4 ms·

For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committ

For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committed enough that they were able to participate in all the recommend physical therapy for recovery, they are both still in more pain than they were before, and 1 of them has actually been getting worse in recent months, and was just told by doctors that based on the images from before his surgery, the surgery they performed was unnecessary and didn't address the root cause of his original pain, and that new imagery showed a lot of damage most likely CAUSED by the surgery. I don't know enough to say, "don't have knee (or foot) surgery", but my limited anecdotal experience really makes me want to see data on such surgeries and how many people feel they are better of because surgery than they would have been with a lifestyle change that avoided a lot of stress on the knee (or foot).

hestipod 9y ago
I dont have references right now but I have continually heard that long term studies have proven that knee (which I have also had that made things worse) and back surgeries (those two common ones have been extensively studied) show no overall improvement in pain years on compared to those who skipped surgery. In fact it is often worse and precipitates new issues. Surgery is a huge cash cow in the US. The ones that are my only option, but am terrified to have given the past, and dont have the stability or money for would cost something like 25,000usd minimum per foot in this country and take 6 months to a year each to recover from with high complication/failure rates AND are likely to exacerbate the RSD. I am guessing based on previous experience it would be maybe 10-15% of that in Poland where I lived before and got excellent care...and that is paying full cash private prices there. I dont want more surgery at all but I can't live like this either. This is what they did to me and the lack of options they left me with. *@astura has linked some in this thread
- TallGuyShort 9y ago
  It's almost like there's a closely related cash cow incentivized to keep people in worsening chronic pain such that they need pain killers or something.
  - hestipod 9y ago
    I have been down that road too and spent years in total heavily medicated with various things that just cost me a ton and added more problems. I was usually treated as if my side effects were attempts to get something "better" when I just wanted something that worked and didn't screw me up more. Getting off of them was a nightmare as well and I ended up in the hospital once after seizures. The benefits were always outweighed by the costs.
astura 9y ago
We know at least some widely used surgeries are probably no better than a placebo. "Placebo" in surgery is when they get a surgical crew together, anesthetize the patient, make an the appropriate incision, and then dick around for the time it would take to perform a surgery, maybe passing some tools back in forth. Basically, an elaborate ritual. https://fivethirtyeight.com/features/surgery-is-one-hell-of-a-placebo/ https://fivethirtyeight.com/features/surgery-is-one-hell-of-... >A 2014 review of 53 trials that compared elective surgical procedures to placebos found that sham surgeries provided some benefit in 74 percent of the trials and worked as well as the real deal in about half.1 Consider the middle-aged guy going in for surgery to treat his knee pain. Arthroscopic knee surgery has been a common orthopedic procedure in the United States, with about 692,000 of them performed in 2010,2 but the procedure has proven no better than a sham when done to address degenerative wear and tear, particularly on the meniscus.3 >Meniscus repair is only one commonly performed orthopedic surgery that has failed to produce better results than a sham surgery. A back operation called vertebroplasty (done to treat compression fractures in the spine) and something called intradiscal electrothermal therapy, a “minimally invasive” treatment for herniated disks and low back pain, have also produced study results that suggest they may be no more effective than a sham at reducing pain in the long term. There's even the question of is the pain even caused by the thing we are trying to fix? >And then there’s what Thorlund calls “car repair” logic — something looks broken, so you try to fix it. A patient comes in with knee pain, and an X-ray or MRI exam shows a tear in the meniscus. The tendency is to assume that the torn meniscus is the cause of the pain and so should be fixed. However, studies show that MRIs can find all kinds of “abnormalities,” such as cartilage damage, even among people without knee pain. One such study looked at the MRI scans of more than 300 knees and found no direct link between meniscus damage and pain. “You can have a meniscal tear without having any problems,” Thorlund said. >Back pain follows a similar pattern. Studies that examined MRIs of people’s backs show that things like slipped, bulging or herniated disks correlate very poorly with pain. Herniated disks and other supposed abnormalities are also common in people without back pain, and it’s telling that studies find that spinal fusion, another popular back surgery used to address disk problems, does not produce better results than nonsurgical interventions.
- TallGuyShort 9y ago
  It would never have occurred to me to look for studies in which "placebo surgeries" had been performed. Thank you for the data!

hestipod 9y ago

I dont have references right now but I have continually heard that long term studies have proven that knee (which I have also had that made things worse) and back surgeries (those two common ones have been extensively studied) show no overall improvement in pain years on compared to those who skipped surgery. In fact it is often worse and precipitates new issues. Surgery is a huge cash cow in the US. The ones that are my only option, but am terrified to have given the past, and dont have the stability or money for would cost something like 25,000usd minimum per foot in this country and take 6 months to a year each to recover from with high complication/failure rates AND are likely to exacerbate the RSD. I am guessing based on previous experience it would be maybe 10-15% of that in Poland where I lived before and got excellent care...and that is paying full cash private prices there. I dont want more surgery at all but I can't live like this either. This is what they did to me and the lack of options they left me with. *@astura has linked some in this thread

TallGuyShort 9y ago
It's almost like there's a closely related cash cow incentivized to keep people in worsening chronic pain such that they need pain killers or something.
- hestipod 9y ago
  I have been down that road too and spent years in total heavily medicated with various things that just cost me a ton and added more problems. I was usually treated as if my side effects were attempts to get something "better" when I just wanted something that worked and didn't screw me up more. Getting off of them was a nightmare as well and I ended up in the hospital once after seizures. The benefits were always outweighed by the costs.

astura 9y ago

We know at least some widely used surgeries are probably no better than a placebo. "Placebo" in surgery is when they get a surgical crew together, anesthetize the patient, make an the appropriate incision, and then dick around for the time it would take to perform a surgery, maybe passing some tools back in forth. Basically, an elaborate ritual. https://fivethirtyeight.com/features/surgery-is-one-hell-of-a-placebo/ https://fivethirtyeight.com/features/surgery-is-one-hell-of-... >A 2014 review of 53 trials that compared elective surgical procedures to placebos found that sham surgeries provided some benefit in 74 percent of the trials and worked as well as the real deal in about half.1 Consider the middle-aged guy going in for surgery to treat his knee pain. Arthroscopic knee surgery has been a common orthopedic procedure in the United States, with about 692,000 of them performed in 2010,2 but the procedure has proven no better than a sham when done to address degenerative wear and tear, particularly on the meniscus.3 >Meniscus repair is only one commonly performed orthopedic surgery that has failed to produce better results than a sham surgery. A back operation called vertebroplasty (done to treat compression fractures in the spine) and something called intradiscal electrothermal therapy, a “minimally invasive” treatment for herniated disks and low back pain, have also produced study results that suggest they may be no more effective than a sham at reducing pain in the long term. There's even the question of is the pain even caused by the thing we are trying to fix? >And then there’s what Thorlund calls “car repair” logic — something looks broken, so you try to fix it. A patient comes in with knee pain, and an X-ray or MRI exam shows a tear in the meniscus. The tendency is to assume that the torn meniscus is the cause of the pain and so should be fixed. However, studies show that MRIs can find all kinds of “abnormalities,” such as cartilage damage, even among people without knee pain. One such study looked at the MRI scans of more than 300 knees and found no direct link between meniscus damage and pain. “You can have a meniscal tear without having any problems,” Thorlund said. >Back pain follows a similar pattern. Studies that examined MRIs of people’s backs show that things like slipped, bulging or herniated disks correlate very poorly with pain. Herniated disks and other supposed abnormalities are also common in people without back pain, and it’s telling that studies find that spinal fusion, another popular back surgery used to address disk problems, does not produce better results than nonsurgical interventions.

TallGuyShort 9y ago
It would never have occurred to me to look for studies in which "placebo surgeries" had been performed. Thank you for the data!