Why Your MRI Doesn't Mean You Need Surgery | Dr Howard Luks

Howard Luks is an orthopaedic surgeon with almost 30 years of experience, and a good deal of his week is spent telling people they do not need an operation. We work through the joints that bring most people into a clinic, knees, shoulders, Achilles tendons and ankles, and separate what a scan is actually telling you from what it is being used to justify.

Almost everyone over 40 has something on an MRI that will be described as a tear. Very few of those people need surgery, and plenty have no pain at all. Howard's case, drawn from three decades in clinic and the sham-surgery and physiotherapy-controlled trials behind it, is that our language has raced ahead of the biology, and that the words we use change how people move and live.

What We Cover

Why "tear" and "bone on bone" are the wrong words, and what they do to a person's behaviour

What sham surgery trials showed for meniscus tears, rotator cuff tears and bone spur removal

How metabolic health shapes both your pain and your ability to heal after surgery

Why tendons respond to load rather than rest

Cortisone, PRP, stem cells and peptides: what the evidence supports and what is marketing

Ice, anti-inflammatories and ankle sprains, and why early movement beats a boot

Plyometrics, balance and power, and why they matter more than strength after 50

This is a conversation about being careful with language and honest about uncertainty, and about keeping your capacity so you can keep doing the things you care about.

To connect with Howard Luks, read his writing on Substack or find him on X and Instagram.