Physical therapy and surgery are two common approaches to pain management. In most situations, doctors (and patients) prefer to start with physical therapy because it’s non-invasive and places less stress and strain on the body, promotes natural healing within the body, comes with lower risks, like infection and blood loss, has a much shorter recovery time, and is a significantly less expensive approach compared to surgery.
Types of Physical Therapy
There are two primary ways to classify physical therapy: passive and active. Passive is any therapy performed on the individual, and can include acupuncture, chiropractic adjustments, hot and cold therapy, and massage therapy. Active refers to any exercise that the individual performs, including aerobics, posture reformation, stretching, and core strengthening. Both forms of physical therapy can help reduce inflammation, improve motion and mobility, and restore weakened muscles.
Common Conditions Frequently Treated With Physical Therapy
The benefits of active and passive physical therapy apply to most types of muscle, tissue, and joint injuries and diseases, including:
- Herniated Discs: Physical therapy techniques, including spinal decompression, postural training, and core strengthening exercises, help reduce pressure on the affected disc and nerves.
- Rotator Cuff Injuries: There are many progressive strengthening exercises that specifically target the four rotator cuff muscles and help improve muscle strength and stability.
- Knee Osteoarthritis: Severe (Stage 4) knee osteoarthritis can be difficult to treat without an invasive procedure. However, when detected in its earlier stages, knee osteoarthritis can be treated (not cured) through low-impact exercises and progressive strengthening exercises.
- Tendonitis & Overuse Injuries: Tendonitis is caused by inflammation, and eccentric strengthening exercises can help reduce that inflammation and promote faster healing.
Risks With Physical Therapy
While physical therapy remains a lower-risk pain management method when compared to surgery, there are still some potential risks and side effects. Some people experience a decreased range of motion during or after physical therapy, which typically self-resolves when the muscles become accustomed to the new routine. Delayed onset muscle soreness (DOMS) can also be a side effect, but this also self-resolves within a few days.
Although physical therapy is beneficial and less risky, it doesn’t mean surgery is never necessary. There are some instances in which surgery is the better solution, especially if the patient has already been through a physical therapy program and has experienced no improvement or worsening of pain.
When Surgery May Still Be Needed
Many people see significant improvement from therapy and may not require invasive care. However, there are some situations where physical therapy is not suitable as a first-line treatment. Keep in mind that these are case-by-case approaches, and there is no black-and-white rule as to when surgery is preferred over physical therapy, except in situations involving open fractures or life-threatening emergencies like vascular injuries. If you’re experiencing any emergency condition, always go to the ER for immediate treatment.
Beyond medical emergencies, surgery may be recommended over physical therapy for:
- Joint dislocations (although physical therapy is needed after surgery to help stimulate muscle growth and recovery)
- Rapidly worsening conditions, like pathological fractures
- Severely torn muscles or fragmented bones that can impede range of motion
As stated earlier, surgery is a case-by-case approach, and your primary care physician will let you know if surgery is the appropriate course of action for your condition.
Schedule a Consultation With Total Health Systems
Total Health Systems is committed to helping you achieve a pain-free lifestyle. If you’re experiencing pain from a non-emergency condition, please schedule an appointment at one of our six southeast Michigan locations. Our physical therapists can work independently or in collaboration with your primary care physician to create a personalized, holistic treatment plan for your condition. Please visit our website to learn more about what to expect during your initial consultation and which insurance providers we work with.
