If I hear one more time “My Doctor said I have the need of a 100-year-old” or “my doctor said it’s bone-on-bone arthritis and that I have no cartilage,” I am going to scream. I’ve heard so many people say that the joint was almost nonexistent. My thoughts are usually, did you really look at the X-ray? Did they show it to you where instead of having a ball and socket joint there was just a stick on one side and the cave on the other side and there was no ball. Also, I want to know if the person knew that cartilage doesn’t show up on an X-ray. Cartilage and ligaments don’t show up on x-Rays, only bone.
Yes, I know there are medical conditions where the bone will wear away or some infection or bacteria did some damage to the tissue. The thing is when stuff like that happens those times generally tend to show up on the patient report or on the patient chart because it’s so significant that you definitely want to make sure you stated what in the Sam Hill was going on. In my 17 years as a therapist, I have worked with multiple patients that unfortunately after some type of joint surgery ended up with an infection and required some type of prophylactic spacer to replace the joint. This is usually a painful and slow process that feels like it takes forever to clear up the infection. These people sometimes end up requiring multiple surgeries. Fortunately most people don’t have that type of issue.
For most people when they are told that they have bone on bone it’s just that they have an arthritic condition. The good news is usually it can be managed with the proper non-invasive steps including diet/nutrition, exercise, proper progressive loading, managing stress, sleeping well, and other lifestyle changes. It’s not a quick process and it’s a lifestyle change you have to keep up. If I over-indulge in shellfish or red meat I know my knee will be madder than a wet hen.
I don’t want it to seem like the Medical Professionals are lying to patients on purpose. For the majority of providers, I believe that we seriously want to help but can use the wrong choice of words. In an effort not to try to trivialize the patient’s concerns, we can make things worse. I know that’s happened to me a few times. I can think of one instance when I was trying to explain to the patient what their X-rays were saying in comparison to the results of the assessment that I just performed. I was trying to let them know that it was a good day and that their prognosis was really good that there was gonna be a short period of therapy and they should be good to go. What they got from our little discussion was that the arm was FUBAR and their life was over. All because I didn’t use the correct words or failed to explain myself properly. Effective communication is definitely important
Other times in trying to make sure we explain the gravity of the situation we can sometimes use hyperbole in giving a description of what is going on. An exaggeration can make a slight rotator cuff tear seem like something that could ruin a patient especially if they aren’t quite familiar with the metric system. So something that could just be due to normal wear and tear can sound like the bone has been completely eaten away because of a poor metaphor or analogy by the physician or medical professional. We are told not to use jargon when we’re speaking with patients but aren’t really trained in how to communicate. It’s always sad to see a patient too shook to perform a certain activity because some medical professional somewhere made the mistake of telling them that a specific activity could mess things up worse.
I remember being told that due to my knee, I should never run again. I took that to heart so I know I didn’t run for a long time because I was afraid that I was gonna do more harm than good until I decided to be rebellious. I found out that running did not aggravate my knee more than normal and actually the weight loss from the cardio helped my symptoms.
Unfortunately, you do every once in a while get the doctors that verbalize situations to sound extremely negative, or even catastrophic. I can’t begin to understand why they would purposely put these negative thoughts in a person’s head and I’m not I’m going to try to guess why. These are the people that perpetuate the stereotype that all surgeon wants to do is cut or all a therapist/chiropractor wants you to do is come in 3x week forever.
Next time you get told that you have the hips or knees or the back of an octogenarian. Ask more questions to get a better understanding of what is going on. Let them know what you understand from the information that they gave you. Most likely you don’t have the worst shoulder that they’ve ever seen unless they have only been in practice 2 months.
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