Gradual Onset Diseases: Misperception of Disease Onset

Discretionary Surgery: A Comparison of Workers’ Compensation and Commercial Insurance

“…Current best evidence supports the concept that rotator cuff disease is an expected part of human aging that develops in the absence of injury, and many patients, if not most, have few symptoms or are well adapted. 6 Similar to other musculoskeletal conditions, 8 newly symptomatic rotator cuff tendinopathy is often misinterpreted as an injury. 9 This misinterpretation may be reinforced when magnetic resonance imaging findings of a defect are interpreted as a “tear” and signal changes and thinning consistent with age-related tendinopathy are interpreted as a “partial tear.” 6,12,13 When a patient is told that they have a “tear,” they may assume that they have an injury and that surgical repair is necessary.…”

“…Although age-related conditions such as rotator cuff tendinopathy and hand osteoarthritis are prevalent and often asymptomatic among the adult population, 6,7 they are often misperceived as an injury when they are newly symptomatic. 8 Studies have shown that people who claim a work injury on one shoulder or knee often have similar or worse age-related changes in the opposite, asymptomatic shoulder or knee. 9 It can be argued that there is no basis for coverage of these conditions by workers’ compensation insurance when there is no clear evidence that a work-related injury was the cause of pathology, especially because there is evidence that such coverage may increase symptoms and limitations.…”

Recovery After Musculoskeletal Injury: Mental and Social Health

“…Think of the lifelong laborer in their 50s unsure of how they will make a living as they start to experience the influence of age on the body. They often present with the misconception that new symptoms indicate new pathology 52,53 or even an injury. 52,54,55 In addition, they may pin their last hope on the orthopaedic surgeon fixing the problem.…”

Editor’s Spotlight/Take 5: Discussing Two Systematic Reviews With Opposing Conclusions on Shoulder Pain After Vaccine Administration

“…Before we theorize that "vaccination can harm the shoulder," we should first consider the potential for harm inherent in the concept. Theories, injury, or harm can reinforce our natural human tendencies to interpret a new pain as signaling a new pathology [23,38] or perhaps an injury [12,24], and a painful activity that will make the problem worse [8,34,39]. These natural-albeit, largely unhelpfulthoughts are measured using instruments such as the Pain Catastrophizing Scale [34], the Tampa Scale of Kinesiophobia [39], and the Negative Pain Thoughts Questionnaire [8].…”

“…Dr. Srikumaran and I agree that there is no evidence of permanent, unique, vaccine-related harm even in the most closely studied patients. The word "injury" is likely being misapplied [5,38] as words often are in discourses about musculoskeletal health [32].…”