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Published on: 27-Jun-2024

Research shows that educated patients can have better outcomes. Dr. Cole is committed to educating his patients and their families on sports medicine conditions and treatment options. We hope you enjoy hearing Dr. Cole’s discussions on joint health.

Video Transcript:

There are several things to consider when contemplating treatment with an orthopedic surgeon. I think the first thing to understand is that treatment is required if the level of pain or dysfunction has essentially reached a level that’s dissatisfying for  you. If that’s the case then treatment is reasonable to consider. 

What’s really important is that most patients who have orthopedic conditions primarily come to me because they have pain. And while pain is particularly subjective it’s also important to understand that pain is often very disconnected from objective testing such as an MRI or an X-ray. There are times we can have MRI’s which are perfectly normal, the patients can have severe pain. Alternatively we accumulate abnormalities over time on our X-rays and MRI’s that often don’t cause any pain or dysfunction at all.

So patients choose to see an orthopedic surgeon when they have pain or dysfunction that’s essentially dissatisfying and prevents them from doing the things that they enjoy. To treat patients who are at that level we can either choose non-surgical or surgical treatments. Non-surgical treatments can be very effective to treat symptoms and this can include activity modification for a temporary period of time.

Physical therapy, oral anti-inflammatories, injections, reassurance that pain is not necessarily associated with progression if patients remain active. And that’s a very important point because intuitively patients think- “look I have pain, if I continue to be active, am i going to make this condition worse?” 

There are only a few conditions that we see regularly that are actually associated with worsening if a patient remains active. So apart from fractures and acute injuries, long-standing more chronic problems are generally not made worse with higher levels of activity. It may escalate symptoms but it doesn’t necessarily make the disease worse. So much of what we do is provide reassurance to you to help you understand that- “look, if the discomfort is tolerable maybe you don’t need any formal treatment at all but just an understanding that remaining active despite slight degrees of discomfort is actually safe to do and not going to put you in a worse place later on”.

Most longer standing conditions have a non-surgical treatment pathway that can be successful. If that’s unsuccessful, surgery can be considered the decision you make which could be different than a decision someone else makes. Understand that a decision for treatment or surgery is not linear. It depends upon your occupation, the severity of the disease, how much it impairs you, what are your other responsibilities, do you have family commitments, do you have travel coming up. There are all types of considerations that lead to the decision for treatment, whether it’s non-surgical or surgical. So my job is to provide  sufficient education to you at  the visit, so you can actually make a suitable decision, even independent of me being present in the room.


The best orthopedic care starts with the best orthopedic research. I am a proud faculty member in the department of orthopedic surgery at Rush University, home to the Midwest’s largest team of bone and joint scientists. With surgeons and clinicians partnering with elite laboratory researchers and data scientists, we continue to devise new solutions that push the boundaries of what’s possible in the treatment of musculoskeletal conditions.

Our work informs orthopedic care around the world and is fueled by donors, patients and families who believe in our research to help more people lead active lives free of pain. To learn more about opportunities to participate in research or become a supporter please ask a member of my team or visit our website at this address: www.rush.edu/liveactive.


Brian J. Cole, MD, MBA, is a nationally acclaimed orthopedic surgeon, specializing in sports medicine for the knee, shoulder and elbow. Dr. Cole is honored to be named in the top 20 in sports medicine, knee and shoulder specialists repeatedly over the last 5 years as selected by his peers. His awards range from the “Best Doctors in America” since 2004 and “Top Doctor” in Chicagoland since 2003. Click here for more of Dr. Cole’s Educational Videos on Patient Care and other Educational Resources.

The post Making the Decision to Seek Treatment appeared first on Sports Medicine Weekly By Dr. Brian Cole.