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There are many factors that influence whether you choose to have surgery for a health condition.

But one you might not have considered is the very name your doctor uses to describe your condition can make you more or less likely to go under the knife, according to a growing body of research.

This is concerning because there are often less invasive options than surgery that are equally effective and safer.

What鈥檚 in a name?

Let鈥檚 take shoulder pain as an example.

Three of us (Joshua, Mary and Giovanni)听听last week finding health professionals鈥� use of certain medical terms might be encouraging patients to say yes to unnecessary shoulder surgery.

Our world-first trial involved 1,308 people from five countries, some with and without shoulder pain, who were randomly allocated to read one of six hypothetical scenarios. The only difference between the scenarios was the medical term used by the health professional to describe the person鈥檚 shoulder pain.

In our study, we used the听听where people feel pain at the front of one of their shoulders which is made worse by lifting the arm and lying on it.

Health professionals use a听听for this pain, including 鈥渟ubacromial impingement syndrome鈥�, 鈥渞otator cuff tear鈥�, 鈥渂ursitis鈥�, and 鈥渞otator cuff related shoulder pain鈥�.

The terms doctors use vary so widely because it鈥檚 currently impossible to pinpoint the exact cause of most shoulder pain, even听听辞蹿听听such as magnetic resonance imaging (MRI).

We found people told they had a 鈥渞otator cuff tear鈥� wanted shoulder surgery the most. Those told they had 鈥渂ursitis鈥� (inflammation of a fluid-filled sac in the shoulder) wanted surgery the least. People told they had a rotator cuff tear had 24% higher perceived need for surgery than those told they had bursitis.

Unnecessary shoulder surgery is a growing problem

The use of surgery for common types of shoulder pain听听听, including听.

Yet some shoulder surgery provides limited benefit to patients.听听is a type of surgery called 鈥渟ubacromial decompression鈥�, which involves reducing pressure on a tendon by removing surrounding tissue. This procedure is no better than placebo surgery (where patients were put to sleep and researchers only conducted a joint examination, rather than surgery).

Other surgeries to repair torn tendons听听little or no benefit compared with non-surgical treatments such as exercise.

Also, there鈥檚 no reliable way to determine that a rotator cuff tear is the cause of a patient鈥檚 symptoms.听听of people aged 30-39 years who don鈥檛 have any shoulder symptoms have rotator cuff tears when they are scanned.

听potentially unnecessary shoulder surgeries are performed in Australia each year, which we estimate to cost听听per year.

Use of surgery is also increasing across many other conditions. For example,听听for anterior cruciate ligament (ACL) ruptures, and spinal fusions for some听. However, evidence suggests surgery is听听听for either of these surgeries.

What about other conditions?

Our study adds to听听showing the name your doctor uses to describe your condition can encourage you to consider unnecessary treatments.

Low-risk 鈥渃ancer鈥�

There鈥檚 a type of abnormal breast cells that can build up in the milk ducts called 鈥渄uctal carcinoma in situ鈥�. For many people, these cells are low-risk and won鈥檛 grow, or grow so slowly they鈥檒l never cause harm.

Using the terms 鈥渃ancer鈥� or 鈥渃arcinoma鈥� to describe this condition听听听from patients, and increases their desire for more aggressive treatments,听.

For patients with these low-risk cells, surgery, radiotherapy and/or hormonal treatments听. Instead, these interventions may cause harm through surgical complications such as persistent pain or skin burns, as well as financial costs and the psychological impact of being diagnosed with 鈥渃ancer鈥�.

Acid reflux

听asked parents to consider a hypothetical scenario in which their otherwise healthy infant cries a lot and 鈥渟pits up excessively鈥�.

It found parents who were told their child had gastroesophageal reflux disease (commonly known as 鈥渁cid reflux鈥�) were more interested in medication compared to parents who didn鈥檛 receive a diagnosis at all. This was true even when parents were told medication wasn鈥檛 beneficial. Medication in babies shows听听in reducing these symptoms.

鈥楶颈苍办-别测别鈥�

A听听presented a hypothetical scenario to parents about viral conjunctivitis. One group of parents were told their kids had 鈥減ink-eye鈥�, and another were told their kids had an 鈥渆ye infection鈥�.

Parents told their children had 鈥減ink-eye鈥� remained interested in antibiotics despite being told the medications were ineffective. Conversely, parents told their children had an 鈥渆ye infection鈥� became significantly less interested in antibiotics when told they were ineffective.

Parents given the 鈥減ink-eye鈥� label perceived the infection as more contagious than those given the 鈥渆ye infection鈥� label, even though both are simply other ways of saying conjunctivitis.

Polycystic ovary syndrome

This is a common hormonal condition affecting many women. But听听are on a spectrum of severity, with no clear line separating normal from abnormal.

听found young women told their symptoms indicated 鈥減olycystic ovary syndrome鈥� 鈥� in a hypothetical scenario of a doctor鈥檚 visit 鈥� were more likely to want further medical testing than those given the term 鈥渉ormonal imbalance鈥�. These women also perceived their condition to be more severe and had lower self-esteem.

What should health professionals do?

It鈥檚 vital health professionals consider whether the terms they use to describe a condition might be causing unnecessary fear and anxiety, and leading patients to consider unnecessary tests and treatments.

Health professionals may find it challenging to avoid terms they鈥檝e been using for many years. But the potential cost of increasing patient鈥檚 fear and anxiety, and making people feel they need surgery when they don鈥檛, cannot be ignored.

Changing how health professionals describe conditions to their patients is a simple strategy that could curb the rise of unnecessary health care.

For patients with shoulder pain not caused by severe trauma, we suggest health professionals avoid telling patients they have rotator cuff tears as this may make some patients think shoulder surgery is needed (which it isn鈥檛).

Health professionals could instead label people with this type of shoulder pain as having bursitis (inflammation), as this was the label that mostly made people think surgery was unnecessary.

听

This article was first published on and was written by Dr Joshua Zadro, Dr Brooke Nickel, Dr Giovanno Ferreira, Dr Mary O'Keeffe, and Dr Tessa Copp from the University of Sydney.