Avoiding surgical approaches to musculoskeletal problems is supported by the best available medical evidence according to a new study.
My wife had told me about a friend of hers who continues to have problems with her shoulder after having multiple surgeries. This is not unusual as many approaches borne out of our over-specialized American medical system have led to unnecessary costs, irreparable damage, and chronic pain.
In 2017, the Annals of Internal Medicine recommended avoiding drugs and surgeries as the first options for lower back pain due to the best available evidence. They included a list of methods that were evidence-based, many of which are regularly used by chiropractors.
The evidence supporting nonsurgical approaches to the musculoskeletal system continues to grow, yet physicians and the systems they work in often ignore the best available evidence, resulting in avoidable and risky surgeries.
Patients are aware that our fragmented system results in higher costs, more tests, and unproven risky interventions. Some wrongly believe that this is all necessary when the truth is, that MRI is opening the door to aggressive intervention. Many shoulder impingement surgeries and knee meniscus surgeries that were so commonplace years ago had been proven to either not work, make patients worse, or resulted in results no better than traditional rehabilitation which also often doesn’t work. Perhaps this is why so many patients are now first seeing out the opinions of chiropractors who look at patients as the sum of their parts and holistically evaluate and treat their patients.
A new paper published in JOSPT (Journal of Orthopedic and Sports Physical Therapy) suggests that the best available evidence supports trying a non-surgical approach first for musculoskeletal conditions. Are doctors being incentivized to use the best available evidence? Are insurance companies making it easy for patients to access a physical therapist or a chiropractor through lower copayments and out-of-pocket costs for treatment? Are they rewarding results rather than procedures yet?
Why you visit first will determine your results and your healthcare journey for a particular problem. While not all practitioners are of equal quality, patients must be better healthcare consumers when it comes to musculoskeletal conditions.
Chiropractors are for many the first choice of provider due to their reputation and the results they get with problems in the shoulder, neck, lower back, knees, feet as well as other common conditions. This is probably because they will often treat the mechanism rather than the symptoms. A primary care approach to musculoskeletal problems as well as the ability to treat on the first visit often reduces costs, offers faster relief, and avoids unnecessary tests and medications.
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