If a surgeon has told you that you’re not a candidate yet, you’ve been handed a waiting period, and it’s worth thinking carefully about what to do with it.
The message underneath “not yet” is come back when this is worse. That’s a reasonable position for a surgeon to hold — operating on someone who doesn’t need it is the bigger mistake — but it’s a strange thing to build the next few years of your life around. Sit with the pain, let it progress, qualify.
There’s another direction available. Rather than waiting to get bad enough for surgery, we can try to move you further away from needing it.
I can’t promise that will work. What I can tell you is that a lot of people are never offered the attempt.
What usually hasn’t been looked at
When a joint sits out of alignment, I want to know why before I decide what to do about it. Is the joint itself the problem, or is something pulling it there?
If something is pulling, then addressing the joint alone won’t hold, because the joint was the symptom rather than the cause. So before anything else I want to know which muscles are tight, which ones are doing work they shouldn’t be, what your day actually asks of your body, and where you’ve been compensating for long enough that you’ve stopped noticing.
That examination is unglamorous and it’s usually where the answer is.
A patient I think about
He’d had shoulder and neck pain for most of his life. Somewhere along the way he was told the shoulder pain was coming from his neck, and so the nerves running between the two were ablated — burned, to stop them carrying the signal.
It didn’t do anything.
When I moved his neck, the joints moved fine. When he moved it himself, there was restriction, tightness and pain. Those two findings disagreeing is one of the more useful things that can happen in an exam, because a joint that moves well passively and badly actively points at muscle rather than joint.
So we worked the soft tissue, decompressed the spine, stretched him out, and went looking for the areas of tension nobody had addressed. He left that first visit with roughly forty degrees more range of motion in his neck.
I did adjust a few things. The adjustment wasn’t the point.
Where I stop
If you bring me imaging that shows you need a hip replacement, we’re already past what I can fix, and I’ll say so and send you to someone who can. I’d rather tell you that on day one than take your money for six months first.
I refer out more than people expect me to. It’s not a failure of the approach — knowing the edge of your scope is part of having one.
The question underneath all of this
This is slow work. If what you want is a quick fix, I’m probably the wrong call, and I’d rather say that now.
But it’s worth asking where you want to put the investment.
The version of you three years from now, in a recovery room, hoping it worked? Or the version ten years from now who’s glad you tried this first?