For people facing potential surgery, it’s not a bad question. Surgery can be a daunting prospect, so it’s natural to wonder, “Are there things I can do to avoid or delay surgery?”
To quickly satisfy your curiosity, the answer is “Yes.” Physical therapy is one way you can often avoid or delay surgery, but the circumstances have to be right and the patient has to be willing to do the work. Meredith Wall, PT, DPT, FAFS provides her professional insight into this matter and we look at the results of studies conducted which measure the success of physical therapy on surgical and pre-surgical patients.
Why Should I Pursue Physical Therapy Instead Surgery?
There are several benefits to choosing physical therapy over surgery.
- Physical therapy is non-invasive
- Physical therapy has less risk than surgery
- Physical therapy is more cost effective (short-term and long-term)
- Physical therapy reduces overall doctor visits, specialist visits, and unplanned absences from work or other obligations
- Physical therapy prevents further injury (1)
One of the biggest misconceptions Meredith sees is the idea that surgery will fix all your problems.” I think almost all surgeons would agree that there are a lot of risks involved with surgery, and there is never a guarantee on pain. In most cases, I feel physical therapy is both appropriate and beneficial, regardless of whether surgery ends up being a part of a patient’s recovery journey.”
While surgery can resolve pain, if there are underlying issues responsible for your condition that go unaddressed, the surgery will only be a temporary solution to a larger problem. Physical therapists evaluate the whole body, how it moves and functions, and can help determine if any of the pain or discomfort you are experiencing is a result of a dysfunction somewhere else in the body.
A 5-year study on patients with ACL injuries discovered that physical therapy played a key role in overall patient health and recovery. Groups that received physical therapy before surgery and physical therapy instead of surgery found that their symptoms had subsided more than participants that received surgery as the first course of treatment. Participants in the surgery first group experienced lasting symptoms, like numbness, from surgery and were more likely to need additional surgery (2).
Learn about the ACL Injury Rehabilitation Program at Spooner Physical Therapy.
Where Do I Start?
Dealing with pain or chronic musculoskeletal disorders can be both physically and emotionally frustrating. The quest for relief from pain or dysfunction, the juggling of medical bills, and the internal struggle related to your next steps can make it feel like the pain has control of your life. Fortunately, we have the tools and the desire to help you regain control.
You can also choose to see a physical therapist first. It’s true that you do not need a referral to see a physical therapist. Physical therapists are highly trained and capable of diagnosing dysfunctions that require medical attention. A physical therapist will be able to prescribe a plan of care that will be beneficial to your health and safe for you to perform.
During evaluations, Meredith always asks her patients, “How is your current quality of life?” and “Can you do everything you want to even though there is some pain?” In her experience, treatment and injury severity depends on the individual. “Just because you have a torn tendon, muscle or ligament, it doesn’t always mean surgery.”
Meredith explains a physical therapist can also call upon their network to ensure you receive the care you need. Meredith will refer a patient to a specialist when she determines that there is risk of further injury or in cases where medical imaging would be beneficial. The most common causes for referral are often related to:
- A fracture that needs to be stabilized
- Apparent nerve damage
- Apparent brain injury
- Signs of spinal cord compression
- Severe joint degeneration
Timeliness Matters
Often times the earlier you seek help, the more options you have when it comes to treatment. Catching a movement dysfunction early means that physical therapy will be more effective in preserving and improving movement.
In 2018, a study showed that patients who received immediate physical therapy (within 1-4 days) after a low-back pain episode had fewer physician visits, fewer imaging tests, less time away from work, and shorter case duration. In addition to all of that, physical therapy patients achieved higher care satisfaction than patients who did not see a physical therapist and received a plan of care that involved medication, injections, and/or surgical intervention (3).
Our bodies change over time, so the choices you make today matter for your future self.
Learn about Spine Rehabilitation at Spooner Physical Therapy.
The Doctor Says I Will Definitely Need Surgery
Sometimes surgery is unavoidable, but even when that is the case, physical therapy before your surgery can help prepare your body and improve your post-surgical recovery.
Physical therapists know how to optimize your body for surgery too. In fact, many people chose to prepare their bodies for a scheduled surgery with physical therapy. It’s known as pre-hab (preoperative rehabilitation). The benefits of pre-hab include strengthening and mobilizing your muscles around the future surgical site. Improved strength and mobility will help to aid recovery and to support your body during healing.
Pre-hab has shown to reduce the chances of complications from surgery, reduce the length of time needed to recover, while also improving outcomes. According to Meredith, “Pre-hab is almost always effective. My patients that get rehab before surgery do so much better than those who elect not to.”
If you’re reading this after having seen your doctor and think you would benefit from working with a therapist prior to surgery, we have good news. You don’t need a referral to get into a Spooner clinic. Arizona has removed referral requirements, making it easier for you to access the care you need, when you need it.
Read more about Pre-Hab from the Spooner blog and what it can do for you!
Why Haven’t I Heard More About This?
Most people view physical therapy as the first step in recovery after surgery. Turning to physical therapy as a way to delay or avoid surgery altogether is gaining more acceptance as studies supporting its benefits become available. More doctors are also prescribing physical therapy in lieu of surgery or painkillers and patients are having remarkable results.
You are empowered to take control of your health and knowing your options is the first step. Physical therapy helps thousands of people every year preserve their health and save on costly surgery and lengthy recovery. As the healthcare landscape continues to evolve, more people are placing value in their health and movement. Physical therapy has proven as a means to help people achieve a quality of life they didn’t think was possible. Are you ready to get your health in motion? You might be surprised by the gains you are able to make and the successes you are able to achieve.
Click here to schedule an appointment or complimentary movement screen with a Spooner physical therapist at one of our locations throughout the valley.
References
- Craig, M. (2016, October 25). Physical Therapy Versus Surgery. Retrieved from Nu Sci: https://nuscimag.com/physical-therapy-versus-surgery-9c2320e4b7bc#:~:text=Therapy%20is%20often%20more%20cost,the%20case%20for%20ankle%20sprains
- Filbay SR, Roos EM, Frobell RB, et alDelaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome: an exploratory analysis of the KANON trialBritish Journal of Sports Medicine 2017;51:1622-1629.
- Xinliang Liu, William J Hanney, Michael Masaracchio, Morey J Kolber, Mei Zhao, Aaron C Spaulding, Meghan H Gabriel, Immediate Physical Therapy Initiation in Patients With Acute Low Back Pain Is Associated With a Reduction in Downstream Health Care Utilization and Costs, Physical Therapy, Volume 98, Issue 5, May 2018, Pages 336–347, https://doi.org/10.1093/ptj/pzy023