6.05.2015

Orthopedic Snake Oil

The original.
No to be confused with the poser snake oils like emu oil.
Snake Oil never went away. In terms of popularity, snake oil is more potent then ever! Let us put aside the fad diets, most (but not all) supplements, over-the-counter joint creams (Emu oil, really), or exercise gadgets. For now I'll run with what I know well, the structure and function of the neuromusculoskeletal system.

To be clear, I'm rarely against any one treatment or method, especially if the side effects are minimal. If you have found some item or method that sounds suspect to me but has proven beneficial, who am I to tell you to stop? What I'm against is all the weaseling and pandering and clearly false promises in the healthcare and wellness communities.


The gimmicky sales and fraudulent claims can be found everywhere. A good example of medical pseudo-science can be found at Inlet Physical Medicine.

http://inletphysicalmedicine.com/neck-shoulder-pain-relief/

First off, the name. To me the word "physical" implies some type of active involvement where the patient (er, customer) actually has to move or, ya know, do something on their end. But there is not one hint of this. The entire site speaks "it is up to us to fix you and unlike everybody else, we can."

Most of the site is clearly written to please a Google bot far above an actual person. Which is fine, but let's not pretend this is medical information. For example;

In Murrells Inlet, SC, chronic pain management, is managed by the medical professionals at Inlet Physical Medicine, who work within physical medicine disciplines to create a customized treatment plan.

They go on to make many claims, chief among them being that you will Avoid Surgery with a New, Non-Surgical Treatment That Delivers Safe, Lasting and Remarkably Effective Results!

I want to give them the benefit of the doubt, for I understand that neck and back pain is common, complex, and often treated inappropriately. But the magic healers at Inlet Physical Medicine are apparently standing against the world.

They ask how it can be possible that a treatment for back and neck pain does not exist. I suppose they have not considered the countless people who physical therapists (and other providers) help every day. No, most people do not fail traditional models of physical therapy. I see most (but certainly not all) of my clients walk out the door feeling and functioning much better.

No, orthopedic doctors usually do not rush to surgery. I've spent hours in the exam room with some of the most well known orthopedic doctors in central PA. My point of contention is with their emphasis on cortisone injections, but that's another matter. But they definitely do not push surgery until patients are practically begging for it.

BANDS AROUND THE WAIST
seem to be an enduring gimmick.
Inlet Physical Medicine claims to possess a technology that allows them to determine precisely what's wrong and where the pain is coming from. To the average Joe this sounds like common sense. But to the trained clinician it's generic bunk. How are they determining precisely what's wrong? With nerve conduction studies? Diagnostic ultrasound or MRI? Palpation? I would guess that it's something gimmicky such as detecting "hot spots" of temperature variation along the spine. Where are their reliability studies? Any legitimate healthcare professional will freely admit that there is no one method to reliably diagnose all typical sources of pain.

Another no:

Their "Spinal Decompression" is neither new nor cutting edge. What's relatively new is using that term rather than calling it "spinal traction." Although the details of the on:off cycle may vary between typical "decompression" and traction, there is no evidence that any one method provides a better outcome.

They also claim that Plasma Rich Protein and Laser Therapy are sure-fire ways to lasting pain relief. These modalities have been proven somewhat effective at the tissue level, and I would possibly use these if I had easy access to them. But there is far more to recovering well. For example, lets assume that we use these to facilitate healing of damaged and irritated tissues. The root of typical orthopedic problems is often mechanical (movement-related) in nature. Functional well in the long-term almost always requires consistent movement-related intervention.

One yes:

Yes I understand that just because I don't understand or believe in a certain treatment does NOT mean that it doesn't work. For this I rely upon a collective. I've worked taking formal and informal notes on thousands of typical and atypical people typical and atypical problems over the last 15 years. I've developed professional and personal relationships with a handful of family physicians, orthopedists, podiatrists, physiatrists, dentists, pain management doctors, and personal trainers. Over time, the truth gradually comes out.

In the end, I suppose that the real problem is the complex levels of bureaucracy among traditional healthcare professionals. Not that greedy and fraudulent mainstream professional don't exist. But even the sharpest clinicians with the best of intentions are usually rushed and unable to address their patients from a holistic, "whole person" perspective. They will not cater to a persons need to shun responsibility (at least in part) for their problem.They are unable to always offer clients a compassionate ear and take the time to research and refer them to an appropriate provider.

But there are plenty of pseudo scientists who will...

Instead try
Examine.com
http://www.ncbi.nlm.nih.gov/pubmed/
American Physical Therapy Association
American Academy of Orthopedics


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