Bend the Curve

Most orthopedic conditions naturally get worse over time. In the figure above, the red line shows how arthritis and tendinitis typically are allowed to progressively advance. The usual treatment paradigms for joint and tendon injuries is to temporarily control pain, wait for the condition to progress, then proceed with a fairly extreme surgical treatment such as joint replacement which involves cutting out the joint or a similar treatment.

A different approach is to try treatments that help to reduce the usual progressive course of the condition. This approach is meant to bend the curve of the usual progression, represented in the above figure by all the other lines. Instead of a linear progressive course, use treatments that bend that curve, maintaining functional ability, and prevent further damage.

This requires better and earlier diagnosis, a more detailed and individualistic approach to care, and a willingness to use all the available newer non-surgical treatment modalities. It requires physicians who are looking for better treatment options, a healthcare team that is in tune with patient expectations, and patients who are forward thinking. Most of all it requires good communication and trust between the patient and her healthcare team.

Bending the curve is a newer way of approaching orthopedic problems. But these treatments are available already. While it may not work for someone with advanced conditions, for the rest of us this is a better approach than the usual care. Focus on interventions that have the ability to safely bend the curve.


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