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Is Surgery Always the Answer?
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Is Surgery Always the Answer?
A long-term study found that one of the most common operations for chronic meniscus tears offered no better results than placebo (sham) surgery, and, after 10 years, those who had surgery actually had poorer knee function and more progression of osteoarthritis. (link in comments)
It made me think about surgery more generally.
My mother had eight back operations over the years. Sadly, they changed her life, and not for the better.
Then I think about my aunt. She also had a very bad back, but she decided surgery wasn’t for her. Instead, she lost weight, started moving more, and took up Pilates. The difference was remarkable. The last time we visited, she looked years younger and was enjoying life again.
Of course, some surgery can be necessary and life-changing for some.
But, have we become too quick to operate when there may be other options worth trying first?
Have you, or someone close to you, had a surgery and looking back, would you make the same decision again?
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8 Replies
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An acquaintance of mine in Finland, Teppo Järvinen, is one of the prime movers of a group called FICEBO (
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Right down the alley of your post, Helen, is an acquaintance of mine in Finland, Dr. Teppo Järvinen. He is one of the prime movers of a group called FICEBO (the Finnish Centre for Evidence-Based Orthopaedics) — https://ficebo.com. Their summary of purpose states: “Since 2002, FICEBO has been at the forefront of evidence-based medicine, conducting research that challenges deeply held medical beliefs. Our principle is simple: only practices proven effective should be offered to patients.” Teppo has published many studies exposing the problem of many surgical procedures that do no better than non-surgical approaches for various orthopedic problems. (And when FICEBO says “evidence-based medicine,” they mean the real thing, not the debased process that so often claims to be that.)
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Thank you for sharing this @dickatlee …. I hadn’t come across FICEBO before, but I’ll definitely be taking a look.
I really love their guiding principle: only practices proven to be effective should be offered to patients. Why isn’t this the standard of practice for all surgery?
It’s great to know there are researchers out there willing to challenge accepted practice when the evidence points in a different direction.
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I had to laugh when I went to the NEJM to see the article Joe Mercola was pointing to: https://www.nejm.org/doi/full/10.1056/NEJMc2516079. When I got to the LONG list of authors below the paywall notification, the principal author turned out to be Teppo :-).
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I had horrible wrist pain with no discernible cause during a very active point in my life that included push ups, but stopping that didn’t help. Referred to the wrist ortho guy I had a tendon release that did nothing and I had a painful click so he proposed an ulnar shortening because he noted it was long. This was over 10 years ago and I was feeling the pressure because my modified duty time was getting close to the limit. The shortening didn’t help and after a period I had the plate removed. I sought out two different opinions and picked the one who had written some papers. He removed some debris and I had a slight improvement. I have a mild click and often prefer to use my left hand for some activities. I don’t think that invasive ulnar shortening was necessary and I regret it but felt pressured. I had trusted that first surgeon and didn’t question or research enough. In my HMO I am finding that the Sports Medicine department is a better bet. For my shoulder pain that is probably from some tears from age and exercise I refused the cortisone and got a referral to sports medicine for a PRP injection since it had the potential to actually help heal. Found that regular PT was actually harmful and I was disappointed that they didn’t have a better plan in place with instructions and appropriate therapy so got assigned to a wonderful therapist in sports medicine who has really helped. It’s a shame time was wasted though. This therapist in my HMO did manipulation that hurt like heck, but helped get my ROM back. I am thankful I did not have surgery back when I was around 20 with my herniated discs from a ju-jitsu self defense class. Time and movement did help and that same prescription has helped each time sciatica has appeared in my life. At the same time I understand people desperate for relief without definitive answers for pain.
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@pojeda Your story really captures how complicated these decisions can be, especially when you are in pain, under pressure, and trusting the specialist in front of you.
I just know that feeling of “I wish I had questioned more” will resonate with so many people, but sometimes its hard to slow down and research.
I also think your point about sports medicine is an example of finding the right kind of treatment or the right therapist, so your body can heal instead of rushing toward something invasive.
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