There is an old saying, “When you are a hammer, everything looks like a nail.” We are predisposed to use the tools that we are familiar with.
Doctors that specialize in orthopedics are familiar with surgery and treatment. Thus, they often approach every problem with the mindset it can be fixed by surgery or more treatment.
A new study, however, is the most recent in a string of studies to cast doubt on the efficacy of many tried and true orthopedic procedures. The British Medical Journal recently published research that shows patients who suffer ankle sprains do as well with rest, ice, and over the counter pain medications than they do with a program of physical therapy.
This study comes on the heels of host of recent studies that show very common orthopedic surgeries do not provide benefits over conservative care. For example, every day, thousands of adults undergo knee surgery to trim the meniscus of their knees. A large study showed this common surgery is no more effective than conservative care in reducing long term pain or improving physical function. Moreover, these surgeries are not without risks, including deep vein thrombosis, pulmonary embolisms, and infection.
Similarly, a 2013 study in the prestigious journal Spine, concluded patients that underwent the very significant surgery to fuse the vertebrae in their lower back fared no better than those that underwent cognitive behavior and exercise therapy.
This idea has spread to the treatment of prostate cancer, where in many cases automatic surgery and/or radiation (and their significant side effects) has been replaced with “watchful surveillance.”
The bottom line is any time your doctor recommends a procedure or treatment, especially surgery, it is important ask whether there is science based evidence the surgery or treatment provides real benefits over conservative therapy. In many cases, there is no proven benefit. You should go into these important decisions armed with the knowledge to make an informed decision.
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