Samuel G Oltman, ND, RMSK
Defining success based on your personal timeline and preferences is one of the most overlooked conversations in orthopedic medicine. Is the goal to relieve pain as quickly as possible? Or is the goal to promote the best healing response possible for long term health? What outcome counts as “working”? On what timeline must this occur? The answers to these questions result in startlingly different treatment plans.
Most patients just want to “get better”. However, people don’t always have a clear idea of what “getting better” means. Unfortunately in my experience, many of the doctors they’ve seen don’t have a clear sense of what this means either. Even more unfortunately, it’s not communicated clearly and the patient gets a treatment they didn’t desire or need.
Short Term vs Long Term
Relieving pain in the short term can be achieved in a variety of ways for most conditions. This is generally most important for athletes or individuals who have immediate movement goals such as a race/event or a vacation. Having a short term goal like this is not shortsighted– it’s just clear thinking. The mistake is made when patients think the treatment they are receiving is best for their long term health and it’s actually a short-term pain reliever.
Long term goals tend to insinuate healing rather than just immediate pain relief. They also tend to be more functional: continuing participation in a favorite hobby or sport, or simply keeping up with the grandkids. This can mean more time with mild pain/discomfort up front as the body goes through the necessary processes to heal damaged tissue and learn new movement patterns. A longer timeline may only be weeks or months, but this can feel like a long time when you’re the one in pain. When healing for the long term is the goal, working through a few weeks of discomfort is a small price to pay to reach your ultimate goal.
Steroids vs Orthobiologics
Distinguishing between these two ways of thinking results in treatments that are often the opposite of each other. For short term pain relief, a corticosteroid injection (“cortisone”) is often the best treatment because it provides quick-acting inflammation reduction that tends to last for 1-2 months. Corticosteroids, however, are not a long term solution and the more they are repeated, the higher risk the patient has for accelerated degeneration in that area. Icing injuries is another example in this category that I will cover in-depth soon.
For long term healing, orthobiologic treatments (MFAT, PRP, Prolotherapy) are the best option (along with exercise) because they harness your body’s innate self-healing mechanisms. Orthobiologics, however, tend to cause some increased discomfort in the short term (1-5 days) and take 1-3 weeks to take effect. Over the long term, what we want to promote is healing, not merely the covering up of pain. Orthobiologics treatments are often the best available treatment available for the goal of healing but not for next-day pain relief.
The Cascade Regenerative Medicine Difference
At Cascade Regenerative Medicine, my goal is to provide the highest quality, most personalized holistic orthopedics care you’ve ever received. This includes a thorough discussion about your specific goals and the differences in the treatment plan based on if you are prioritizing short term or long term outcomes. I will fully explain the entire menu of options you have in front of you and the implications of each of them. Ultimately, it’s your decision what you want to have done to your body and I am not dogmatic about what medicine I use– I just want you to be clear about your choice. The only way to make an informed decision about your health is to be fully informed.
If you are seeing someone who isn’t discussing these differences, it is time to see for yourself how much better your orthopedic care can be at Cascade Regenerative Medicine.