Recent research is showing that surgery might not be needed as often as we think. A large review estimates that 10% to 20% of surgeries might be unnecessary and that in some specialties such as cardiology and orthopedics, that number might be higher. The reasons for so many unneeded surgeries being performed are varied, but the most common are that more conservative options aren’t tried first, or that there is a lack of knowledge or information regarding current research or outcomes studies being given to patients by the operating physician and/or other advising health care practitioners.
Recent research about the outcomes after certain common surgeries is showing that in some cases complicated operative procedures aren’t performing any better than a placebo. Two such examples are kyphoplasty – a procedure for spinal compression fractures, and partial meniscectomy – a procedure used to treat tears of the meniscus in the knee. Generally, unless they read a lot of medical literature, a typical health care consumer won’t know that these surgeries often don’t offer any more benefit than a non-surgical treatment. When a person is in pain and is seeking relief, it is often tempting to believe that surgery can offer a “quick fix”. Without bigger picture knowledge about the risks and benefits of surgery in comparison to other non-invasive treatments, many patients seek out surgical procedures, which will continue to be performed to meet public demand – particularly when health insurance continues to cover the procedures regardless of their potential efficacy.
Every surgery, even “minor” ones carry risks. These include complications from anesthesia, blood clots after surgery, delayed healing of the incision, infection, and unintended damage to nerves or other organs near the surgical site. Some of these risks cause discomfort for a period after surgery and go away, but others can result in permanent disability or even death. For some patients and conditions, surgery is a great treatment option, but with all the associated risks, when surgery can be avoided, it should be.
For musculoskeletal problems like back and joint pain, sprains, and strains, seeing your PT before a surgeon can help keep you out of the operating room and get you back to life without surgery. Studies have shown that physical therapy is just as good if not better than surgery for a multitude of conditions and carries far less risk. Some examples of common ailments that respond very well to non-operative physical therapy care would include rotator cuff and meniscal injuries, spinal stenosis, general low back pain, and osteoarthritis.
Physical therapy can’t fix every problem, and for some patients surgery is ultimately an appropriate choice. However, more research is showing that surgery isn’t a cure-all, and is sometimes just a very expensive and risky placebo. In most cases, starting with physical therapy is the right choice, and for many patients, PT is ultimately the only treatment necessary.