full article 1000 words
Healing speed is of great interest, and people often believe that treatment X helped them to heal faster. It’s a common marketing claim, of course. A perfect current example is platelet-rich plasma (PRP) injections, which are often branded as a “regenerative” treatment that accelerates the return of injured tissues to a normal tissue state.
Unfortunately, most patients have no basis of comparison, no idea what constitutes a normal healing time — because there is no such thing. Experienced clinicians don’t really know what a normal healing time is either.1 People often recover faster or slower than expected for reasons no one can ever know. We also seem to recover faster or slower depending on which psychological “goggles” we have on (optimistic, pessimistic, etc).
Even if natural variation in healing times didn’t obscure the effects of treatments, it still wouldn’t be possible to know if any treatment helped us heal “faster,” because we can never know in any given case how long healing would have taken without the treatment. You also don’t know what will happen the next time (it could be completely different). The only possible way to settle such questions and confirm a faster average recovery time — especially if it’s only a little bit faster — is with carefully designed scientific testing, and quite a bit of it.
Healing mostly just takes what it takes. It usually starts slowly and then accelerates, as long as nothing gets in the way or goes wrong. A great deal of treatment and therapy are simply a matter of making sure nothing gets in the way or goes wrong — which can be worthwhile. They often get credit for that natural acceleration phase.
Healing in the broadest, subjective sense is recovery from any pathological state, which may have little or nothing to do with any tissue repair that can be sped up. For example, a patient with a tumour may be doomed but otherwise healthy. If the tumour is successfully surgically removed, the patient has “healed” — more less instantly, just by taking out the cancerous trash.2 It’s certainly “healing” from the perspective of the patient! But almost none of medicine’s greatest hits have anything to do with speeding up the biology of healing.
The main kind of healing that can in principle be accelerated is wound healing, the most literal sort of healing, which is a mix of regeneration and repair: either growing new cells where possible, or patching the damaged area with scar tissue. Almost none of medicine’s greatest hits have anything to do with “accelerating” the biology of healing. The more and faster the regeneration, the better, of course … but we’re kind of stuck, for now, with our biological destiny as mediocre regenerators.3
There are also a lot of common problems, especially in musculoskeletal medicine, where there is literally nothing to regrow or patch — and therefore no “healing” to accelerate even in principle. Here’s a couple simple, obvious examples…
And so on. The longer you look at it, the more obvious it becomes: “healing” is not one thing, but a thousand different things … most of which cannot be hurried.
You may not have much control over it, but most healing does progress steadily and even accelerate: the better you get, the faster you get better, a “delicious cycle.” But…what if it doesn’t? Continue reading with Healing Usually Accelerates.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.