Back and shoulder surgery is often worse than useless
Back and shoulder operations for chronic pain are increasingly being questioned, with many citing evidence that common procedures offer little more benefit than placebo and can even cause long‑term harm. Commenters highlight how financial incentives, patient demand for quick fixes, and overreliance on MRI findings drive unnecessary surgery, even though many “abnormal” scans occur in people without pain. Alternatives such as targeted physical therapy, strength training, lifestyle changes, and better diagnostics are emphasized, alongside anecdotes of both surgical success and serious complications, underscoring how hard it is to decide when the knife is truly warranted.
Access to Information
- Several commenters criticize paywalled articles (Economist, Times), sharing alternative links and an archive.
- Some report gift links expiring quickly, limiting broad access to the evidence being discussed.
Personal Experiences with Back Surgery and Chronic Pain
- Multiple anecdotes of severe spinal conditions (herniated discs, stenosis, degenerative disc disease) where surgery did not resolve pain or led to complications.
- Others report transformative benefit from fusions or disc replacements, regaining mobility and normal life.
- A recurring point: imaging can look “terrible” while some people have little or no pain, and vice versa.
Shoulder Surgery: Mixed Outcomes and Decision-Making
- Many users weigh potential shoulder surgery; experiences range from “life‑changing, near-total relief” to partial or unclear benefit.
- Some decided against surgery after multiple surgeons said the likely benefit was uncertain; symptoms later improved with time.
- Advice centers on: ask about long‑term outcomes (10–20 years), exhaust conservative care, and understand the surgeon’s expected odds and error bars.
Physical Therapy, Strength Training, and Lifestyle
- Strong theme: posterior-chain and core strengthening, mobility work, and Pilates or targeted PT often reduce or eliminate chronic back/shoulder pain.
- Counterpoint: some develop chronic pain from strength training despite careful programs.
- Commenters stress ergonomics (chairs, beds), consistent exercise, and posture awareness; but note time and discipline constraints in real life.
Overuse of Procedures and Low-Value Care
- Critique of fee‑for‑service systems and patient belief that “more intervention is better.”
- Estimates that a large share of care is low-value; insurance denials are framed partly as a blunt tool against this.
- Even in public systems, patient demand and “quick-fix” expectations drive unnecessary procedures.
Imaging, Access, and International Comparisons
- Claims that regions like Massachusetts have more MRI machines than entire countries; contrasted with Canadian wait times of weeks to months.
- Some US patients also report long waits and insurance-based cancellations; others get next‑day scans.
- Debate over private vs single‑payer models, dual systems, and medical tourism.
Uncertainty, Risk, and Iatrogenesis
- Concerns that surgical risk and complications are undercounted or obscured in statistics.
- Emphasis that enforced rest after surgery may be the real healer in some cases.
- Concepts like iatrogenesis and placebo‑like effects of some procedures are raised, alongside confirmation bias from imaging findings.
- Alternative ideas appear (peptides, Sarno/TMS), with both curiosity and skepticism; evidence is described as unclear or lacking.