Physical Therapy

Words Matter

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Words Matter:
Language choices made in medicine

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Communication between patients and their medical providers plays a large role in a patient’s understanding of their diagnosis and management options. It can drive a patient’s decision to undergo surgery, start PT, or choose no treatment at all. Whether it is your PT or PCP, you are likely being infiltrated by words which may be scary and/or confusing. Some examples might be “disc herniation of L3-5, severe foraminal stenosis, degenerative disc disease, tibiofemoral osteoarthritis, etc, etc.”

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Research has shown that when a more medically precise term is used to describe a patient’s condition, they tend to have a stronger preference for choosing more invasive treatment options even if this might not be the best option. Additionally, a person feeling fear or anxiety as a result of such terminology is going to have greater difficulty making informed decisions that let them be an active participant in their care. To keep the story short and sweet, try to not let words scare you. And if you do find yourself scared by your diagnosis and treatment option, ask for an explanation that helps you understand your diagnosis better and that lets you move forward with confidence in whatever treatment option you choose. Chances are your diagnosis may not be as bad as it sounds in words or on the MRI report you receive from your doctor; and it may have several conservative treatment options that would be beneficial. Be an active participant in your care and seek out the answers to the questions you have to ensure you’re getting the best possible treatment for your condition.

Citation: “Words do matter: a systematic review on how different terminology for the same condition influences management preferences”

PRP

What is a Platelet-Rich Plasma injection?

Background: Platelet-rich plasma (PRP) injection is a medical treatment for orthopedic injuries and conditions. PRP is a form of your own blood that has a high concentration of cells called platelets. Platelets contain substances called growth factors that have the ability to reduce some pain and inflammation and enhance your body’s ability to heal itself. A PRP injection can possibly reduce the need for surgery or procedures for some people. 

PRP injections have been used to treat a range of conditions including to treat orthopedic conditions, including osteoarthritis, tendinitis, tendon and ligament tears.

Platelets contain components that can be effective in tissue repair:

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  • Connective tissue growth factor (effective on cartilage, tendons, ligaments, bone growths)

  • Insulin-like growth factors: IGF-1 and IGF-2 (increase tissue proliferation, decrease inflammation

  • Vascular endothelial growth factor

  • Epidermal growth factor (EGF)

  • Fibroblast growth factor (helps wound healing, aesthetics)

  • Keratinocyte growth factor (helps wound healing, aesthetics) · Interleukin 8

  • Transforming growth factor beta (TGFβ)

In my case the PRP was used to treat a moderate medical meniscal tear on my left leg. This was an injury that was at the time of injection 6 months old. I had put myself through a conservative rehab regimen of originally rest, then Range of Motion work, and eventually open & closed chain strength training. A side note which I will cover in another blog are the issues that I had for the previous 6 months in compensating for the tear and pain.

The procedure is relatively quick. From check in to walking out was under 60 min. The pain level was very low in my opinion. The knee capsule does have a fair amount of nervous tissue as the wider gauge needle comes into contact with it but would likely rate this a 4/10 and only for 15-20 seconds….

I will be writing more articles on my progression & protocols that I am developing to better work more efficiently with individuals after PRP has been completed.


There are many Offices where PRP is performed:
(here are a few we work with commonly)
Lake Washington Sport & Spine
ProOrtho: Dr. Camille Clinton, MD
Dr. Ghislaine Robert, MD
UW Medicine: Dr. Rao