"That's The Worst Case I've Ever Seen..."

 

I've been hearing the same thing over and over again from patients.  "I've been told that this is the worst case that they have ever seen..."  I find it a tad bit odd.  Does everyone with "the worst case" happen to end up in my office? 
I'm not sure why these patients are told this.  I had a young man (less than 40 years old) in the office the other day saying that "he had the worst case of arthritis in his knee that the doc had ever seen!"  I found it a bit odd for a few reasons;  first, he was relatively young for severe arthritis in the knee (cartilage is pretty spongy when we are younger).  Secondly, he had not suffered significant trauma to his knee.  Third, he had full range of motion.  Lastly, he had not had X rays (not that this is a good way of observing arthritis, but it does give you some information.)  He did have some crepitus that sounded like grinding, but it was not "bone on bone" as it was described to him. 

I get patients with "severe" arthritis in their back and neck.  Some of them have the X rays to prove it (as mentioned, X rays are not the best way to determine how bad someones arthritis is), yet they appear to have minimal pain and decent range of motion.  More importantly, they are able to perform all the activities and/or sports that they would like to continue to do!  So why are they told that they should be in pain?

I think that people need to be enabled.  We need to stop telling them they are in bad shape. That "this is the worst I have ever seen." I think that people are looking for someone to help them get to where they need to be.  We should not be telling them what they cannot do, but how they should be doing the things that they want to be doing!  Lets stop enabling patients to be in pain and give them a helping hand!