![]() Overdiagnosis in musculoskeletal medicine When pain is concerned, ‘too much medicine’ is a train we no longer have control over, it is filled with zombie patients and practitioners and the best we can muster is a few rocks thrown at the track. If the medical system has become unruly in these other areas, then it is a runaway train when it comes to musculoskeletal medicine. ![]() Musculoskeletal problems represent the majority of chronic pain conditions, and low back pain represent the majority of musculoskeletal problems – for this reason I will use these terms interchangeably throughout. Chronic pain is costing more to the Australian Society than cardiovascular disease and diabetes combined ( Ref ). I think it’s important to zero in on this area amongst the broader ‘too much medicine’ concept because the musculoskeletal problem dwarfs the others mentioned. I will focus on the musculoskeletal application of this concept. The overdiagnosis concept can apply to all of medicine, but it may be most well known in the fields of cancer, cardiovascular and diabetes. Some selected work is (there are probably far better examples) here, here and here. This is a concept far too complex to fit into any publically consumable blog, so for brevity and background, I recommend you read all of Lisa Schwartz and Steve Woloshin’s work or Ray Moynihan’s work. This blog is a reflection on the recent Preventing Overdiagnosis Conference 2019 in Sydney, Australia.
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