That’s right – useless. It’s common knowledge to those who are ‘up to date’ with the latest evidence that surgery for shoulder impingement, shoulder bursitis, back pain and knee pain has now been shown to be no greater than placebo effect. You can get the same and better outcomes with education and exercise. In addition, cortisone for these common condition often shows on additional benefit in the medium and long term.
How Can Surgery Be Placebo?
We know the placebo effect is real and measurable. We know that if we take a pill thinking it will do something – IT WILL DO SOMETHING – even if the pill has nothing ‘active’ in it. Surgery is the same. It tricks the brain into thinking that we are getting better but that’s not all.
Add to this the enforced rest period. This is enforced from the doctors and surgeons and we often listen AFTER we’ve had an operation. Without surgery you are tempted to keep pushing through your niggle. In addition you will be more likely to take your rehab at Physio much more seriously.
So when we combine the Placebo, the enforced rest and taking your rehab seriously – of course you are going to get better.
The Freshman Physio – Education and Exercise better than Cortisone.
So Do I Really Need Surgery?
No. If you have shoulder impingement, shoulder bursitis, knee meniscus issues or even back pain, surgery is not the answer. We have the evidence that shows 8-12 weeks of doing the right things (education) and exercise will give you the the best outcome. This also comes without the risks of infection, stiffness and scarring.
Secondly, surgery doesn’t fix the way you move or the strength of your structures. This is likely the reason you have the issue in the first place. If you’re not moving well and your muscles around a joint are weak, you are likely to get pain. Surgery doesn’t fix that and as the saying goes, “you can’t cut out pain”.
Lastly, another good rule to follow is this. Has your niggle or injury been a build up over time? or an acute injury like a ‘tear’ or a ‘pop’ from a fall, an injury or an accident. Most niggles and injuries that have built up over time respond really well to strength training. Think of a classic ‘grumpy shoulder’ that builds over time, rehab is required here not surgery or cortisone.
THE FINLAND STUDY: SURGERY VS PLACEBO FOR THE KNEE;