This is a simple way to categorize approaches to fixing an orthopedic issue: surgically invasive, other invasive, and not invasive. You always want a diagnosis first, and since clinicians in orthopedics diagnose with different approaches, a second opinion is warranted if you are not pleased with your options or progress. (I diagnose primarily via a method of repeated movements, which, on the whole, is more helpful than diagnosing via imaging.)
We all know what surgery is. In my opinion it should be the last resort. Among the many reasons why, surgery (or intentional trauma) should be picked last because of the relative risk. The “other invasive” group includes prolotherapy, PRP, cortisone or any other injection, stem cells, dry needling, pharmaceuticals/supplements, and so on. Things that generally penetrate or enter a person’s skin/body. In the category of “not invasive” are movement, clinician techniques like mobilizations, various modalities such as heat and ice, and others.
Each category has pros and cons. What I find encouraging in this day of costly high-tech alternatives is that an expert program based on movement will still fix most problems! -- Laura
Ever wonder why, with all the technological medical advances in orthopedics, our population doesn’t seem better? In conservative care, there’s been electric stimulation, ultrasound, laser, and less techy modalities such as tape and soft tissue tools. Outside conservative care, we’ve gone so far as to make injecting steroids, fusing spines, electrifying nerves, and removing and replacing whole joints commonplace!
Perhaps the worst offender is the MRI. Imaging is certainly warranted in a few situations (as is surgery), but it’s current widespread use isn’t. Not only is this expensive for society, but overreliance is bad medicine: MRIs cannot reliably demonstrate cause and effect regarding symptoms and they often create needless fear in patients’ minds that they’re degenerating.
The human body has an amazing capacity to heal itself; orthopedic issues such as fractures, tears, disc herniations, sprains, etc. are regularly alleviated with time, not medical intervention. However, when a body’s independent healing falters, learning the right movement (and learning which to temporarily avoid) is key. Immobilization is rarely necessary. A clinician who uses her ears and brain to thoughtfully understand a patient’s problem should realize that a self-management protocol based on movement – nature’s best remedy – is almost always the best medicine. -- Laura
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