Orthopedic surgeons, physiatrists, and their patients writing on KevinMD about musculoskeletal care: back pain and the procedures that can weaken a young spine, knee and joint surgery, spinal stenosis treated least invasive first, non-opioid pain management and how it is paid, orthopedic residency and the women entering it, and what a patient in pain needs to be asked. Two maintained records draw on this archive: Opioids: what physicians and pain patients say, in their own words and Surgeons and surgery: what surgeons say, in their own words.

Choosing a limb lengthening surgeon requires accountability

Physician
September 23, 2026

Patients considering cosmetic limb lengthening usually begin with one question: How much height can be gained? That question is understandable, but it should not drive the decision. The more important issue is who will remain responsible for the patient’s care throughout the process and what will happen if recovery requires extra attention.

Cosmetic limb lengthening is often presented as a procedure that increases height. Technically, that is the goal, but it …

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Choosing a limb lengthening surgeon requires accountability

Patient communication ends when the patient understands

Patient
September 19, 2026

For decades, we have been told the stories of medicine through the eyes of the people who provide it. Medical dramas place doctors and nurses at the center of the narrative: the brilliant surgeon making impossible decisions, the exhausted emergency physician racing against time, the nurse carrying the emotional weight of caring for patients through crisis. Even in today’s most authentic medical dramas, including The Pitt, patients are often catalysts …

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Patient communication ends when the patient understands

Non-opioid pain management gets separate pay in 2026

Conditions and Diseases
September 19, 2026

As the third-highest opioid-prescribing medical specialty representing 6 to 8 percent of all U.S. opioid prescriptions, orthopedic surgeons carry an outsized share of responsibility for reducing patients’ opioid exposure. Orthopedic procedures dominate this pattern as they represent four of the five surgeries with the highest opioid prescription rates among patients aged 45 to 64. Even more alarming, orthopedic surgeons often treat young and active patients, and for many, surgery …

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Non-opioid pain management gets separate pay in 2026

Barriers to yoga practice, and how to lower them

Conditions and Diseases
September 15, 2026

Musculoskeletal and mental-health conditions are among the most consequential and costly health challenges in the United States. Musculoskeletal conditions affect more than one-third of U.S. adults and account for more than $300 billion in medical spending, while mental illness is estimated to cost the broader U.S. economy approximately $282 billion annually. Although many of these conditions are chronic and cannot be addressed through a single universally effective intervention, …

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Barriers to yoga practice, and how to lower them

Patient experience in urgent care is a workflow issue too

Physician
September 11, 2026

When I joined OrthoIllinois in 2022 and took on leadership responsibilities at Injury Express, our orthopedic urgent care practice was already delivering high-quality clinical care. But as I became more involved in reviewing our patient-experience data, I noticed that some of our biggest opportunities for improvement had little to do with the medical care itself. Many involved waiting.

In 2022, our overall patient satisfaction score was 92.10 percent. When we looked …

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Patient experience in urgent care is a workflow issue too

7 questions to ask before pain treatment begins

Conditions and Diseases
September 7, 2026

When pain interferes with work, exercise, sleep, or everyday movement, it is natural to look for the fastest possible solution. Patients often arrive at an appointment asking whether a particular treatment will “fix” a painful knee, back, shoulder, or hip. That question is understandable, but it may not be the best place to begin.

Before choosing any non-surgical approach, patients should first understand what may be causing the pain, what the …

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7 questions to ask before pain treatment begins

How does a rehabilitation physician actually think?

Physician
September 7, 2026

It’s not a simple question, and one that many physicians outside our specialty still find surprisingly difficult to define. Have you ever called a rehab consult and struggled to understand why you need one? Many have. The truth is, physiatrists often think differently. Every specialty develops its own lens through which it views disease. A surgeon asks whether a problem can be repaired. A neurologist localizes it. An oncologist determines …

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How does a rehabilitation physician actually think?

Being dismissed by a doctor because I stock retail

Conditions and Diseases
August 25, 2026

My story begins the weekend before the Fourth of July. We were celebrating at our friend, the window guy’s, house on June 27th. Tom decided to have the party a weekend early because this year marks the 250th anniversary of our country, and he knew the holiday weekend would be packed with other celebrations.

That Saturday, I had a stinging sensation in my neck and my arm was sore. I was …

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Being dismissed by a doctor because I stock retail

A back procedure that can weaken a young spine [PODCAST]

Podcast
August 20, 2026
YouTube video

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A young patient walks in with ordinary back pain and leaves on a path that can quietly weaken the muscle holding the spine together. Francisco M. Torres is an interventional physiatrist who noticed these patients coming back to him sooner, and traced …

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A back procedure that can weaken a young spine [PODCAST]

6 lumbar spinal stenosis treatments, least invasive first

Conditions and Diseases
August 20, 2026

Lumbar spinal stenosis (LSS) is one of the most common causes of pain and disability in older adults. Characterized by narrowing of the spinal canal that compresses neural elements, it classically produces neurogenic claudication that presents itself with leg pain, numbness, or weakness provoked by standing or walking and relieved by sitting or flexion. With an estimated prevalence of 11 percent among older adults in the United States and …

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6 lumbar spinal stenosis treatments, least invasive first

Return-to-play decisions begin long before the whistle

Physician
August 16, 2026

Friday nights are loud.

The student section is impossible to miss. Faces painted in school colors, homemade signs held high, voices already hoarse before kickoff. The marching band fills every pause with music while parents and grandparents search the field for familiar jersey numbers. I hardly notice any of it.

By the time the crowd begins finding their seats, I’ve already been watching the …

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Return-to-play decisions begin long before the whistle

In 2026, the surgical backlog has a training bottleneck

Medical Education
August 15, 2026

Every conversation about the surgical backlog focuses on the same fix: more OR time, more staff, more beds. That’s necessary, but it treats the bottleneck as a capacity problem. A second bottleneck nobody’s pricing in is how long it takes to produce a surgeon who can operate independently, and that number is quietly getting longer. Cuts in one place always show up in another, and it’s often education that takes …

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In 2026, the surgical backlog has a training bottleneck

Physician peer review must balance safety and fairness

Physician
August 14, 2026

Medicine is one of the few professions in which a colleague may understand exactly how difficult the journey has been and simultaneously possess enormous influence over whether another physician is permitted to continue that journey.

Becoming a physician requires years of education, medical school, residency, examinations, credentialing, sacrifice, and continual professional development. For surgeons, the pathway often includes additional fellowship training and years spent developing technical judgment that cannot be acquired …

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Physician peer review must balance safety and fairness

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How the benefits of active sitting change desk work

Conditions and Diseases
August 14, 2026

“That which is used develops; that which is not used wastes away.” Hippocrates wrote that around 450 B.C., and it turns out he understood office ergonomics better than we do.

Dozens of companies sell “ergonomic” office chairs, and they are all built around the same idea: a backrest, usually armrests, and always lumbar support. If this design solved the problem of sitting, why do 80 percent of Americans eventually develop …

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How the benefits of active sitting change desk work

Why soldiers are athletes and their bodies pay for it [PODCAST]

Podcast
August 12, 2026
YouTube video

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A 30-year-old soldier can have the knees of a 60-year-old. Not from one bad injury, but from carrying a load every single day for years. Family medicine and sports medicine physician Ann Lebeck returns to explain why she came to see soldiers …

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Why soldiers are athletes and their bodies pay for it [PODCAST]

When patients ask for a knee surgery brand they don’t understand [PODCAST]

Podcast
August 10, 2026
YouTube video

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A patient asked for her knee surgery by its brand name. She used the term perfectly. She just had no idea what it actually meant. Orthopedic surgeon Cory Calendine, who does nearly 700 to 800 hip and knee replacements a year, returns …

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When patients ask for a knee surgery brand they don’t understand [PODCAST]

A physical therapy referral needs more than a signature

Conditions and Diseases
August 1, 2026

One of the reasons I chose to specialize in physical medicine and rehabilitation (PM&R) was influenced by Puerto Rico’s distinctive regulations governing physical therapy. At the time I trained, a physical therapy practice could not legally operate without a physiatrist’s license on file. Only a physiatrist could refer a patient to physical therapy, and only a physiatrist’s credentials permitted the clinic to function, as defined under Puerto Rico’s physical …

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A physical therapy referral needs more than a signature

What the children of physicians carry

Conditions and Diseases
July 24, 2026

Back when I was a senior in college, I wrote a peer recommendation for my pre-med boyfriend’s medical school application. Nearly two decades later, that boyfriend is my husband, the father of my adorable children and a surgeon who I am incredibly proud of.

I may just have my B.S. and no M.D. or PhD after my name but I’ve certainly put in my time throughout the past fifteen-plus years of …

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What the children of physicians carry

What bull riding taught me about sports medicine gaps

Conditions and Diseases
July 19, 2026

It was our first night at a bull riding event, Shoot Out Arena in Tombstone, Arizona, an August night, and I had no idea yet what any of this actually looked like up close.

We were sitting beside the chutes in the VIP section. The rider gave the nod, the gate swung open, and the clock started. Bull and rider came out together …

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What bull riding taught me about sports medicine gaps

Discipline isn’t the missing piece. Agency is.

Physician
July 17, 2026

A patient once sat across from me in my exam room, glanced at the bookshelf behind me, and said, “Doc, I just don’t have your discipline.” He was looking at a copy of one of my first books, Dr. T’s Drop the Fat Diet, which features a before-and-after photo on the cover. The “after” image shows a six-pack I built through years of focused effort. To him, that cover …

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Discipline isn’t the missing piece. Agency is.

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