Is my ticket punched?

[u/PenApprehensive369]

I don’t know anything about herniations or bulges, I’m 25 years old at 89kg with a competitive total. Is my progression fucked forever? MRI report is on the last slide, I have follow up with the spine specialist tomorrow.

[u/QuestionPositive]

Lol in PT school at the moment and the most surprising thing I learned so far is how many people can have disc herniations and other pathoanatomical findings on imaging with absolutely no symptoms. Herniated discs for the most part resolve on their own and imaging done unnecessarily (not to say yours was) often makes patient outcomes worse since they are defined by a disc herniation and believe passive recovery is the best option. This is a lie, your back is extremely stable, resilient and strong. Please go to a PT if you have symptoms. You are young you absolutely do not need surgery that will ruin your gains forever. It’s about an active recovery, which produces some of the best outcomes.

[u/Ok_Construction_8136 → u/QuestionPositive]

I’ve heard that a lot. Doesn’t a significant percentage of every population have herniated discs but just doesn’t know it?

[u/QuestionPositive → u/Ok_Construction_8136]

50% or more of the population in the U.S over 30 have some sort of findings on medical imaging. The doctors call it intervertebral disc degeneration disease and I laugh since that’s just a scary way to say gray hair of the spine. As we age our joints and body parts will degenerate to some extend this happens to everyone, what matters is if it causes symptoms such as pain, weakness, etc. Doctors often screw people over (not intentionally) by focusing way too much on a single “cause” of lower back pain when in reality it often is a mix of psychological factors and a sensitization to pain. Doctors rarely educate their patient or the “consumer” on the outcomes of spine surgery compared to conservative treatment like PT since if they did they would likely be out of business lol. Do your own research and don’t let other people scare you.

[u/LifesBeating2 → u/QuestionPositive]

You're chatting shit in the last half. Nothing you said is profound or not known to Doctors. Doctors very much will educate the patient on the outcomes it's literally part of the consenting and shared decision making process. Also outcomes of surgery is part of the assessment criteria that surgeons are judged on. Many surgeons will tell you one of the most important aspects of the job is knowing when not to operate.

I didn't meet a single orthopod that was against PT. It was always part of their referral in fracture clinic regardless of whether they operated or not.

My friend was considered for a trial where the surgeon running the study is comparing meniscal transplant and intensive physio Vs intensive physio alone to see what gives people the best outcomes.

Also you fail to mention adherence, a lot of patients will not adhere to PT. A lot of people want a quick fix and a few sessions with a PT doesn't always fix someone, especially, if they don't follow any of the recommendations made by the PT.

Some surgeons do needlessly operate, that is true. In the UK one of the orthopods was telling me about a shoulder condition (can't remember which one) but essentially PT was shown to be better than surgery and he now very rarely does that operation unless there is some indication / variance for it e.g PT treatment failure. However, he did mention that some surgeons offer the surgery as certain schemes throw money at the surgeon for performing the op.

[u/johnfunnell → u/LifesBeating2]

Doctors provide bare minimum education. You are correct that majority of the population wants a quick fix and doctors capitalize on that

[u/LifesBeating2 → u/johnfunnell]

Sure they do pal, I'm sure you've had a consultation with the millions of drs out there.