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Physical Therapy, Surgery, or Both?

Should you have elective surgery?


No surgery is entirely without risk.

Having an elective surgery is not a decision to make lightly. Surgery has risks - risks that increase for those with serious underlying health conditions, and as we age. In addition to facing these possibilities, we must also take into consideration the sometimes lengthy and painful process of recovery.


If your doctor is recommending an invasive surgical procedure, or you believe you need one for pain or dysfunction in muscles, tendons, ligaments, bones, and joints, there might be another answer. If you haven’t yet, talk to your doctor about treatment with physical therapy.


Physical Therapy is as effective as surgery


There is mounting evidence pointing to the fact that physical therapy is as effective as surgery for some types of pain and injury - without the added risks and side effects. Consider the following examples:

  • Studies have shown that physical therapy can be as effective as surgery in providing pain relief for one of the most common types of lower back conditions, spinal stenosis.

  • A study in the New England Journal of Medicine (NEJM) found that physical therapy is as effective as surgery in treating patients with meniscal tears.

  • Evidence supports the use of physical therapy for cases of moderate to severe osteoarthritis.

  • Research shows that physical therapy is just as effective as surgery for some types of rotator cuff tears.

  • A study published in the Journal of Orthopaedic & Sports Physical Therapy showed that patients with carpal tunnel syndrome responded just as well to physical therapy as to surgery.

  • World Neurosurgery found that patients with degenerative disk disease showed similar long term results whether they chose operative or nonoperative treatment.

There are times when surgery cannot be avoided: emergency situations when it is the clear and only answer, or times when all other avenues have been unsuccessful. However, if you are considering an elective surgery as a first course of action, think about giving physical therapy a chance first.


Physical Therapy and Surgery Combined


Prehabilitation:

Your doctor may still be interested in you working with a physical therapist before your surgery for what’s called prehabilitation (prehab). The goal of prehab is to increase the chances of a better outcome after surgery.


Prehab often works on an integrated model of health. By strengthening muscle groups, overall fitness levels, improving nutrition, and teaching stress/anxiety reduction techniques, the practitioner and patient work together to prepare the body for the stressor of surgery and the period of relative inactivity to follow.


The postoperative benefits of prehabilitation are evident:

  • Reduced length of hospital stay

  • Less postoperative pain

  • Fewer postoperative complications

  • Improved function

  • More independence

Rehabilitation:

Rehab generally starts shortly after surgery with simply getting out of bed. Depending on the seriousness of your surgery you may move from the hospital into a rehab center where therapists can help you learn to safely walk, bathe, and care for yourself independently.


Some of the goals of rehab include:

  • Improved movement and range of motion

  • Muscle strengthening

  • Pain reduction

  • Assistance with returning to daily activities if needed


What about Telehealth?


No one wants to spend more time at the doctor’s office than they have to and if you’re looking at an upcoming surgery you’ve probably had all the waiting rooms, exam offices, and hospitals you need for awhile. Which is why you might be especially glad to hear that physical therapy has fully made the leap into the world of telehealth. These days you can schedule many of your physical therapy appointments at a time and location that’s most convenient for you.



If you’re interested in learning more about the benefits of telerehab in surgery prevention or for pre- and postoperative care, contact us. We’d love to give you more information or to set you up with one of our licensed physical therapists for a free 15-minute consultation.

Don't take our word for it!


References

Admin. (2019, January 10). How Can Physical Therapy Help to Avoid Surgery? Retrieved from https://www.tucsonortho.com/how-can-physical-therapy-help-to-avoid-surgery/


Ambardekar, N. (2020, January 21). Rehab After Surgery: Why You Need It and How It Helps Recovery. Retrieved from https://www.webmd.com/pain-management/rehab-after-surgery#2


Banugo, P., & Amoako, D. (2017, August 16). Prehabilitation. Retrieved from https://academic.oup.com/bjaed/article/17/12/401/4083340

Brett Sears, P. (n.d.). Physical Therapy Versus Surgery for Rotator Cuff Tear. Retrieved from https://www.verywellhealth.com/physical-therapy-versus-surgery-for-rotator-cuff-tears-2696052#:~:text=Research has shown that if,your arms and upper extremities.


Howard LeWine, M. (2020, June 17). Physical therapy as good as surgery and less risky for one type of lower back pain. Retrieved from https://www.health.harvard.edu/blog/physical-therapy-as-good-as-surgery-and-less-risky-for-one-type-of-lower-back-pain-201504097863#:~:text=One type of lower back pain, called lumbar spinal stenosis,in Annals of Internal Medicine.


Mounsey, A., & Ewigman, B. (2009, March). Arthroscopic surgery for knee osteoarthritis? Just say no. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183924/


Physical therapy as effective as surgery for torn meniscus and arthritis of the knee, study suggests. (2013, March 21). Retrieved from https://www.sciencedaily.com/releases/2013/03/130321133244.htm


Smith JS;Sidhu G;Bode K;Gendelberg D;Maltenfort M;Ibrahimi D;Shaffrey CI;Vaccaro AR;. (n.d.). Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease Have Similar Long-Term Clinical Outcomes Among Patients With Positive Discography. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24047821/


Smith JS;Sidhu G;Bode K;Gendelberg D;Maltenfort M;Ibrahimi D;Shaffrey CI;Vaccaro AR;. (n.d.). Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease Have Similar Long-Term Clinical Outcomes Among Patients With Positive Discography. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24047821/


The effectiveness of prehabilitation for adults having elective surgery: A systematic review protocol. (n.d.). Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=3477125&Journal_ID=3425880&Issue_ID=3476640#:~:text=Prehabilitation is defined as a,a better place before surgery.


The effectiveness of prehabilitation for adults having elective surgery: A systematic review protocol. (n.d.). Retrieved from https://www.nursingcenter.com/journalarticle?Article_ID=3477125&Journal_ID=3425880&Issue_ID=3476640#:~:text=Prehabilitation is defined as a,a better place before surgery.


Staff, S. X. (2017, March 02). Physical therapy proves as effective as surgery for carpal tunnel syndrome. Retrieved from https://medicalxpress.com/news/2017-03-physical-therapy-effective-surgery-carpal.html#:~:text=Physical therapy proves as effective as surgery for carpal tunnel syndrome,-March 2, 2017&text=Physical therapy is as effective,Sports Physical Therapy (JOSPT).


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