Why would you trust a LLM over a battery of human experts? I find it hard to believe that the doctors never proposed exercises or some kind of physical therapy for you, at least in the US.
No doctor or physio has ever been able to fix my chronic issues, and I've always had to figure them out myself through lots of self-study and experimentation.
Yes, they propose exercises.
No, they don't work.
For certain (common) conditions, PT seems to have it nailed - the exercises really help. For the others, it's just snake oil. Not backed by much research. The current state of the art is just not good when it comes to chronic pain.
So while I don't know if an LLM can be better than a battery of human experts, I do know that those human experts do not perform well. I'm guessing with the OP's case, that battery of human experts does not lead to a consensus - you just end up with 10 different treatments/diagnoses (and occasionally, one is a lot more common than the other, but it's still wrong).
I would not expect most physicians to have a deep fund of literature-backed knowledge to draw from regarding exercise. Telling someone to do an exercise probably doesn't compensate well.
That said, I'm also pretty negative about the availability of rigorous literature regarding much of nutrition, dentistry, podiatry, physical therapy, etc... you know, the things that affect the health of most human beings that have ever lived.
Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments. Like even something common like a rotator cuff tear isn't one single thing that can always be treated the same way. Patients and practitioners will often have to follow a trial-and-error process until they figure out what works in a particular case. Experienced providers who see a lot of cases eventually develop a lot of tacit knowledge about this in a way that's difficult to codify or explain.
> Because there is so much variability in individual injuries and physiology it's extremely difficult to do rigorous studies comparing different treatments.
This is generally true of research in all areas of medicine; I don't see it as a fundamental reason why we wouldn't hope for equally powered and rigorous studies focusing on the issues that affect most of the population, even if there are not pharmaceutical or device companies that will profit from the recommended interventions.
I'm only a decade in, but my clinical experiences in my area of expertise vary widely from those of my colleagues, which vary from those of other colleagues, in spite of years of shared experience in a fairly homogenous demographic. Expert opinion is not a level of evidence that carries much weight in my mind.
It may be the best we have in many cases, I just wish we had something better.
Some specialist physicians have a deep knowledge of exercise for injury prevention and rehab. But it also helps to get input from a good physical therapist and/or personal trainer. As a patient it can be tough to discriminate the good ones from the quacks.
The endpoints for such research don't have to be problematic; regarding musculoskeletal complaints it's fairly straightforward to measure self-reported pain, self-reported level of function, or more objective measures like working days lost, strength, stamina, range of motion. The more difficult issue is determining an appropriate control group / placebo intervention.
(Also, I'll point out that my initial comment also included nutrition, dentistry, and several other fields under the same umbrella of "not enough good research" -- or to further specify, my complaint is that the burden of disease is disproportionate to the availability of rigorous literature.)
> Some specialist physicians have a deep knowledge of exercise for injury prevention and rehab.
By what measure? As in "they have a lot of clinical experience" -- (the "plural of anecdote")? Or as in they have read a lot of books on the subject? In which case, you seem to be agreeing that the evidence base is weak, so I'm not sure how authoritative this body of literature could be.
> As a patient it can be tough to discriminate the good ones from the quacks.
I imagine they would be virtually indistinguishable as a patient. Based on the context of this conversation, how would you recommend that I, as a physician, tell them apart? (It's hard enough to do with other physicians.)