Short-Term Satisfaction, Long-Term Problems?

 One of the biggest tensions I see in the rehab world is the competition between the short and long terms, both in identifying MSK problems and treating them.

You have probably felt this before and often been asked “what is wrong with me?” and “how do we fix it?”

And like me, felt the pressure to answer both immediately and confidently. The persons satisfaction with you right now may even depend on it!

We don’t want to appear like we don’t know what the problem is, or how to fix it.

The tension to give a label

Patients want to know what the problem is, why would they not? And many times, there can be a simple label that help guide treatment.

 But not always.

Just because someone gets a label and is satisfied in the short term does not always lead to longer term resolution and therefore longer-term satisfaction! My personal practice is littered with specific labels and interventions but still with ongoing issues.

That’s precisely what we see here.

“Specific diagnostic labels were validating but promoted fear and a biomedical view of pain” (Martin 2025)

The label was validating; it means the problem is real and identifiable and treatable. But for every label given, intervention applied, has the outcome been satisfactory?

And we must consider, as per the study above, how does the label given improve the accuracy of the treatment or the outcomes we see?

I see this issue similarly to the debates around MRI. People often want MRI’s as well. Again, why would you not if you felt it gave you the answers to your problem. Problem is that it may give you problems that don’t relate to your problem or a whole bunch of new ones you hadn’t considered.

“Early MRI without indication has a strong iatrogenic effect in acute LBP, regardless of radiculopathy status. Providers and patients should be made aware that when early MRI is not indicated, it provides no benefits, and worse outcomes are likely” (Webster 2013)

 And….

 “Incidental findings may also provoke worry or concern in patients from a labelling effect (possibly delaying recovery) if they fail to understand that these anomalies are common and benign” (Hall 2021)

 In the longer term, can they create more problems than they solve? Hence why the advice is not to get an immediate scan for the majority of back pain!

The tension to treat the problem

There can also be a pressure to do something about this problem, right now!

Doctors probably feel the pressure daily to give out antibiotics for colds. It would absolutely satisfy people in the short term, but we know over the longer term might lead to wider societal issues.

I think this often leads to treatments that look at modulating pain rather than bigger picture thinking around wider contributors to the problem.

Can you do both? Of course!

Does this always happen? I will let you make up your mind on that.

It’s much easier for everybody to simply apply a treatment than modify lifestyle, training or mindset, especially if it fixes the problem you have previously identified.

Maybe the human organism makes treatments look good, as Voltaire said “amusing the patient whilst nature cures the disease”

Or maybe it doesn’t, and we have a list of treatments that failed to actually help the problem in the longer term, and hence why the patient is sitting in front of you.

So, let’s just consider if short term actions lead to more than short term satisfaction!

Stephen Martin, Matthew Smith, David A Wilson, Joshua R Zadro, Giovanni E Ferreira, Mary O’Keeffe, Non-specific diagnostic labels for musculoskeletal conditions foster positive views about prognosis and non-invasive management but require clear explanation: a systematic review, Journal of Physiotherapy, Volume 71, Issue 3, 2025,

Webster BS, Bauer AZ, Choi Y, Cifuentes M, Pransky GS. Iatrogenic consequences of early magnetic resonance imaging in acute, work-related, disabling low back pain. Spine (Phila Pa 1976). 2013 Oct

Hall A M, Aubrey-Bassler K, Thorne B, Maher C G. Do not routinely offer imaging for uncomplicated low back pain BMJ 2021