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PT Can Prevent Unnecessary Surgery

July 9, 2020

Physical therapists are health care professionals who work with patients to restore and improve mobility and function. Research indicates that physical therapy offers patients with an effective alternative to medications and surgeries for various conditions, ranging from shoulder impingement to knee osteoarthritis.1, 2

There is an increasing trend for physicians to recommend conservative, non-operative treatment for certain conditions prior to suggesting surgery. A recent study in the New England Journal of Medicine found no difference in functional outcomes for patients with knee osteoarthritis and meniscus tears who underwent surgery versus physical therapy.3 Other studies have reached similar findings, noting that surgeries and conservative treatments (physical therapy) produce similar outcomes for patients with shoulder pain and low back pain, specifically non-traumatic rotator cuff tears, lumbar spinal stenosis, and lumbar degenerative disk disease.4, 5, 6

All surgeries, whether “minor” or “significant,” carry inherent risks including blood clots after surgery, infection, slowed healing of the incision, complications from anesthesia, and accidental damage to nerves and other organs. While some of these risks may only cause temporary discomfort and pain, others can result in more significant issues, including permanent disability and death. In fact, Dr. Anthony Delitto, PT, PhD, FAPTA, the lead author of a study on surgery versus physical therapy for lumbar spinal stenosis, said in a Reuters article that, “Surgery is a riskier procedure, with about a 15% complication rate, and half of those are life-threatening. It isn’t a life-risking procedure to do physical therapy.”7

Recent research also shows that physical therapy can help prevent surgery and decrease costs for patients, employers, and insurance companies, especially by allowing patients to return to work earlier.8. 9 Virginia Mason Medical Center, located in Seattle, WA, has created collaborative, evidence-based processes for treating patients with headaches, joint pain, back pain, and non-cancerous breast concerns. They found that physical therapists helped physicians see more patients than they previously could, and patients generally returned to work faster after illness/injury when treated with physical therapy. This resulted in decreased costs for patients, insurers, and employers. Another study found that patients with low back pain who were referred to PT earlier by physicians tended to return to work earlier.

Physical therapy can’t address every musculoskeletal issue, and surgery may be the best treatment for some conditions. However, research now shows that surgery may not be indicated for many health conditions, and sometimes carries unnecessary risks and price tags. In many cases, trying physical therapy first is a safe, effective, and cost-effective choice, and for many patients, it may be the only treatment they need to eliminate their pain, improve their quality of life, and get back to doing the activities they love.

ABOUT WATER & SPORTS PHYSICAL THERAPY

Water & Sports Physical Therapy is the only practice in San Diego that has our patented, state of the art, 3D infrared analysis system, which allows our doctors to identify strengths and weaknesses, develop a comprehensive and unique rehab program for each patient, assist with injury prevention, and help improve sports performance.

If you are interested in receiving a FREE infrared analysis with your one hour evaluation covered by your insurance, please call 858-488-3597 or email info@waterandsportspt.com. We have 8 convenient locations all over San Diego to assist with your healthcare!

REFERENCES

  1. Holmgren T, Hallgren HB, Öberg B, Adolfsson L, Johansson K. Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. British Journal of Sports Medicine. 2014;48(19):1456-1457. doi:10.1136/bjsports-2014-e787rep.
  2. Kirkley A, Birmingham TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee [published correction appears in N Engl J Med. 2009 Nov 12;361(20):2004]. N Engl J Med. 2008;359(11):1097‐1107. doi:10.1056/NEJMoa0708333.
  3. Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus Physical Therapy for Meniscal Tear and Osteoarthritis. New England Journal of Medicine. 2013;369(7):677-678. doi:10.1056/nejmc1307177.
  4. Kukkonen J, Joukainen A, Lehtinen J, et al. Treatment of non-traumatic rotator cuff tears. The Bone & Joint Journal. 2014;96-B(1):75-81. doi:10.1302/0301-620x.96b1.32168.
  5. Delitto A, Piva SR, Moore CG, Welch WC. Surgery Versus Nonsurgical Treatment of Lumbar Spinal Stenosis. Annals of Internal Medicine. 2015;163(5):397. doi:10.7326/l15-5129-4.
  6. Smith JS, Sidhu G, Bode K, et al. Operative and Nonoperative Treatment Approaches for Lumbar Degenerative Disc Disease Have Similar Long-Term Clinical Outcomes Among Patients with Positive Discography. World Neurosurgery. 2014;82(5):872-878. doi:10.1016/j.wneu.2013.09.013.
  7. Rapaport L. Physical therapy may be as good as surgery for common back problem. Reuters. https://www.reuters.com/article/us-lumbar-stenosis/physical-therapy-may-be-as-good-as-surgery-for-common-back-problem-idUSKBN0MX1FU20150406. Published April 6, 2015. Accessed May 20, 2020.
  8. Blackmore CC, Mecklenburg RS, Kaplan GS. At Virginia Mason, Collaboration Among Providers, Employers, And Health Plans To Transform Care Cut Costs And Improved Quality. Health Affairs. 2011;30(9):1680-1687. doi:10.1377/hlthaff.2011.0291.
  9. Ehrmann-Feldman D, Rossignol M, Abenhaim L, Gobeille D. Physician Referral to Physical Therapy in a Cohort of Workers Compensated for Low Back Pain. Physical Therapy. 1996;76(2):150-156. doi:10.1093/ptj/76.2.150.
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