photo: Ed Yourdon
Over the years, the medical community has created a need to give everything that can go wrong in your body a name; e.g. lateral epicondylitis (‘tennis elbow’), patellar tendonitis (‘jumpers knee’). A lot of the pain related conditions were defaulted to something ending in ‘itis’ implying an inflammation of a particular tendon or bursa, but these diagnoses only really apply to people in the acute phase of pain or injury. Quite often people continue to experience pain or dysfunction for months in the complete absence of swelling or inflammation. Labeling a five month old elbow or knee problem a tendonitis is just not accurate or helpful to the person in pain. The solution became to call them a tendonosis which acknowledges the tendon is not actively inflamed, but there is ‘disorder in the tendon.’
People tend to seek a diagnosis, but what they are really after is an explanation of why. When it comes to persistent pain, a diagnosis just gives you something to tell your family or employer ‘what you have,’ but typically does very little to help you get rid of it and can even hinder your progress. Most persistent pains in your body develop from a combination of mechanical, cognitive and emotional reasons and where it actually hurts is just the symptom at the end of a chain of events. Unfortunately most doctors’ knowledge level on musculoskeletal pain is limited to the area where it hurts and not the chain of events that made it hurt.
I try my best to not tell you ‘what you have’, but instead explain to you ‘what is going on.’ It is usually way more information than you were anticipating, but makes all the difference when it comes time to convince you that you may have to change some of your habits.