Useless diagnosis hides in plain sight as syndrome

Upper Crossed Syndrome, Lower Crossed Syndrome, Chronic Regional Pain Syndrome, Compartment Syndrome, Sinus Tarsi Syndrome Psoas Syndrome. There is no shortage of syndromes within the Physiotherapeutic vernacular. And it seems there is no sign of a reduction in their popularity among clinicians.

“I’ve always known I’m as useful as tits on a bull… but these clinicians just keep using me” said a loose lipped yet surprisingly insightful Upper Crossed Syndrome. “I guess it makes life easier for practitioners if they they can simply blame someone like me, you know, a sciency sounding combination of simultaneously weak, tight, overactive and underactive muscles. They can’t lose when they use me… prescribe strength for the weak areas, activate the inactive ones, release the tight ones, deactivate the overactive ones… who’s going to question their judgment on what is tight or weak or overactive? And if that doesn’t work, blame the patient for not doing a good enough job with their day to day efforts to improve their posture.”

Mr Upper Crossed’s sentiments were supported by another cluster of symptoms going by the name Double Crush Syndrome. Ms Double Crush explained to our reporter “I’m pretty much a vacuous diagnosis built upon an inexplicable emphasis on regional pathoanatomy. That’s always been clear to me and I’ve always thought it strange that I’d be held up as the double barrel cause of someone’s pain but nevertheless, I’m still popular among clinicians”.

From our perspective as humble reporters, it appears that in healthcare, a syndrome might initially function as a cautious descriptive label for a set of symptoms for which their is no clear cause. But it seems as time goes by the widespread use of the label sees it morph in such a way as to function as a discrete diagnosis, from which specific interventions can be initiated and justified. We asked local Physiotherapist, Wade Indeep, if this was a fair summary of how syndromes are utilised within the profession.

”Yes I think it’s a fair summation. There are some conditions, like Down’s Syndrome, that describe a specific condition with precise pathology. But most of the time, if we’re talking syndrome, it’s because we don’t have a clue what the specific cause is for a common cluster of symptoms. And no one likes that level of uncertainty. It’s satisfying to both patient and practitioner to frame treatment around a discrete, specific diagnosis with a clear treatment protocol”.

Asked if he anticipated a shift toward the use of more precise language in the future, Mr Indeep replied “Haha… I doubt it mate. The path of least resistance will reign supreme”.