What's The Biggest Deciding Factor For Musculoskeletal Surgery In The UK...?

Posted Apr 01, 2022 at 04:45

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Have you ever thought about “ what is the largest contributing factor for musculoskeletal surgery?” The answer may surprise you. 

By MSK surgery we mean procedures such as, Discectomy, Hip or Knee replacements, Labrum tears, Arthroscopies etc. But despite these procedures taking place on multiple different areas of the body they all have one key thing in common. Without the presence of this key factor most procedures dont go ahead. Do you know what it is? 

For those of you who guessed tissue damage, injury or something alike you are sadly mistaken. The largest contributing factor is the presence of pain. How confusing it is that when 99% of the time a Doctor or Orthopedic consultant uses an XRAY or MRI result to justify grounds for surgery but the biggest contributing factor is actually pain, something that can not be shown, proven or identified on imaging. 

Earlier this week I had a client come in explaining how the Dr had called and had seen the MRI results, saying surgery was required on one or two of the clients Lumbar discs. The client then explained to the Dr how they were no longer experiencing any intense pain, nor had they got any referred neural symptoms such as pins and needles, numbness or foot weakness anymore and had in fact just walked 7 miles in the countryside. They were n longer taking any medication or pain killers and felt much better. 

This came as a surprise to the doctor, but nonetheless went on to say that in that case surgery was no longer required and to carry on with the conservated route of healthcare. Despite this surprise, the doctor did NOT ask how the client had prevented their need for surgery which is the real shame!

So what really changed during that conversation. The client's MRI results certainly didn't. They showed 2 discs that required surgery. The only thing that changed was the client's symptoms. Which begs the question, which is the larger contributing factor for surgery, the MRI results showing tissue damage or the symptoms? The symptoms of course. That's the only thing that changed, and as a result so did the need for surgery…..

I explained it like this. Imagine you have a twin and you both have the EXACT same MRI results. To the millimeter. Twin A is in pain, has pins and needles etc, Twin B feels nothing, they are pain free. Twin A now has grounds for surgery but Twin B doesn't. 

This entire blog is underpinned with the understanding that tissue damage does not equate to symptoms. Osteoarthritis, bone spurs, disc prolapses are in all of us, but the presence, severity and or location of the pain isn’t. 


Tissue damage doesn’t equal symptoms.