Back and Shoulder Surgery Is Often Worse Than Useless
Millions of back and shoulder operations are unnecessary and can leave patients worse off. The Economist argues that with $500bn spent annually on adult care in America alone, and risks inherent in any surgery, many procedures should be scrapped.
Yet a growing body of evidence suggests millions of surgeries performed each year are unnecessary—and, given the risk of complications when a person is sliced open, often worse than useless.
- tptacek
This is a huge problem in US health care financing: we have a fee-for-service model, no price transparency, and a consumer base (insulated from a lot of the costs of procedures by indirect payment through employer-provided insurance) conditioned to think procedures are inherently good. We waste billions annually on procedures that shouldn't be delivered at all.
I'm fond of pointing out the stat (true as of a year ago) that Massachusetts (I think it's MA?) has more MRI machines than the entire country of Canada.
- nradov
There's a huge amount of confirmation bias in the process of diagnosing musculoskeletal conditions based on imaging studies. When a patient presents with a complaint about pain or lack of mobility then the care team will order imaging, and when they see some anatomic abnormality they'll assume it's causing the symptoms and needs to be surgically repaired. But studies have shown that if we perform the same imaging studies on a random population of subjects we'll find a lot of abnormalities and yet most of those subjects are asymptomatic.
- jader201
As someone who's going to the doctor next week to discuss potential shoulder surgery, this is timely.
I really need to figure out whether it's going to make things better or worse, but unfortunately, that feels like something a doctor can't guarantee one way or the other.
Any anecdotes or other experiences/thoughts are appreciated.
- philajan
Here’s the accompanying article from the Science & Tech section.
https://www.economist.com/science-and-technology/2026/09/23/...
Gift link: https://www.economist.com/science-and-technology/2026/09/23/...
- majorchord
As someone with herniated discs, spinal stenosis, degenerative disc disease and scoliosis for decades, who's already had surgery but still got worse... what else even is there besides more surgery?
I can't wave a magic wand and just put more space between my discs... that's the only thing that's going to ease off my pain as far as I'm aware.
- claaams
Well, sample size of 1 but a family member was in debilitating pain all the time until they had a couple vertebrae fused. They can walk and life is mostly normal for them now.
- bentt
I'd encourage anyone with chronic pain to explore the work of Dr. John Sarno.
https://en.wikipedia.org/wiki/John_E._Sarno
https://en.wikipedia.org/wiki/Tension_myositis_syndrome
These ideas and methods cured my back pain.
- txhwind
Most back and shoulder pains are caused by bad habits. Cutting something from your body doesn't help a lot. Go to gym or physical therapist first.