When you are injured or experiencing pain, what should your first steps be? Medical education and the most recent scientific evidence concur that the more conservative treatment approaches are always the preferred first steps, with more invasive treatments reserved for a minority of people who fail conservative measures and are unable to find relief and/or unable to resume functioning as they did before the injury.
Treatment options for injuries/pain syndromes should begin with PT, then escalate in invasiveness to pain management including medications, injections, and then surgery. The decision for any procedure leading up to surgery is always a complicated one, with many variables, pros and cons. There is no question that a percentage of traumatic injuries require immediate emergency surgery. This is not the population to which I am referring. In my practice, we evaluate patients on a daily basis who are considering surgery but have chosen to try PT first. These patients are oftentimes skeptical that exercise can "fix" their injuries, but considering the alternative of surgery and all of its risks, they are willing (or encouraged by other medical professionals) to try.
A large part of my professional responsibility as a physical therapist is to educate my patients and the community about injury prevention, appropriate treatment options when injuries do occur and to assist in the treatment decision making process for the ultimate goal of full recovery. Injury prevention is a whole other topic that I am passionate about (see some of my previous posts), but that is not the focus of this post. When I find my patients, family members and friends considering surgery, it is my duty to educate them about their options.
The human body is quite amazing in its healing capabilities. When removing the sources of trauma while promoting therapeutic movements/positioning, re-learning correct body mechanics, strengthening weak muscles, stretching tight muscles, releasing knotted tissue, restoring flexibility, regaining joint/body stability and learning lifelong strategies to maintain a healthy body, I have seen numerous people fully recover without surgical intervention. Some of our biggest success stories are patients who enter with a variety of common diagnoses including torn muscles/tendons/cartilage, joint damage including arthritis, spine fractures, herniated spinal disks or those who have had past surgeries and are considering repeat surgeries. While it may not be a fast process, a majority of these patients are able to function pain-free without any treatments other than skilled physical therapy.
If you are considering surgery and have not tried PT first, I urge you to consider this powerful treatment option. Research the pros and cons, discuss it with your current medical providers and certainly feel free to reach out to me (or your trusted PT) with any questions you may have. It is our ultimate goal as PTs to get you back to as close to 100% functioning as possible and, as professionals, we will provide honest feedback on your prognosis and recommended treatment options.
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