After an eye-catching blog title like that, you're probably thinking that I am going to sit here and bash different medical procedures, injections specifically, for musculoskeletal pain management. That is not the case, however, I will provide a list of things you must consider and ask yourself prior to having the expectation that the Lord and Savior of your pain is NOT that cortisone shot, PRP, or Stem cell injection.
First, we send a high majority of our patients to NON-OPERATIVE Orthopedists when we believe conservative management is not the best option, we attempted a trial of conservative care with minimal results, or we need a more specialized opinion. There are many options they can provide and do have good results with their treatments. We prefer non-operative prior to those who are willing to cut anyone open because most MSK surgeries don't have the best long-term results (for non-traumatic/non-severe injuries). For example, meniesctomies have decent acute results within the first 1-2 years of surgery, but long-term outcomes are the same as those who never got the surgery.
That is one of many examples but really think about that for a second. 1-2 years after surgery you'll have somewhat less pain and somewhat more functionality after surgery, but after that, you'll end up the same as someone who had a similar injury and never had surgery. Wild thought.
What you have to understand with medical management in neuro-musculoskeletal pain is that you (the injured person) are a nail, and they (the clinician) are a hammer. They don't get paid by insurance to tell you that you can just rehab the injury and you'll be fine. They get paid to prescribe medications, and injections, or perform procedures. This absolutely isn't every doctor and we pride ourselves in whom we refer to, but we've seen some pretty wild recommendations when it comes to this stuff. Our latest example is of a knee pain patient who saw a highly-recommended ortho who used to work in professional sports. The athlete was told that rehab will most likely not help, resting 3 months from the sport is advised, to work out minimally, and PRP will help.
After asking a few questions, the patient was told the PRP injection would cost $600. The patient got a second opinion and was told that PRP was going to cost $2,000. The clinician who recommended the $600 said that the majority of those injections were 90% the same and it didn't really matter. The $2,000 injection argued it absolutely did. And what did both say would be the outcome of this? That the pain would most likely be taken care of, but still a good chance it will come back.
Now imagine putting that $600-$2,000 to learn how to move your body better, how to control your joint positioning better, how to improve your stability, your flexibility, your strength, your endurance, and so on. Sure one, might take time, sweat, and effort to learn how to move, perform your recommended exercises, and develop a plan that fits your schedule, but in the long run, doesn't that seem like a better option??
Cortisone injections have similar stories. We have patients who have had good results and patients that it did absolutely nothing for. The worst part is that cortisone is always talked about by patients as if it is this magic fix. It's really not that good for you and can result in quicker degenerative changes in a joint, especially if performed too much. Seeing someone believe it is going to be this magic fix and then get it done with no results is honestly hard to watch, but that's why we try and manage expectations from the beginning. On our end, it looks like we are just trying to keep them in the office, however, that's far from the case. The best part is, no matter the injection, physical rehabilitation, and movement are recommended with or without those injections.
In essence, injections have their time and place for a lot of injuries, however, they are not magical fixes that most people think they are. If it has come down to needing one, you need to have a list of questions to ask such as what are the outcomes, what are the risks, etc.
If you are dealing with an injury and need help and an honest opinion, Strength & Spine is for you. Schedule at strengthchiro.com today so we can get you started on your journey to being pain-free!
Dr. Cameron Gholampour DC, MS, CCSP
International Certified Sports Chiropractor
Strength & Spine Chiropractic
