Hierarchy of Care #2

To be safe, I generally recommend a hierarchy of health treatment. You realize that I am talking of non-emergency issues here. By hierarchy, I mean starting with the least invasive type of treatment with the lowest risk and working up to methods with more risk. For example, you can start with home remedies and if those don't do the trick, check with your health care practitioner that uses generally safe methods such as massage therapy, chiropractic and acupuncture. From there you go to drug therapy and finally surgery. Drug therapy and surgery have their hierarchies too. Start with milder drugs and work up as needed. With surgery, find the surgeon who specializes in the least radical approaches first.

BACK PAIN EXAMPLE

I am a chiropractor, so it is easy for me to use this example. Let's say you are developing back pain. You might start treatment with low back stretches, modifying your activities such as how you lift, sit and sleep. It might be time to get a new mattress. Then add exercises such as walking and weight workouts at the gym, maybe with a trainer. Exercise in the pool can be helpful for some as is yoga and/or Pilates.

If that doesn't work, now move on to therapies such as massage, chiropractic and acupuncture. These practitioners might also have some nutrition ideas that can help your body heal.

From there you move to pharmaceuticals and maybe injections. If you still aren't getting the relief you need, it may be time to start thinking surgery.

Surgeons today seem to be fusion happy. This isn't because fusions give the best results. The surgeon's fee for a three-level fusion is more than most people make in a year. No wonder they like this. You should start talking with a surgeon who specializes in the least invasive, clean-up methods. You can always do the more radical procedures if all else fails. You might have to do some hunting to find the appropriate practitioner, but it will be worth it.

SAME FOR KNEE REPLACEMENT

The same hierarchy works for knees too. I see too many people jumping right to a knee replacement. Too many alternatives are available, including stem cell procedures to start with the most radical of methods.

You will be wise to stay away from medicine as much as possible. Did you know that properly practiced medicine is the third leading cause of death behind heart disease and cancer? That doesn't seem like a world you should rush into, does it?

START WITH TREATMENTS WITH LOW RISK OF COMPLICATIONS

So, to sum up, we like to work from remedies with lower rates of risk and move up as needed to more radical treatments with higher rates of poor outcomes. This approach takes time and research but the more radical the treatment, the higher rate of permanent problems. Again, I see way too many people jump to knee replacements and spinal fusions when they should be using the hierarchy process.

Often a person can get the results they need from a supplement and diet changes instead of drugs with a long list of possible bad effects. Sure, insurance won't help out and it takes some effort, but we are talking about your health here.

A side note on stem cell treatments. These are getting better and better, but you will still find a wide range of expertise and methods until this gets standardized sometime down the road. We have seen good things from the right approach from our docs in Reno. We can help direct you to this type of therapy if that is where you are in the healing process.