I believe it’s crucial to clarify some of the misconceptions around treatment options for nerve, muscle and joint pain. Physiotherapy and other “conservative” treatments are commonly opted for in trying to avoid surgery, as if surgery is the ultimate solution. This potential treatment-overlap is smaller than what we tend to think. Traumatic injuries, which account for only a small portion of both physio and surgical visits, have the potential to be effectively treated with either approach, weighing pros and cons on an individual basis.
However, similar to assuming who is guilty in a murder mystery, for most painful conditions and musculoskeletal complaints three common (and often misguided) scenarios can arise when the ideal profession to address a person’s condition was not consulted from the start:
- Physiotherapists may unknowingly try to treat structural problems, which could on occasion be alleviated in part but will never be rectified without surgery.
- Surgeons may operate on non-structural conditions, having assumed that their interpretation of the problem was correct, leading to lengthy recoveries and extensive rehabilitation without the surgery having had the capacity to remedy the true underlying cause of a person’s symptoms.
- Lastly, conditions exist where neither physiotherapy nor surgery is suited to the problem, often requiring completely different solutions (e.g., rheumatic conditions, cancer, infections, etc) while both physiotherapy and surgery may at times be complementary to the treatment most valuable for that condition.
The quality of care provided to a patient therefore depends greatly on a medical professional’s ability in assessing each person’s history and current presentation in detail. Applying sound clinical reasoning to the information gained in the assessment to ultimately determine the cause behind the symptoms should be non-negotiable. We’re the detectives in the human body’s crime scene but that’s just the start… In addition to a reliable assessment, health professionals should prioritise two key considerations: understanding the nuances of each patient’s presentation and determining the patient’s best interest. This approach should take precedence over financial motivations or professionals justifying treatment within their scope of practice or their area of expertise.
Unfortunately, crime dramas have nothing on health care, due to:
- Imaging limitations (e.g., incidental findings resulting in misplaced assumptions)
- Healthcare systems driven by financial and status considerations
- Overlapping symptoms obscuring the correct diagnosis, and
- Our professional and personal biases despite our best intentions with patient care
Your health and wellbeing deserve informed, personalised care. For tailored support, please discuss any questions or concerns with your physiotherapist of choice.