When it comes to medical treatment, surgery is one of the most interesting topics. The history of surgery until the last 100 years of medical advancements was fairly bleak to say the least. And it’s easy to understand why when you really stop and think. It is amazing that people can have joints replaced, new blood vessels attached to beating hearts, or our brains operated on with the individual living to tell the tale. Surgical advancements have without a doubt improved our longevity and quality of life. As a result of these advancements and improved access to healthcare over the past few centuries, surgery has become increasingly common.
Orthopedic surgeries, meaning those that affect the bones, muscles, and associated tissues like tendons, are fairly common. Most people know of a family member or friend who have had a joint replacement, rotator cuff repair, or some sort of spinal surgery, and anyone who watches sports has some idea of how an ACL tear usually goes (hint, it’s surgery). With how common these surgeries are, you might think that most people would have a decent understanding of what to expect from a surgery.
Unfortunately, there are some common misconceptions about how surgeries go, including:
- “The surgery is going to fix everything right away” – Most people want a quick fix, and surgery often seems like one. Most of the time, recovery time after a surgery is going to take time, and that varies greatly depending on a ton of factors. For example, an ACL repair will effectively keep an athlete off of the court or field for competitive play for almost a year before they’re back at it. Most of the time it takes another several months to fully regain the strength to feel “normal”, simply because they lost strength while recovering from surgery. For surgeries like a joint replacement, there’s usually going to be a 2-3 month time period where people still feel pretty limited. Again, the time frame varies greatly, but it’s very rare that someone gets surgery for an orthopedic issue and feels 100% better that day.
- “My symptoms are going to go away completely” – This one gets a little hairy. Again, most surgeries provide a great deal of relief or improvement to whatever symptom or limit in function someone is experiencing. This tends to come up the most with back pain. As we’ve discussed before, imaging doesn’t always correlate to pain. Just because a herniated disc was removed or a painful joint was fused, that doesn’t mean that disc or joint was the problem. Muscle function, nerve sensitivity, and your brain’s perception of that area all have a huge impact on pain, and surgery doesn’t necessarily correct those issues. This is true for the back as much as it is for the knee, shoulder, etc.
- “Something is torn / I have arthritis, so I need surgery” – This is one that comes up the most in Physical Therapy. If we look at rotator cuff tears, the majority of them don’t cause pain or dysfunction(1). As for arthritis, yes, it can absolutely cause pain, stiffness, and according to the Arthritis Foundation, even predict the weather. Exercise has been proven to reduce knee pain related to arthritis(2), but exercise is not going to change an arthritic joint. Exercise cannot get rid of arthritis, but it often is the best way to improve pain related to arthritis. Remember, just because something is off with imaging, that doesn’t mean it needs to be surgically corrected.
When it comes to orthopedic issues, surgery should be considered as the last case scenario. Remember, surgery does have risks, it’s expensive, and you can’t go back once you’ve had it. Surgery is also not always a quick fix, it isn’t guaranteed to provide 100% relief, and you may not need it in the first place. Before you go under the knife, you should be aware of all treatment options that may exist for your issues.
When it comes to any muscle, joint, or ligament/tendon pain, physical therapy should come up on your radar first. For most issues, physical therapy should at least be attempted prior to surgery, since many conditions, including muscle or partial tendon tears and arthritis, respond to physical therapy within a 1-2 month span. If there’s an option that will take essentially the same amount of time, cost significantly less (for you and the medical system as a whole), and has significantly fewer risks for what is often the same outcome, would you take it? That’s where physical therapy provides value: you moving better and feeling better. If physical therapy doesn’t get the results you want, then you have basically gone through what is known as “pre-hab” to strengthen you prior to surgery, which makes your recovery faster and more effective.
There are certainly instances where surgery is necessary and the best option right away, but those instances are not as common as one might think. If you’re dealing with pain or dysfunction, physical therapy should be your first choice.
Got questions? Feel limited in what you’re able to do? The staff at Limitless Physical Therapy in Eugene, OR can show you how to discover your future without limits.
***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice. Please contact a certified healthcare professional or your primary physician for any personal concerns.
- Minagawa H, Yamamoto N, Abe H, Fukuda M, Seki N, Kikuchi K, Kijima H, Itoi E. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. J Orthop. 2013 Feb 26;10(1):8-12. doi: 10.1016/j.jor.2013.01.008. eCollection 2013. PubMed PMID: 24403741; PubMed Central PMCID: PMC3768248.
- Jansen MJ, Viechtbauer W, Lenssen AF, Hendriks EJ, de Bie RA. Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review. J Physiother. 2011;57(1):11-20. doi: 10.1016/S1836-9553(11)70002-9. Review. PubMed PMID: 21402325.