Austin and Jordan,
First off, I want to applaud you for a great forum. I’ve enjoyed all interactions here.
I have two questions regarding things I encounter daily in the clinic.
Patient presents with (insert body part) pain. Patient underwent injection (ESI/cortisone/trigger point/wet needling/etc) 24-72 hours prior to evaluation. I ask “did it help?” A common response is no, followed by “the doctor said it could take up to two weeks to work?”
First questions:
Is this a valid statement? Is this the physician’s way of keeping people from coming back to the clinic? Is this the physician’s way of enhancing the placebo? Is this BS? All of the above?
Second question:
How can so many surgeries be “the worst I’ve ever seen?”
I look forward to your responses!
Matt
Hey, thanks for the kind words (and for contributing around here!).
No, it’s not a valid statement. Whoever says that is probably repeating things they heard when they were in training to perform the procedure in question. Additionally, they may have had this bias confirmed through uncontrolled observation where the natural history of a painful condition progresses (as I’m sure you know).
The typical line I heard when I was trained to perform joint injections (assuming a combination of analgesic/corticosteroid) is that the xylocaine would “work” quickly but the effects would also fade away within the subsequent hour or two, while the steroid would take a day or two to “kick in”. Of course, I’ve remained skeptical of all of this as well.
As for the second question … I have no idea, man. It’s malpractice.