It is as well to remember that diagnoses , by and large made without the benefit of the patient being a corpse and being examined by a coroner, are best guesses, based , we would hope , on best available evidence , common sense and the science of medicine. Many diagnoses offered to physiotherapists are clearly wrong , or at best , offered without the kind of tactile relationship consistant with examination protocols common to physiotherapy. It is fair to assume that in many cases where the "OA" and other pathological explanations are given for hip and knee pain , that the kind of thorough , manual therapy inclined examinations and post treatment testing routinely done by physios , are left out of the diagnostic routines of many GPs.
This is not a negative or disrespectful position to take , we all ( we would hope ) take our own brand of skillfullness to the table when we examine and assess, not someone elses.
Gps are generalists, physios who regularly work in the MSK arena , if not initially , then with practice , become akin to specialists. Particularly so when able to cross the floor as it were and discuss cases with both medical and paramedical colleagues. Who amongst the practitioners regularly seeing orthopaedic cases regularly, would not say words to the effect, It is as well that physiotherapy stands somewhere between Gps and surgeons , to filter and reduce those who without such attention , by themselves and others , would ultimately find their way , wrongly, prematurely or both , to the surgeons table .
OA certainly does occur , to joints, adding to the distress of those unfortunate to have progressed to the point of pain and disability. No doubt about it . My point , Mr Bed, is, are we keen and alert to the prospect that diagnoses like these are skewed by a lack of the very sensitivity and understanding that goes hand in hand with a willingness , indeed reson dete, to percieve pain as a companion to pathology , rather than to dysfunction.
We occupy a special position in the medical team . A position not so rigidly defined by issues of safety by exclusion , of pathological threats to life and limb. We are the group , who by our interest in function , will often see alternatives to surgery , to pills and potions , to bed rest , to the otherwise ultrconservative regimens predicted by medicines answers,. particularly to MSK problems.
This, really ,is our reason to be.
Referred pain is the most commonly mistreated , misdiagnosed, and misunderstood issue in medicine . By remaining alert to the prospect , even under the shadow of a confirmed diagnosis of OA related breakdown, I am able to offer significant problem solving to many whose future had been considerably altered by the prospect of only medical or surgical answers to MSK problems. I recommend readers become skilled in and alert to spinal neuralgic events in their assessments for this reason.