Back and shoulder surgery is often worse than useless

Commenters debated an Economist claim that back and shoulder surgery is often unnecessary and sometimes harmful. Several argued the problem is structural: tptacek pointed to fee-for-service incentives, opaque pricing, and a culture that equates procedures with care, while nradov and havaloc warned about confirmation bias from imaging and "age-appropriate" MRI findings that get over-interpreted. Aforwardslash and redundantly shared personal harm and reporting concerns, saying complication and long-term harm are undercounted in outcomes data. Others pushed back on simple comparisons about MRI availability: tptacek's Massachusetts-vs-Canada stat drew counterpoints from FlyingAvatar, doubled112 and kibwen, who noted triage systems, geographic distribution, and research uses for machines.

Views diverged on remedies. Many commenters - ld_path, txhwind, asdff, cj and Julesman - favored conservative care: physical therapy, strengthening, ergonomics, and lifestyle changes, with some pointing to psychosomatic approaches (bentt citing John Sarno). A few shared successful surgical anecdotes (claaams) or reported surgery as the only option after long deterioration (majorchord), while others urged second opinions and caution (aforwardslash). The overall split was between skepticism of routine surgical intervention and acknowledgement that for certain advanced or structural cases surgery may still be necessary.