In this post, we discuss the danger of over-medicalising common physical complaints and what we can learn from this.
I’ve noticed a pattern over the years –individuals who’ve had the most rigorous medical investigations are generally worse off in terms of both pain and function.
It’s not just me either.
Take a common complaint, like back pain for example. Several investigations have found that patients sent for an early MRI are more likely to receive invasive treatments like injections or surgery – yet they’re also more likely to be in pain a year on compared to those who aren’t sent for early imaging.
So what’s going on?
The over-medicalised person
It’s common when meeting these unfortunate people to be confronted with a long list of every ‘abnormality” that has been pointed out to them on scans over the years.
They frequently display a fear of movement, or kinesiophobia, as it’s known. As a result, they’re usually deconditioned and may experience exaggerated responses to even light exercise.
Understandably, they feel fragile and they’ve completely lost confidence in their bodies.
They are casualties of a well-meaning medical system that has provided them with too much information and not enough context.
And which, in some cases, still holds the mistaken belief that pain is always related to a structural issue that can be injected or treated with surgery.
To someone with a hammer, every problem looks like a nail
It’s important to recognise that once you step into a hospital for an issue that perhaps doesn’t belong there, you increase your chances of treatment going in a certain direction.
This is to be expected.
In some ways, both exercise and rehab professionals are to blame.
If the application of exercise for common complaints like back pain was of a higher standard, individuals wouldn’t feel the need to seek further investigations.
Once it’s been decided you haven’t responded to exercise, then the door is open to more invasive options. No matter how badly that exercise was applied.
The thought occasionally crosses my mind: if the exercise I prescribe post-surgery had been done beforehand, would the surgery even have been necessary?
So what can we learn from this?
Medicine can be bad for your health, especially in the case of musculoskeletal issues.
Scans should only be used when serious pathology is suspected.
Results should be explained with particular reference to what is normal and most likely age related.
The scan doesn’t necessarily have to change for you to feel better.
When exercise doesn’t work, it might have more to do with the exercise and the way it was applied than any particular condition you may have been diagnosed with.