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Are We Just Aching for a Surgical Fix? Part 3 -- Any ideas on how we can know?
17 Aug
In part 1 and 2 of this little series, we looked at studies that found similar positive outcomes for patients whether they used physical/training rehab only or had the surgical intervention. This kind of information gives us the chance to consider our own attitude towards surgery.
The issue of whether to have a surgery is not simple. As I have tried to figure out my own health needs this year or walk through it with clients, I am continually struck by how challenging it is to have enough information to make make good decisions about potentially life-changing surgeries with very sketchy information. The standard answers of get two opinions or check your doctor's ratings simply don't begin to cover the information needs. At this point, I have only more questions. Among them:
When are we simply in too big of a hurry to get past pain or limitations instead of moving with the body's healing rhythm? How can we know?
If we are in this helping, teaching, health profession, how can we help others discover?
How can we be part of creating a system that lends itself towards reduction of unnecessary surgeries?
How can we be part of creating a system that lends itself towards reduction of unnecessary surgeries?
Hope to hear your thoughts and ideas and questions on this important subject.
submitted by Cynthia Allen
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Are We Aching for a Surgical Intervention? Part 2 of 3
13 Aug
How Much Does Knee Surgery Help?
Tuesday, I posted about a 2002 study on arthroscopy for osteoarthritis. In the past few days, the New York Times highlighted a study published this year. As always they have very readable articles. http://nyti.ms/binvsE Take a look first hand or read on for my synopsis.
The study followed two groups of people with a torn anterior crutiate ligament (ACL): one group received physical therapy and the other surgical intervention. The upshot of the research was that outcomes for the two groups were virtually the same after two years. The rebuilding of the ACL in the knee resulted in greater stability, but not in a knee that was necessarily healthier than one without surgery. The researchers are suggesting that as many as half of ACL surgeries are unnecessary.
Published in 2009, a ten year retrospective study reviewed the outcomes of various ACL interventions and noted that stability in the knee joint is often associated with health. And indeed, those with the surgery have greater stability. But in terms of functional capacity, those opting for a conservative treatment plan did just as well.
This is again a surgery where surgeons and patients report good outcomes. But what if, as the researchers suggest, half of the people getting surgery don't really need it and would do just as well with conservative treatment?
In the last post of this series, I am going to invite discussion around the difficult topic of how any of us can make wiser decisions related to surgery or not.
submitted by Cynthia Allen
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Are we just aching for a surgical fix? Part 1 of 3. Be prepared to be surprised...
11 Aug
A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
N Engl J Med 2002; 347:81-88 July 11, 2002
Recently, while reading Bruce Lipton's Biology of Belief, I became aware of a study done in 2002 evaluating the effectiveness of surgery for debilitating knee pain related to arthritic changes in the joint. Arthroscopic knee surgery for osteoarthritis is now quite common. People report good results. Surgeons know it works. But some researchers felt that WHY the surgery works was still a question to be answered.
So they set up a study. 180 people were randomly divided into two groups. One group, a placebo group, underwent a sham surgery. Yep...they received skin incisions and underwent a simulated debridement without the insertion of the arthroscope. The other group received the real surgery.
The results are shocking even to me (who isn't big on surgical interventions). Over 24 months, there was no clinically significant difference in outcomes for the two groups. Both benefitted.
This particular study raises questions for me, such as:
- Do patients "comply" (a nasty word but it is what the medical profession uses) better with therapy after the surgery because they "now have confidence it will get better?
- Does the surgery force a slowing down and working the plan attitude?
- Do therapists' mindsets change, thereby improving the quality of their interaction with patients?
- Is the standard protocol used for post surgical rehab different than that used when a person presents with knee pain from osteoarthritis?
Read the study first hand. http://itybityurl.com/11671
Enter the dialogue.
What does this mean to us as patients wanting to heal?
How can we determine the best path?
When are we simply in too big of a hurry when life has its own rhythm? All are questions for me.
Tomorrow I will post on a recent study comparing knee surgery for torn anterior cruciate ligament and conservative treatment. I bet you know already what the results will be....
submitted by Cynthia Allen
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Science and Somatics | a practitioner’s guide
12 Feb
Three seasoned practitioners in the Feldenkrais Method and Bones for Life Trainers offer their knowledge by publishing periodic papers. Check us out regularly as we write and post articles aimed at bridging the gap between Science and Somatics. Many articles include an addendum that highlights the benefits of the Feldenkrais Method and/or Bones for Life for the topic matter at hand.
 Cynthia Allen GCFP, BFLT/T |  Denise Deig MS PT, GCFP, BFLT/T |  Carol Montgomery MSPT, GCFP, BFLT/T |
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| Vol. 1, Issue 15: Walk Like an Upside-Down Pendulum by Cynthia Allen |
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| Vol 1. Issue 14 Total Joint Replacement by Carol A. Montgomery. If you work with individuals with Total Hip Replacement, in particular, this is a great reference. |
| Vol 1. Issue 13 Spine Surgery by Denise Deig. |
| Vol 1. Issue 12 Spinal Disc Disease by Denise Deig. This article reviews Thinning, Torn, Bulging/Slipped, and Heniated/Ruptured Disc, Radiculopathy and Sciatica as well as the more general diagnosis of Degenerative Disc Disease.  |
| Vol 1. Issue 11 Spinal Stenosis by Denise Deig |
| Vol. 1 Issue 10 Spondylolithesis by Denise Deig |
| Vol. 1 Issue 9 Scoliosis by Denise Deig |
| Vol. 1 Issue 8 Spondylosis: Osteoarthritis of the Spine by Denise Deig |
| Vol. 1 Issue 7 Knee Osteoarthritis by Carol A. Montgomery |
| Vol. 1 Issue 6 Osteoarthritis by Carol A. Mongtomery |
| Vol. 1 Issue 5 Osteoporosis by Denise Deig |
| Vol. 1 Issue 4 Bone Mineral Density by Cynthia M. Allen |
| Vol. 1 Issue 3 Research Bibliography: Related to Bones, Gait and more compiled by Cynthia M. Allen |
| Vol. 1 Issue 2 Reviewing and Using Research by Cynthia M. Allen |
Vol. 1 Issue 1 The Birth of Osteoporosis and Osteopenia as Diagnoses by Cynthia M. Allen |
As we develop more articles, we will add them to this post. Let us know if you find value in them. We want to hear from you. You may also find our Animation Library helpful. Here you can watch overviews of a hip or total knee replacement, various spinal disorders and even print quick brochures that include all the pictures and test. Note: The topics here are for informational purposes only. They are not intended as a substitute for medical advice from your health care provider. Any decisions you make regarding your health care options should be made after consulting with a qualified physician.
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