Orthopaedic surgeons do not operate on “pain” because there is no anatomical structure called “pain”.
Surgeons operate on anatomical structures they believe could be causing abnormal function that leads to pain.
The goal of surgery is to restore anatomy and improve function.
Unfortunately, there is no guarantee that improving function will eliminate pain after surgery.
Because there are risks and serious consequences from any kind of surgery, it is always considered the last resort and only considered when all non-surgical treatment options have been exhausted or ruled out.
- It’s estimated that 100% of seventy year old adults will have evidence of hip or knee arthritis on an x-ray – yet less than 30% may experience decreased function that requires medical attention, including surgery.
- It’s estimated that 90% of patients with sciatica (leg pain) will improve with non-surgical treatment within three months and never need to see a surgeon.
- It’s estimated that the majority of patients with a complete rotator cuff tear on an MRI will improve with non-surgical treatment within three months and never need to see a surgeon.
So, just because you have an abnormal x-ray or MRI does not mean you need to see a surgeon or require surgery –
Surgical Referral To-do Items
- See the most experienced orthopaedic physiotherapist in your community to ensure you get on the most appropriate non-surgical treatment plan.
- Research conducted at the University of British Columbia (1), found that experienced orthopaedic physiotherapists were four times better at identifying patients who require surgery than emergency room physicians and family physicians (91% vs 22%).
- If your physiotherapist believes you require surgery, please include a letter from them in your referral letter to a surgeon.
If you’re declined a surgical consult, this doesn’t mean your condition isn’t important to a surgeon – instead it means they believe you may be able to improve through safer non-surgical treatments that your physician or physiotherapist haven’t tried yet.