Detailed, evidence-based help for common painful problems

Should I have surgery?

 •  • by Paul Ingraham
Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

People often seem to expect me to be clearly for or against orthopedic surgery for a specific condition, as if the diagnosis is the only factor, as if people with certain conditions should almost always have surgery, or almost never. Putting aside the absurdity of asking me, a non-surgeon, it’s obviously more complicated than that. Here’s my standard basic answer to “should I have surgery?”:

Many orthopaedic surgeries are proving to be mostly bogus (see Louw et al), so we must be quite wary. But there is always a real chance that surgery is worth it for your case … even if it’s probably not worth it for 20 other people. So you have to ask a couple surgeons about your case, and ignore the ones who don’t seem to be aware of how often surgery fails. The best shot you can have at knowing if surgery is a good idea is to have a good conversation about it with a humble surgeon.

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