# This is why I hate going to the doctor **URL:** \ **Category:** In My Humble Opinion\ **Created:** [August 22, 2014, 11:46pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253 "2014-08-22T23:46:03Z")\ **Posts on this page:** 20\ **Page:** 10
**Author:** ![sara20](https://avatars.discourse-cdn.com/v4/letter/s/e79b87/32.png) [@sara20](https://boards.straightdope.com/u/sara20)\ **Post date:** [August 27, 2014, 4:16pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/181 "2014-08-27T16:16:59Z")
> [@WhyNot](#): > > Most often what I see recommended to people is, more or less in order: > > Tylenol > Losing weight (admittedly, lots of doctors skip this advice, because they’re so used to people refusing to do it; it feels like a waste of time and breath to even mention it.) > Increasing activity, slowly and with good technique (they skip this one too often, too, for the same reason) > Topical treatments like BioFreeze or BenGay > Ibuprofen or Naproxen at fairly high doses > Orthotics to correct alignment problems > Physical Therapy > Tramadol > Hydrocodone/APAP (Still mostly Tylenol, with a bit of narcotic in it) > TENS therapy > Steroid injections > Synovial gel injections > Surgery > Knee replacement > > So you’re, like, 12 steps away from being advised to try surgery, much less knee replacement surgery, in my experiences with roughly 300 patients of various doctors in the last 3 years. Why is TENS therapy ranked AFTER hydrocodone (a opiate narcotic)? It seems like it should be right after tylenal or physical therapy. Is there any risks or downside to TENS therapy? ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [August 27, 2014, 6:56pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/182 "2014-08-27T18:56:36Z")
> [@sara20](#): > > Why is TENS therapy ranked AFTER hydrocodone (a opiate narcotic)? It seems like it should be right after tylenal or physical therapy. Is there any risks or downside to TENS therapy? Let me clarify that the list isn’t an official one from an official list of interventions in a hard and fast order. Rather, it’s what I see most often, and the order of events I see most often, in my job as a home health nurse. As to why TENS isn’t used more often, or sooner - money, mostly, I think - Medicare will only pay for a TENS unit for very specific diagnoses, after other therapies (including painkillers) have been tried and documented as failing to provide relief. Patient compliance and training, after that; they don’t always like taking the 15-20 minutes necessary to do it, and they’re sometimes scared of it and/or they have trouble reaching the spot the pads need to be in and may not have someone to help them. And coming in a distant fourth - many doctors don’t know about or have much faith in TENS. I’ve got a couple of doctors who prescribe them early and often, but most of them I’ve got to talk into it, and a few are just completely unwilling to try it. The only downside I know of is that eventually TENS just stops working. You can develop a tolerance to it just like you can medications, and in a surprisingly short time - perhaps as little as a week.[It seems as though using both low and high modulated frequencies might avert the tolerance issue](https://www.icts.uiowa.edu/content/icts-pilot-grant-update-avoiding-pain-relief-tolerance-transcutaneous-electric-nerve), but once a thing gets a bad rep, it’s hard to modify people’s thinking about it. For more info, you’d have to ask a Physical Therapist - they know much more about TENS than I do. ---
**Author:** ![sara20](https://avatars.discourse-cdn.com/v4/letter/s/e79b87/32.png) [@sara20](https://boards.straightdope.com/u/sara20)\ **Post date:** [August 27, 2014, 7:06pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/183 "2014-08-27T19:06:56Z")
> [@WhyNot](#): > > Let me clarify that the list isn’t an official one from an official list of interventions in a hard and fast order. Rather, it’s what I see most often, and the order of events I see most often, in my job as a home health nurse. As to why TENS isn’t used more often, or sooner - money, mostly, I think - Medicare will only pay for a TENS unit for very specific diagnoses, after other therapies (including painkillers) have been tried and documented as failing to provide relief. Patient compliance and training, after that; they don’t always like taking the 15-20 minutes necessary to do it, and they’re sometimes scared of it and/or they have trouble reaching the spot the pads need to be in and may not have someone to help them. And coming in a distant fourth - many doctors don’t know about or have much faith in TENS. I’ve got a couple of doctors who prescribe them early and often, but most of them I’ve got to talk into it, and a few are just completely unwilling to try it. > > The only downside I know of is that eventually TENS just stops working. You can develop a tolerance to it just like you can medications, and in a surprisingly short time - perhaps as little as a week.[It seems as though using both low and high modulated frequencies might avert the tolerance issue](https://www.icts.uiowa.edu/content/icts-pilot-grant-update-avoiding-pain-relief-tolerance-transcutaneous-electric-nerve), but once a thing gets a bad rep, it’s hard to modify people’s thinking about it. For more info, you’d have to ask a Physical Therapist - they know much more about TENS than I do. How effective is TENS compared to narcotic painkillers and have long do the pain killing effects last after one session? ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [August 27, 2014, 7:15pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/184 "2014-08-27T19:15:13Z")
> [@sara20](#): > > How effective is TENS compared to narcotic painkillers and have long do the pain killing effects last after one session? No idea. I can’t find a study comparing the two directly - which may be why Medicare is reluctant to pay. Anecdotally, most of my patients who have tried TENS and are trained by my best Physical Therapists in how to do it end up throwing out their pain meds and don’t ask for them again while I’m seeing them (which is generally 2-6 months.) Whether they ask for the meds again later, I couldn’t tell you. Do we have any pain specialists on the Dope? ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [August 27, 2014, 7:21pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/185 "2014-08-27T19:21:44Z")
> [@7e42](#): > > They get paid nice money to > > 1. Tell you what you don’t want to hear > > 2. Tell you they don’t know what your medical issue is or what caused it It’s usually No. 2 for me which is why I rarely bother. I’ll have some chest or stomach pain, wind up taking $500 in tests and be told “I dunno.” If it’s something obvious like a bad cough where I’ll get some antibiotics or if my arm got cut off and I need it re-attached then sure. Everything in the middle of those ends invariably proves a complete waste of my time and money (and it’s never just a little bit of either). ---
**Author:** ![Lanzy](https://avatars.discourse-cdn.com/v4/letter/l/74df32/32.png) [@Lanzy](https://boards.straightdope.com/u/Lanzy)\ **Post date:** [August 27, 2014, 7:51pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/186 "2014-08-27T19:51:22Z")
> [@WhyNot](#): > > No idea. I can’t find a study comparing the two directly - which may be why Medicare is reluctant to pay. Anecdotally, most of my patients who have tried TENS and are trained by my best Physical Therapists in how to do it end up throwing out their pain meds and don’t ask for them again while I’m seeing them (which is generally 2-6 months.) Whether they ask for the meds again later, I couldn’t tell you. > > Do we have any pain specialists on the Dope? I am only a pain specialist of my own pain. I was given a tens unit for a shoulder pain and it worked as well as any narcotic but not for as long. When I had my knee replaced I would use the Tens unit before physical therapy and the therapy would go much easier. In both cases I only used the units for about 3 weeks each before they did not seem to help much. I was a VA patient for both. ---
**Author:** ![7e42](https://avatars.discourse-cdn.com/v4/letter/7/51bf81/32.png) [@7e42](https://boards.straightdope.com/u/7e42)\ **Post date:** [August 28, 2014, 1:43am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/187 "2014-08-28T01:43:29Z")
> [@sara20](#): > > Did you go to a orthopedic doctor or a regular family doctor? And did you have any xrays or other tests? Yes I had the X-Ray and physical Therapy was recommended. Fish Oil was the better solution ---
**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\ **Post date:** [August 28, 2014, 2:20am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/188 "2014-08-28T02:20:38Z")
> [@7e42](#): > > Yes I had the X-Ray and physical Therapy was recommended. Fish Oil was the better solution So what dream or Ouija board suggested fish oil in the first place? ---
**Author:** ![7e42](https://avatars.discourse-cdn.com/v4/letter/7/51bf81/32.png) [@7e42](https://boards.straightdope.com/u/7e42)\ **Post date:** [August 28, 2014, 2:21am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/189 "2014-08-28T02:21:05Z")
> [@RivkahChaya](#): > > So what dream or Ouija board suggested fish oil in the first place? One of my coworkers ---
**Author:** ![Lacunae\_Matata](https://avatars.discourse-cdn.com/v4/letter/l/8491ac/32.png) [@Lacunae\_Matata](https://boards.straightdope.com/u/Lacunae_Matata)\ **Post date:** [August 28, 2014, 2:53am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/190 "2014-08-28T02:53:25Z")
> [@7e42](#): > > Yes I had the X-Ray and physical Therapy was recommended. Fish Oil was the better solution I may have missed the answer above, but - did you actually try PT? ---
**Author:** ![7e42](https://avatars.discourse-cdn.com/v4/letter/7/51bf81/32.png) [@7e42](https://boards.straightdope.com/u/7e42)\ **Post date:** [August 28, 2014, 2:56am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/191 "2014-08-28T02:56:55Z")
> [@Lacunae\_Matata](#): > > I may have missed the answer above, but - did you actually try PT? No because I had family members who tried it and it didn’t work ---
**Author:** ![outlierrn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/outlierrn/32/3005_2.png) [@outlierrn](https://boards.straightdope.com/u/outlierrn)\ **Post date:** [August 28, 2014, 3:13am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/192 "2014-08-28T03:13:16Z")
Anamen, I think you’re wrong. Try this: I go to the doctor with a sore throat. After a thorough work up the conclusion is that I do not have acute epiglottitis, throat cancer, fulminant streptococcal infection or esophageal varices. What I do have in one of a dozen viruses that cause similar symptoms and usually run their course. Knowing which virus is not as important as knowing what I don’t have. ---
**Author:** ![Declan](https://avatars.discourse-cdn.com/v4/letter/d/ecae2f/32.png) [@Declan](https://boards.straightdope.com/u/Declan)\ **Post date:** [August 28, 2014, 6:50am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/193 "2014-08-28T06:50:51Z")
> [@7e42](#): > > I had joint pain in the knees and hip and could not walk at all and was very concerned. Do you know this dumb doctor suggested I get some Tylenol??? Is that her idea of resolving a issue a patient has? I had to find my own solution to the knee and hip pain which turned out to be FISH OIL. So again what the hell is the purpose of a doctor? To take money out of your account and tell you they don’t know what’s wrong with you? Your really your own primary doctor, what your GP did was to give you the tier one hypochondriac diagnoses and get you out of the office. I think it would have been better for you, had she referred you to a doctor that specializes in sports medicine, and quite possibly a foot doctor. I dont have any thing to add about your supplements, but arthritis is agrravated by weather conditions, so better weather might give you a false positive about the effects of the supplements. Declan ---
**Author:** ![Lacunae\_Matata](https://avatars.discourse-cdn.com/v4/letter/l/8491ac/32.png) [@Lacunae\_Matata](https://boards.straightdope.com/u/Lacunae_Matata)\ **Post date:** [August 28, 2014, 6:54am UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/194 "2014-08-28T06:54:05Z")
> [@7e42](#): > > No because I had family members who tried it and it didn’t work Of course. ---
**Author:** ![AnaMen](https://avatars.discourse-cdn.com/v4/letter/a/dfb087/32.png) [@AnaMen](https://boards.straightdope.com/u/AnaMen)\ **Post date:** [August 28, 2014, 12:31pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/195 "2014-08-28T12:31:50Z")
> [@outlierrn](#): > > Anamen, I think you’re wrong. > > Try this: > I go to the doctor with a sore throat. After a thorough work up the conclusion is that I do not have acute epiglottitis, throat cancer, fulminant streptococcal infection or esophageal varices. What I do have in one of a dozen viruses that cause similar symptoms and usually run their course. Knowing which virus is not as important as knowing what I don’t have. No doctor is running tests on you for all that stuff because you come in with a sore throat. To undergo tissue removal from your throat for a biopsy is not nothing, you know. Even if they did test for that stuff, how and why is it more important to know you don’t have any of them when you don’t have them? There is no treatment you must start on, and you remain as you were. ---
**Author:** ![Inner\_Stickler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/inner_stickler/32/318_2.png) [@Inner\_Stickler](https://boards.straightdope.com/u/Inner_Stickler)\ **Post date:** [August 28, 2014, 1:30pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/196 "2014-08-28T13:30:41Z")
Given the substitution prevalent in the supplements industry, I wouldn’t buy anything from GNC or similar stores as there’s no guarantee that what the label says is in the bottle is in the bottle. ---
**Author:** ![VinylTurnip](https://avatars.discourse-cdn.com/v4/letter/v/b2d939/32.png) [@VinylTurnip](https://boards.straightdope.com/u/VinylTurnip)\ **Post date:** [August 28, 2014, 2:30pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/197 "2014-08-28T14:30:49Z")
Dunno about oil, but I think we may be the fish. ---
**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\ **Post date:** [August 28, 2014, 3:00pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/198 "2014-08-28T15:00:57Z")
> [@7e42](#): > > No because I had family members who tried it and it didn’t work :smack: ---
**Author:** ![AnaMen](https://avatars.discourse-cdn.com/v4/letter/a/dfb087/32.png) [@AnaMen](https://boards.straightdope.com/u/AnaMen)\ **Post date:** [August 28, 2014, 5:36pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/199 "2014-08-28T17:36:44Z")
> [@7e42](#): > > No because I had family members who tried it and it didn’t work This is exactly why we have not evolved to be rational creatures. ---
**Author:** ![Lacunae\_Matata](https://avatars.discourse-cdn.com/v4/letter/l/8491ac/32.png) [@Lacunae\_Matata](https://boards.straightdope.com/u/Lacunae_Matata)\ **Post date:** [August 28, 2014, 6:47pm UTC](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253/200 "2014-08-28T18:47:58Z")
So, really, your doctor provided you with a diagnosis (OA,) recommended a mild pain reliever to alleviate symptoms temporarily, and physical therapy to improve symptoms (long-term.) That’s not really the big fat nothing that you say you wasted your money on. Sounds like exactly what I’d expect, in fact. But, if you aren’t going to listen to the doctor or follow a treatment plan, why waste her time and your time and money? [Previous page](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253.md?page=9) [Next page](https://boards.straightdope.com/t/this-is-why-i-hate-going-to-the-doctor/696253.md?page=11)