If there was an easy, one-word answer to the question, this would be a very short article. However, instead of a simple “yes” or “no,” the answer is “it depends.” It depends on so many variables.
What kind of surgery are you talking about?
Frozen Shoulder occurs when the shoulder loses motion and is painful because of inflammation. According to an article in The New York Times, frozen-shoulder can be treated non surgically through the use of anti-inflammatory nonsteroidal medications and intense physical therapy. Surgery is recommended when the nonsurgical treatment is deemed ineffective. Shoulder arthroscopy is performed under anesthesia and physical therapy is required after surgery. Interestingly, it is stated that left untreated, frozen-shoulder often gets better within two years all by itself.
A Torn Meniscus can be corrected with knee surgery, and is, nearly half a million times a year in the U.S. Physical therapy comprised of at least nine sessions plus exercise at home was found to be about equally effective as surgery, according to CBSNews.com. Those that had surgery stated that in general they had seen no improvement from the therapy, or they opted for surgery first because they simply wanted to be fixed. Physical therapy is a logical first strategy.
Lumbar Disc Surgery, according to a featured research article in Science Daily, compared favorably to the nonsurgical treatment for herniated disc patients which resulted in less long-term improvement in pain, disability and functioning compared to those undergoing surgery. The research leans heavily toward the conclusion that patients who underwent surgery averaged 11 points lower on a pain scale of 100, than the nonsurgical treatment group. The research acknowledges that while the average outcome scores for those having surgery were better, that there was significant improvement for those patients with nonsurgical treatments as well.
Rotator Cuff Tears are a common ailment that can be treated both surgically and nonsurgically, but which is best? If it’s a non-traumatic tear, physical therapy produces results as good as or better than surgical methods, and physiotherapy should always be considered the initial treatment for this condition.
Stress Urinary Incontinence isn’t necessarily an ailment one would consider as a candidate for physiotherapy, but in fact, pelvic-floor muscle training is considered a first-line treatment. When physiotherapy is deemed unsuccessful, midurethral-sling surgery is recommended. Conclusions are generally that surgery results in higher rates of improvement.
Does it have to be one or the other?
Instead of thinking of physiotherapy and surgery as competing treatment options, it is most often that they go hand-in-hand. According to Results Physiotherapy, “Physiotherapy is often recommended as a conservative approach to pain and movement management with the hope of avoiding surgery all together. However, even if surgery is eventually indicated, physical therapy is usually part of the recovery process.”
What other options are there?
We’ve discussed physiotherapy and surgery, but there are other methods of controlling pain and movement limitations that deserve consideration.
Aerobic exercise, swimming, cycling, yoga and pilates are the first step, conservative procedures one can try, as always, under the guidance of a physician.
Pharmaceutical resources are many, effective, sometimes dangerous, often addictive yet effective initially. While it may be easy to pop a pill, once should discuss the side effects of prescription pain killers.
Acupuncture is a minimally invasive procedure most commonly used to treat pain by balancing the flow of energy through pathways in the body by using thin needles inserted at strategic points on the body.
Common sense?
Yes, common sense is the best approach. If you have pain, and surgery is an option for relief, discuss the alternatives with your doctor before scheduling surgery. It should be a last resort, not your first option. It’s not that surgery’s bad, but it carries with it risks that other procedures don’t have. If you can get to wellness through physiotherapy or one of the other more conservative procedures, do it. You’ll always have surgery as an option.
