I’m always exceptionally grateful and proud of the person when I am asked this. We are well past the point where medical professionals hold all the cards, and patients should have the opportunity to make a truly informed decision, especially on major procedures. It is after all one of your rights as a patient.
Once your doctor recommended surgery, a second opinion is easily come by from a friend but unfortunately its likely to be poorly informed, and based on a single, personal experience. Another surgeon is commonly consulted for a second opinion, but I find myself wondering what value there may be in asking a second person if something is a nail when they too are already holding a hammer…
It’s true that we’ll all do our best to help you get better, but surgeons are most skilled in their surgical techniques (I’d be very worried if this wasn’t where they ensured proficiency), so if surgery is something you’d preferably avoid in your recovery, asking a non-surgeon if they have the solution makes far more sense in my mind.
So, when faced with this question, what do I say? “I’ll need a little bit more information.”
Once we’ve confirmed that we’re not dealing with true structural short comings like broken bones, dislocated joints or tendon / muscle tissue which was literally torn in half, the likelihood of a surgical need is mostly excluded already. This is usually the point where along with the history from a complete assessment, I can say that delaying or even avoiding surgery won’t cause more damage and having surgery isn’t a guaranteed solution either. We then have the comfort of knowing that a rash decision isn’t needed which allows you the time to gather more information and perhaps even to resolve the condition.
As I am credentialled in the McKenzie method which aims specifically to classify or exclude mechanical conditions (which account for up to 98% of the remaining causes of pain and dysfunction), I would recommend a complete mechanical assessment to determine the scope of the functional and symptomatic concerns and establish if and how these may be influenced or controlled to ultimately confirm the classification for the condition affecting someone. Such a classification is far more specific than “hip pain”, “rotator cuff syndrome” or “tendonitis” because these would merely describe symptoms or groups of symptoms which do not identify what lead someone to that point, how to escape it or how to avoid a repeat. The classifications within the McKenzie method gives us this additional insight and paves the road to a resolution – which may on occasion require the operating theatre but at this point any delay is already known to not be detrimental, and then surgery would not have been a path you landed on unnecessarily or by default.
Recommending a surgical consult (and the imaging investigations those come with) isn’t something I take lightly because it can reveal multiple indicators pointing towards surgery when commonly, it ultimately isn’t the real cause and surgery doesn’t resolve the problem – this is true for many treatments, but surgery can have lasting consequences and certainly doesn’t come with any ‘undo’ button. There are however certain musculoskeletal conditions where a mechanical, conservative or medical approach isn’t appropriate and surgery is then more likely to be the answer needed, and then taking that ‘chance’ is justified, well-informed and sensible – a luxury we do not often come by once surgery has been put on the table.
Your health and physical wellbeing should be a priority deserving of quality care. Make sure to discuss any concerns you may have directly with your preferred physiotherapist, so that you can receive the appropriate guidance for your unique situation.
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