like that very much, and this is where we can see shooting pain down the legs, buttocks, or even to the feet, as in Sciatica or radiculopathy.
You may be wondering: why can’t painkillers simply take care of the discomfort while the bulging disc heals? This is where things get interesting! So the whole area surrounding the tear is inflamed, right? Meaning lots of fluids are competing for space and it is causing pressure on the nerves… Well, it turns out that long lasting inflammation like this will actually cause the core muscles to atrophy, or lose strength. And these core muscles (ie: abdominals and glutes) are precisely what helps hold proper posture for the spine and protect it from shock.
This happens in non-injury chronic pain as well. The smallest things like repetitive movements at work or while playing sports can prevent a pain cycle from being broken.
This is where good physical therapy comes in. Rehabilitation science has advanced to the point where there are extremely effective exercises indicated for each back pain situation. Imagine for a second if we only used painkillers in the situation above. The patient would be stuck in a cycle of continued inflammation, muscle loss, and increased pain without any kind of physical therapy. This is where people will increase painkiller dosage, which presents quite a trap, especially when those painkillers are habit forming.
Is Dorsal Health legit for pain treatment and therapy?
We know that Dorsal’s treatment protocols are well vetted by its advisory board of accomplished specialists. But doing our own digging into the medical research confirms this as well. They are a legitimate, online telemedicine provider treating back pain with proven, science-backed treatments.
- Physical therapy has been shown to be extremely effective for back pain, especially when hip exercises are included.
- The Mckenzie method has been determined to be more effective than manual therapy and exercise combined.
- Core Strengthening has been proven to be more effective than resistance training at solving back pain.
- Back pain patients who receive Education on back care and mechanics have been shown to have better outcomes than those who do not.
- The 15 medications on Dorsal’s list are more effective than aspirin or ibuprofen but don’t include anything with addictive potential.
What’s it like to use Dorsal Health at home?
The whole experience starts with a friendly questionnaire about your personal pain problems… even before you sign up for a payment plan, you answer the first set of basic questions about your goals, fitness levels, etcetera.
From there, the survey asks about qualities of your pain, including time of day, and what makes it worse or better, as well as how it started.
Here’s the important part: entering everything you’ve already done for your back pain, including any doctors, physical therapy, medications, injections, and especially any surgeries.
Any imaging you’ve had done along with the results is also important here. They will want to know which treatments have been working, and which are you still using. From there, the questionnaire goes into more focused questions based on your responses.
Dorsal’s intake survey finishes with all the classic questions like height and weight, when your last physical exam was and what the results were, and whether you’ve had a blood pressure check in the last 6 months. One perk is that the online platform provides a pretty foolproof way of understanding and reporting your blood pressure numbers:
Perhaps the most innovative part of the questionnaire is the optional virtual physical exam, which takes just a few minutes but provides the doctors more information about your ranges of motion and which movements cause you problems.
Movements include the slump test, which is classically used to detect spinal issues:
How much does Dorsal cost?
Affordability goes a long way when it comes to choosing a telemedicine provider that you plan on using long term. Doral Health has a monthly plan that runs just under $60, but the upfront promo makes trying the service out very affordable. And shipping is included. See our next note on how they work with your FSA, and if they take insurance.
What is covered?
|Introductory or trial rate||$5.99 for first 30 days|
|Monthly plan||$59.99 flat fee||Comprehensive doctor consultation 1 to 3 different MedicationsMonthly refills on MedicationsAt-home Physical Therapy Follow up care Unlimited contacts with care team|
|Bi-monthly payment plan||$39.99 flat fee|
|Cancellation Policy||Cancel or change plans at any time by emailing [email protected]|
Can I use insurance or FSA/HSA to pay for Dorsal Health?
While most health insurance plans won’t cover Dorsal’s costs, but customers can save up to 30% by using their pre-tax health savings account dollars. And it’s pretty easy: Dorsal Health will offer Health Savings Account or Flexible Spending Account users an itemized receipt for reimbursement; alternatively, Dorsal also accepts HSA and FSA cards directly as payment.
Reviews of Dorsal Health: What are customers saying?
For a newish company, Dorsal has overwhelmingly positive reviews. In general, customers call the service effective, friendly and easy to use:
In addition, reviewers of Dorsal say that:
- Dorsal doctors are attentive, listen, and seem like they really care.
- The staff is friendly.
- Dorsal doctors stay in contact for several months to tweak and adjust the plan.
- Follow ups continue every 2 weeks.
- The education and physical therapy videos are very helpful.
- The experience feels personally tailored.
How does Dorsal compare to the alternatives?
Average conventional medical coverage
|Monthly Cost||$39-59||$250 or more|
|Wait to get an appointment||Less than 24 hours||2-6 weeks on average|
|PT sessions||3-5 per week||Once per week, commonly limited to 20 visits total|
|24/7 help, even on nights and weekends||Yes||Uncommon|
In general, Dorsal has excellent customer service and quality of care compared to most conventional healthcare coverage. One downside is that it’s services are not available in all states… and the only way to find out whether you have access is to begin the questionnaire.
More information on Dorsal Health
Source: Dorsal Health
The founding team behind Dorsal Health calculated that they had collectively spent about 50- hours in waiting rooms for physical therapy, chiropractors, and other healthcare services. In realizing that this kind of time lost can be a barrier to healing, they started Dorsal Health to be a more nimble and personalized experience.
Because if you’re spending hours in a waiting room, in line for prescriptions, or searching for the right physical therapist, you also probably don’t have time to fully and effectively treat your chronic pain.
The other folks behind Dorsal Health are five Medical and Osteopathic advisors, who are experts from large hospital systems such as Mount Sinai. From orthopedic surgeons to sports medicine to pain management specialists and rehabilitation experts, the team is a powerhouse of expertise focused on chronic pain.
The Verdict: Do we recommend Dorsal Health for chronic pain relief?
So do we recommend giving Dorsal Health a try? If you’re struggling to treat back or arthritic pain and would like a more convenient way: absolutely! Dorsal is a high-quality and high-value personalized concierge medical service with evidence-based care in a flexible online format to fit your schedule and your life.
In the past, if you threw out your back or developed symptoms of arthritis, you’d make an appointment to see your primary care doctor, who is most commonly a general practitioner, or GP. While many family doctors are great, they are trained to handle a wide variety of common ailments, but not necessarily experts in chronic pain. Since it can be such a persistent (and agonizing!) puzzle to solve, seeking help from specialists is recommended. Dorsal Health gives you access to a specialist with just a few clicks so you don’t have to seek referrals or get mediocre treatment from your busy GP whose steroid shots or opioid script won’t ever help get to the root of the problem.
Back pain and orthopedic specialists, on the other hand, have seen many more cases of chronic pain over their careers, and many more hands on hours with chronic pain patients.
Dorsal keeps prices low, with prescription costs at about 75% less than normal retail value. They can afford to do this because they don’t have overhead costs like brick and mortar offices, and instead run everything online.
Dorsal also leaves room for a wide range of treatment choices, including alternatives like acupuncture, CBD oils, and herbs and supplements:
With the COVID-19 pandemic underscoring the importance of at-home treatment, Dorsal’s timing to the market couldn’t be better. We like that their service increases access to quality, non-addictive treatment for chronic pain, mostly by making it exceedingly convenient. We hope you never NEED a service like Dorsal, but if you’re suffering everyday from back pain, we recommend you check them out.
We hope this review helps you understand Dorsal Health and their virtual solution for back pain. Please don’t hesitate, as always, to drop us a comment below if you have questions or feedback. This being such a new service, we’d love to hear your own review of Dorsal if you end up trying their service.