I've had a searing rotator cuff for over 2 years. Someone recommended peptides called Wolverine Blend. It is now healed after 3 weeks of injections.

The thing is, this seems to be rather common.

This is a huge problem in US health care financing: we have a fee-for-service model, no price transparency, and a consumer base (insulated from a lot of the costs of procedures by indirect payment through employer-provided insurance) conditioned to think procedures are inherently good. We waste billions annually on procedures that shouldn't be delivered at all.

I'm fond of pointing out the stat (true as of a year ago) that Massachusetts (I think it's MA?) has more MRI machines than the entire country of Canada.

There's a huge amount of confirmation bias in the process of diagnosing musculoskeletal conditions based on imaging studies. When a patient presents with a complaint about pain or lack of mobility then the care team will order imaging, and when they see some anatomic abnormality they'll assume it's causing the symptoms and needs to be surgically repaired. But studies have shown that if we perform the same imaging studies on a random population of subjects we'll find a lot of abnormalities and yet most of those subjects are asymptomatic.

Strengthening my posterior chain solved my back pain from desk based living. I didn't realize how weak it actually was. It is almost like strong muscle structure helps brace and hold the bones in better position.

As someone who's going to the doctor next week to discuss potential shoulder surgery, this is timely.

I really need to figure out whether it's going to make things better or worse, but unfortunately, that feels like something a doctor can't guarantee one way or the other.

Any anecdotes or other experiences/thoughts are appreciated.

Here’s the accompanying article from the Science & Tech section.

https://www.economist.com/science-and-technology/2026/09/23/...

Gift link: https://www.economist.com/science-and-technology/2026/09/23/...

Surgeons often jump too quickly to the knife. Effective physical therapy or lifestyle adjustments frequently offer superior, less invasive outcomes.

As someone with herniated discs, spinal stenosis, degenerative disc disease and scoliosis for decades, who's already had surgery but still got worse... what else even is there besides more surgery?

I can't wave a magic wand and just put more space between my discs... that's the only thing that's going to ease off my pain as far as I'm aware.

Well, sample size of 1 but a family member was in debilitating pain all the time until they had a couple vertebrae fused. They can walk and life is mostly normal for them now.

(Below has nothing to do with people who need surgery due to catastrophic injury or congenital defect.)

Most surgeries are followed by more surgeries.

And the hard truth is that most surgeries happen because most people do not have the discipline to do what's needed over many months to solve the problems they are having with the chronic pain they are in. They want a faster solution and are never really told by anyone that the only real permanent solution is one that will be difficult and take months.

Rather than change their habits and their environments and their bodies, people opt to do things that have surprisingly low rates of success and more often than not result in a state than can never be fixed.

Some people get past the point of no return. For those people, surgery may be the only option. But for most people the only real option is a change in lifestyle that is more or less like deciding you are going to get very fit. It takes months and in the mean time, theres a lot of effort and discomfort.

In addition, most people don't really get how much of their back pain and ailment is due to ergonomics. That their bed is wrong. That they are sitting in a bad office chair or couch.

But more than that, most people don't get how central exercise and core strength are for maintaining the health of your back.

So before you get back surgery, consider getting a new office chair, exercising more, and facing that pain for a few more months. Work toward a real solution.

The same could be said about economist articles behind paywalls; worse than useless as it prevents linking to an article covering it at a different source. Perhaps https://www.unsw.edu.au/newsroom/news/2022/03/three-orthopae... or https://www.thetimes.com/life-style/health-fitness/article/h... instead

One thing that bodybuilding taught me is to never underestimate how significantly you can change how your body works through weight training, mobility work and physical therapy.

I used to suffer from chronic low back pain. It hurt to get out of bed every day for years. 1-2 years after getting into bodybuilding the pain disappeared and didn’t come back. Not only that, but I’m not physically limited by my back whatsoever.

I’m not suggesting you start bodybuilding. But the things I think that helped was 1) weight training, 2) mobility work / stretching, 3) physical therapy. That combo can be really powerful.

Single anecdata here.

My mother-in-law has spinal surgery last christmas, the pain for her, prior to the surgery, was unbearable so it's hard to justify not running from that into the arms of a surgeon. The surgeon showed exactly what was to repair though so it was simple enough to understand and clear in the way it was going to help her.

About 9 months out from that surgery and she doesn't have anymore pain.

Anecdote: My dad has had two shoulder surgeries, one to repair his rotator cuff +15 years ago on his right arm, one back in March of this year on his other shoulder. I couldn’t tell you what specifically was wrong with it this time.

He was a regular golfer until last year when the pain got too bad to play through. He just started playing golf again at the beginning of September. He told me after three or so rounds he can’t even tell he had surgery or any previous pain in that shoulder.

He’s had one doctor do his knee surgery and the aforementioned shoulder surgery and he’s really happy with all of their work.

I hope you have as good of an experience as my dad has had.

The question you want to ask is what is the long-term outcome. In 10-20 years time will you have better usage of the shoulder with or without the surgery?

As an anecdote: Family member has a partial lateral meniscus tear in the knee. Surgery was considered as if successful then returning to running might have been possible. Specialist opinions varied as did their reading of the MRI scans.

After a lot of research there was emerging evidence that long-term, surgery was more likely to result in osteoarthritis. So had to weight up long-term mobility over short-term pain relief and not having a major lifestyle change.

You see professional athlete undergoing surgery the next day, but their income relies on regaining usage as quickly as possible. The alternative is physio exercises to strengthen the supporting muscles and avoiding anything that might cause a re-injury.

Go see a specialist sports doctor. They deal with lots of these types of injuries. My physio sent me to one when I did my shoulder in a motorcycle accident and for my case, the data showed that it was better not to operate.

Obviously, don't take medical advice on HN too seriously, but my uncle had shoulder surgery and was happy with the results. I have heard many more complaints about back surgeries making things worse than shoulders.

However, if available I would try to find a good Pilates/dance/sports instructor that has a Gyrotonic machine, which is built for repairing and strengthening shoulder muscles. I had debilitating back issues from sitting in a chair all day and a good instructor fixed it over a year through low impact Pilates. YMMV and group classes tend to be ineffective because so much of it is doing the exercises precisely correct - they were built for injury recovery

I had a remplessage in February and I’m probably at 80% mobility now.

Previously if I coughed my arm would fall entirely out of socket and I would need a propfol shot to allow the doc to relax it to get it back in.

In my case I was basically immobilized and in excruciating pain and fear 100% of my day.

Now thats only like 50% of the day

exercises that place the arm above the head become difficult if not impossible after some shoulder surgeries. these exercises position the shoulder in a comfortable locked in position. training in this position (eg. pull-ups) serves to strengthen muscles like the lats, which in turn support the shoulder in its resting position. i cant say avoiding surgery is fool proof - there is a markedly higher risk of dislocating, and many exercises (eg. bench press) become impossible with a loose shoulder joint. but personally i dont care, my destroyed shoulder becomes fixed after consistent pull-up training, do not see a need to lose half a year in recovery atm.

There is an even stronger version of your argument, one that works without shifting to the same old "you don't need the expensive stuff, just get your life together" advice that already has kind of a bad rep for not fixing depression. You can accept that you cannot inject much more of necessary discipline and motivation into people after they leave school.. and still argue against many types of surgery in mostly the same way: by strictly comparing them to other costly endeavors that could bring about those probably-helpful life changes. Many more people could work towards that "real solution" by benefiting from some other spending.. which merely happens to be cheaper than surgery, while still not being entirely up to them.

Example: My town installed an outdoor "grown-up playground" in the nearby park. Probably cost a little over two complicated surgeries. Already saved 10 people from neglecting upper body workout. Just 10 people having a really low-barrier-of-entry gym available to them whenever walking their dog. I suspect its already been cost-effective. Plus, it is reusable and low-maintenance. Try to beat that in the operating room!

It’s worth recalling that a large (possibly majority) share of the population has extreme limits on their time imposed by economics.

While I’m fortunate now to be able to dedicate time to the gym and other physical fitness, this was not always the case.

We lack the societal incentive structure to allow someone working 60-80 hours a week to reduce their workload to physically recover. We do allow that same person to spend 5-10 years income on surgeries which have 4-6 week recovery times.