Thursday, April 30, 2015

"Like a bridge over diagnosis"

Or, if you prefer,  Like a Bridge Overdiagnosis. 
Anyway, this link crossed my path, about how verbs of clinical observation are turned into "nouns" of diagnosis, and how this can be a real disservice. 
Why?
Because as soon as an event or a verb or a set of symptoms floating by in awareness are turned into a "noun" that has a "name" it is then regarded by our human brains as a "thing". 
This is called "reification" - treating an abstraction as if it were a real thing. 

Then the instinct to go after that thing, hunt it down and nail it, switches on.  Especially perhaps in the medical world, because of the momentum for preserving "life" by fighting anything that has been labelled a "disease". 

For your listening and viewing pleasure:



A few days ago I blogged about some papers indicating that yes-ciception (or, as I like to call it, social grooming) can trigger growth of new neurons in the spinal cord that inhibit nociception.

I think this is a wonderful start to a vindication of keeping manual therapy (or as I like to call it, human primate social grooming) in our scope. 


I included a video of Martin Hey speaking at a conference about the state of the profession

PT is kind of a mess these days, everywhere, not just in the UK.
Every so often though, I see something that cheers me up again. 


I had not seen Nancy Zimny's paper before, but I like the gist of it.
Nancy J. Zimny; Diagnostic Classification and Orthopaedic Physical Therapy Practice: What We Can Learn from Medicine. J Orthop Sports Phys Ther • Volume 34 • Number 3 • March 2004 (FULL TEXT)

This paper comes even closer to taking Occam's Razor to all the clutter of orthopaedic overdiagnosis.
René Pelletier, Johanne Higgins, and Daniel Bourbonnais; Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders? BMC Musculoskelet Disord. 2015; 16: 25.  (FULL TEXT)

Finally, because it is so engaging and brilliant, 
Arnold C; Ants Swarm Like Brains Think. Nautilus April 23 2015

(It's basically a reprint of her article from about a year ago, by the same title: Ants Swarm like Brains Think, April 24 2014 with the idea of positive feedback loops extracted/emphasized, and blogged about here: The ants go marching one by one.)

It seems to me that positive feedback loops operate at societal levels too, maybe even easier than they do at ant levels or neuronal levels. 
Maybe that's why medicine and especially orthopaedic medicine and certainly the app to orthopaedic medicine, known as PT, has succumbed to overdiagnosis. 

Isn't it all long overdue for some social inhibition?





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