Surgery on a herniated disc in the lower back is far from always offering the certainty of a successful recovery. This emerges from the research of physiotherapist Stijn Willems, who shows that the differences between patients are great - and that this calls for a much more personalized approach to care and education.
Every year, many people undergo hernia surgery, often with good results. Yet not everyone recovers in the same way. Where one person is soon symptom-free, another suffers long-term pain and limitations. Willems' research shows that these differences are difficult to predict with the usual medical data, such as age, BMI or the severity of symptoms before surgery.
"That is precisely where the friction in practice lies. Patients want to know where they stand: how long will the recovery take, when can they return to work or sports, what is the likelihood that symptoms will return and what will my recovery look like compared to others? So far, they are getting mostly general answers, based on averages. But those averages give a distorted picture, according to the researchers. They don't show how diverse recovery trajectories really are," Willems said.
'People-like-me' method
To close that gap, Willems introduces a new approach: comparing patients to others who closely resemble them. This so-called "people-like-me" method offers a more realistic and personalized picture of recovery. Instead of one average line, patients gain insight into multiple possible scenarios that better reflect their own situation.
The impact of this approach can be significant. Better, personally tailored information helps patients form realistic expectations. This is important because expectations affect the recovery process itself. Those with a better understanding of expectations are less likely to become anxious and can work with health care providers in a more focused way toward recovery.
The results are especially relevant to the collaboration between patients, physicians and physical therapists. They provide a basis for more joint decision-making and customized treatment. In time, the method can be integrated into digital applications, such as patient portals or e-health apps. These would allow someone to see immediately after surgery how similar patients are recovering - and what to expect in the coming weeks.
Willems highlights a broader development in healthcare: away from averages, toward personalized predictions based on data. Hernia surgery may often be successful, but recovery turns out to be anything but standard. This is precisely why customization is not a luxury but a necessity.