The wait and see approach is often utilized by primary care physicians in the management of musculoskeletal conditions. The underlying idea behind this approach is the improvement of symptoms over time, natural history, of these conditions. The error in this treatment method is the patient has already tried the wait and see approach, and a likely internet search, but is still having symptoms hence the physician appointment. Secondly, an active approach involving Physical Therapy has been shown to accelerate a patient’s healing over their natural history for a variety of spinal and extremity conditions including back and neck pain, as well as, shoulder and knee pain. A recent systematic review of the available research on the most common knee pain condition (patellofemoral pain syndrome), seen in both primary care offices and our Boulder Physical Therapy offices, describes the importance of a more active approach to this condition.
Winters and colleagues published the results of their review in the British Journal of Sports Medicine (2020). Authors included 22 randomized controlled trials on the conservative treatment of patellofemoral pain syndrome. Included interventions including education, exercise, manual therapy, orthotics, and taping. They reported all interventions were more beneficial for patients when compared to the natural history or wait and see approach. Consistent significant treatment effects were found with exercise and educational interventions for this patient population. In conclusion, the authors recommended avoiding a wait and see approach for patients with pain on the front of their knee or patellofemoral pain syndrome.
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