What is "sick talk" and why should you care?

“Sick Talk” is a term that is used to describe using words that validate, maybe give larger life to some sort of medical diagnosis than it deserves. It is something that generally works against you when it comes to recovery. Medical providers and the internet can be just as guilty of using it as someone who has no clinical knowledge.

There are so many examples of this it’s hard to pick one, but let’s go with “Arthritis”. You hear it all the time “the doctor told me it was bone on bone and that I need a joint replacement”. Then the patient describes pain that has been there for a few weeks. Some days it hurts a lot, and some days it seems okay and doesn’t hurt at all.

From rational perspective we can understand that the likelihood of a joint getting to “bone on bone” did not happen over the course of “a few weeks”. The joint was most likely like that (based on X Ray) long before the pain started in (so already the clinical relevance of the X Ray comes under scrutiny). On top of that, the patient has good and bad days. I think it is safe to say the “bone on bone” status does NOT change day to day allowing the patient to have both good and bad days.

So then, what is the cause of the pain? Well, that is the million dollar question. In my experience a lot of the time it comes down to something like a malpositioning of the joint, or a structure within the joint, or an imbalance around the joint. When I am talking to patients who had a total knee or hip replacement I am amazed at how often they will tell me “this one (the non surgical one) was worse on X Ray. We just did the other one because it hurt me more. The Doctor was surprised the other one didn’t hurt” (because it looked worse on the X Ray).

Whoa, hold the phone. That is quite a statement. Two knee’s, both degenerative and arthritic, and the one that gets surgery is the one that looks better on X Ray (because it hurt more)? So ultimately surgery is done on the knee with “less arthritis” because it was more painful. However it was the X Ray finding of the “bone on bone” arthritis that led to the patient being told to have surgery in the first place. Maybe the severity of the X Ray finding is not as directly correlated with pain as we believe. That in fact is often the case.

“Sick Talk” is a term that is used to describe using words that validate, maybe give larger life to some sort of medical diagnosis than it deserves. It is something that generally works against you when it comes to recovery. Medical providers and the internet can be just as guilty of using it as someone who has no clinical knowledge.

There are so many examples of this it’s hard to pick one, but let’s go with “Arthritis”. You hear it all the time “the doctor told me it was bone on bone and that I need a joint replacement”. Then the patient describes pain that has been there for a few weeks. Some days it hurts a lot, and some days it seems okay and doesn’t hurt at all.

From rational perspective we can understand that the likelihood of a joint getting to “bone on bone” did not happen over the course of “a few weeks”. The joint was most likely like that (based on X Ray) long before the pain started in (so already the clinical relevance of the X Ray comes under scrutiny). On top of that, the patient has good and bad days. I think it is safe to say the “bone on bone” status does NOT change day to day allowing the patient to have both good and bad days.

So then, what is the cause of the pain? Well, that is the million dollar question. In my experience a lot of the time it comes down to something like a malpositioning of the joint, or a structure within the joint, or an imbalance around the joint. When I am talking to patients who had a total knee or hip replacement I am amazed at how often they will tell me “this one (the non surgical one) was worse on X Ray. We just did the other one because it hurt me more. The Doctor was surprised the other one didn’t hurt” (because it looked worse on the X Ray).

Whoa, hold the phone. That is quite a statement. Two knee’s, both degenerative and arthritic, and the one that gets surgery is the one that looks better on X Ray (because it hurt more)? So ultimately surgery is done on the knee with “less arthritis” because it was more painful. However it was the X Ray finding of the “bone on bone” arthritis that led to the patient being told to have surgery in the first place. Maybe the severity of the X Ray finding is not as directly correlated with pain as we believe. That in fact is often the case.

(Mechanical Diagnosis and Therapy aka McKenzie method) has been proven time and time again and is based on motion and patient self treatment strategies. Choose your clinicians wisely, and educate yourselves. Don’t let “sick talk” from friends, family, or providers limit your ability to recover and get painfree again without surgery!

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