Try Physical Therapy 1st: Physical Therapy or Orthopedic Surgery?
Low back pain has reached epidemic number, with 80% of the population having low back pain sometime in their life. Two conditions often treated surgically for low back pain are spinal stenosis or disc herniation. A study comparing physical therapy and a surgery group showed that the same amount of improvement in pain and physical function at a two-year follow-up
Studies have clearly shown that seeing a physical therapist first through direct access can: improve musculoskeletal pain faster; reduce or remove the need for some types of musculoskeletal surgery; reduce opioid use, improve patient satisfaction, reduce expensive medical testing, and help patients get needed treatment faster. (Physical Therapy, 2017)
Research has also shown that physical therapy should be your first choice before having many orthopedic surgeries. Trying physical therapy first can often can eliminate the need for orthopedic surgery while improving recovery time and decreasing health care costs.
In the shoulder, rotator cuff injuries are common. The rotator cuff is four muscles that surround the arm bone keeping it centered and stable in the shoulder joint. Tears of the rotator cuff are often surgically repaired; however, studies show that trying physical therapy first may prevent the need for surgery. A study showed no clinically significant difference between surgery and active physical therapy in a 1-year follow-up. The study recommended a conservative approach as the initial treatment modality. However, with large rotator cuff tears, early surgery is recommended to prevent retraction of the rotator cuff tendon. (Disabil Rehabil. 2017)
Low back pain has reached epidemic number, with 80% of the population having low back pain sometime in their life. Two conditions often treated surgically for low back pain are spinal stenosis or disc herniation. A study comparing physical therapy and a surgery group showed that the same amount of improvement in pain and physical function at a two-year follow-up. The most common complications in the lumbar surgery group were; delayed wound healing, infection, and repeated need for spinal surgery. In the PT group, the only complication reported was increased symptoms. (Annal Int Med, 2017)
The knee has four ligaments hold the thigh bone and leg bone together. The anterior cruciate ligament (ACL) is one of those ligaments frequently injured in sports like football, basketball, soccer, and ice hockey. In a study comparing an ACL surgery group with physical therapy, 61% of the physical therapy group avoided surgical reconstruction. Also, early ACL reconstruction did not have better results, with no difference found between physical therapy only group and the reconstruction group. (BMJ. 2013) If there is instability of the knee surgery would be recommended. Depending on the individual’s activity goals, physical therapy is an option to avoid ACL surgery.
The meniscus is the cartilage that provides cushion separating the thigh and leg bones at the knee. For meniscal surgery, a study in the New England Journal of Medicine found no significant differences in pain and function in those that had surgery and those with only physical therapy. Also, 70% of patients continued to see the benefits of physical therapy six months after discharge, not needing the meniscal repair. (New Eng J of Med, 2020, N Engl J Med 2008)
Health care costs are continually rising, representing 18% of the US gross domestic product (GDP) in 2020. (Statista, 2020) Physical therapy can significantly reduce health care costs by; reducing the need for surgery, eliminating joint injections, reducing chronic use of pain medications, and limiting the need for advanced imaging, such as MRI. When comparing the expense of surgery to physical therapy, the difference is dramatic. For example, the typical cost for physical therapy rehabilitation is $1,000 to $2,000. In contrast, orthopedic surgery can cost between $20,000 to $50,000. Trying physical therapy first can reduce expenses helping the US economy by reducing the GDP.
When you have pain, limited function, and poor quality of life, physical therapy can be your first step to recovery. Seeing a physical therapist first will help you begin the recovery process without using drugs or surgery. If you need surgery, physical therapy before surgery (prehab) will help improve your outcome by preparing the body for an optimal return during the post-surgical rehabilitation process.
We can help!
If pain is limiting you from doing the activities you enjoy, call Mishock Physical Therapy for a Free Phone Consultation (610)327-2600. Email your questions to mishockpt@comcast.net. Visit our website to learn more about our treatment philosophy, our physical therapy staff, and our 7 convenient locations in Gilbertsville, Skippack, Phoenixville, Boyertown, Limerick, Pottstown, and Steiner Medical at www. mishockpt.com.
Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He uses the combination of the two to help his patients. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon.