Physical Therapy vs Surgery: Which to choose?

When we meet our patients, they’re often fed up with their condition. Totally understandable: dealing with chronic pain is not fun, and it’s normal to feel as though a surgical intervention is the proper next step.

Deciding on physical therapy vs surgery can be a scary choice, as surgical interventions often come with important considerations down the road.

Choosing physical therapy over surgery might be preferred for less severe conditions, as it offers a non-invasive, gradual approach to recovery with fewer risks. However, surgery should be chosen when a swift, definitive intervention is necessary, especially in cases of significant structural damage or trauma.

In this article, we’ll discuss why or why not to choose surgery over physical therapy, and how (technically), the correct answer is often “both.”

Is physical therapy better than getting surgery?

We’ll admit that we are biased here. It’s common in the physical therapy world to hear that getting physical therapy first is preferable.

Note that we are not anti-surgery: in many cases, getting surgery is the right thing to do. However, we’d like to explore some of the nuances involved in making that decision and discuss why getting physical therapy first is often a very, very good idea.

3 Benefits of Physical Therapy vs. Surgery

Though more invasive options can sometimes be preferable, there are numerous benefits to physical therapy vs surgery or medication. Below are three important ones:

1. Physical therapy is non-invasive

Physical therapy offers a non-invasive alternative to surgery, allowing patients to address a variety of conditions without the risks associated with surgical procedures.

The focus of physical therapy is to assist you in a tailored exercise program focused on improving mobility and function in the affected joints. This can be particularly advantageous for individuals with milder or chronic issues.

2. Minimized risks and side effects

Physical therapy generally involves fewer risks and side effects compared to surgery, which may entail complications such as infections, anesthesia-related issues, or post-operative pain. Your physical therapist will focus on natural healing and rehabilitation, minimizing the likelihood of adverse reactions.

3. Physical therapy is more cost-effective

In many cases, the cost of physical therapy proves to be a more the more affordable option. It typically requires fewer financial resources than surgery, making it accessible to a broader range of individuals.

In many cases, physical therapy services can help individuals avoid surgeries, if possible.

4. Preservation of tissues and structures

Unlike surgery, which may involve the removal or alteration of tissues, physical therapy focuses on preserving the body’s natural structures. This is particularly relevant for conditions where maintaining the integrity of tissues is crucial for optimal function.

5. Physical therapy offers a reduced recovery time

Recovery from physical therapy is often quicker than post-surgical recovery. This can be a bit counterintuitive for many patients. After a physical therapy session, you get to resume your daily activities, even if your issue isn’t fully “solved” yet. Additionally, any surgical intervention will come with its own recovery time, which typically is sped up by seeking physical or occupational therapy.

How to know when it’s time for surgery

In spite of all the benefits listed above, there are many patients who truly will get the most benefit out of seeking surgery and then using physical therapy as part of a proper aftercare recovery plan.

1. Surgery is best for fixing massive trauma or structural damage

If your injury involves tears of connective tissue, fractures, or trauma to tissue, then surgery is often the only option in the beginning. Consult with your medical provider on this issue. They will be able to guide you in this decision, and many times they will make a recommendation if surgery is strictly necessary.

2. Other interventions have not worked

If you’ve been struggling with chronic pain or a recurring injury for a long time, and you’ve tried other interventions, then it may be time to consider surgery.

If conservative treatments, including physical therapy or chiropractic, have been tried without success or have not provided sufficient relief, surgery may be the next step to achieve better outcomes.

3. Loss of function or progression of the condition

When a medical condition results in a substantial loss of function, limiting the ability to perform essential physical activities of daily living, surgery may be considered to restore or improve functionality.

Additionally, if the condition is progressing despite conservative measures, surgery may be necessary to prevent further deterioration and complications.

4. Diagnostic imaging findings

Results from diagnostic imaging studies, such as X-rays, MRIs, or CT scans, may reveal abnormalities or damage that could be better addressed through surgical intervention.

5. Emergency situations

In certain cases, such as traumatic injuries or acute medical emergencies, immediate surgical intervention may be necessary to prevent further harm and facilitate rapid recovery.

Why the right choice can often be “both”

As we’ve alluded to already in this article, it’s common that physical therapy and surgery will be used together to form an entire course of treatment. Both surgical interventions and physical therapy have their own pros and cons.

The most obvious application of this approach is to seek physical therapy after surgery. Generally, there will be some rest time after a surgery, followed by a recovery phase to get you back to peak function.

You’ll need time to recover your range of motion, rebuild strength, and get back to your daily activities. This time can be greatly reduced if you’re also completing physical therapy during this time.

However, seeking physical therapy before surgery is also a common approach. We often work with orthopedic surgeons in our area to prepare a patient for a knee or hip surgery with a bout of physical therapy services to strengthen the area. Strengthening the musculature and connective tissue around a joint prior to surgery can also greatly reduce the post-op recovery time, but it can also reduce the potential for complications during the surgery.

The average cost of physical therapy vs surgery

The average cost of physical therapy compared to surgery varies significantly, reflecting the fundamental differences in their approaches to healthcare.

Physical therapy is generally more cost-effective, involving a series of sessions with a trained therapist aimed at rehabilitation and prevention. Costs may vary based on the duration and frequency of sessions. You will likely have to pay copays or pay down your deductible, based on your insurance plan, but the sum total is often quite a bit less than the cost of surgery.

Additionally, the cost of physical therapy can often be offset by workmans’ compensation, and we’ve generally got out-of-network physical therapy options available as well, giving you quite a lot of choices.

In contrast, surgery typically incurs higher expenses due to the complexity of procedures, operating room fees, anesthesia, and post-operative care. Moreover, surgical costs are influenced by factors such as the surgeon’s expertise, hospital fees, and any potential complications during recovery.

While physical therapy offers a more budget-friendly option for certain conditions, the decision often hinges on the specific medical needs, financial considerations, and individual preferences of the patient.

Also, note that if you get surgery, you’ll likely need physical therapy to recover the joint(s) anyway.

So, which should you choose: Surgery vs physical therapy?

A wise man once said, “the correct answer to every question is it depends.”

We hope that the information contained in this article has been helpful in your decision making process, but ultimately the best recommendation will come from a medical professional who’s familiar with your case. Be sure to visit your doctor and bring up any concerns you have, including those points from this article which you found the most helpful.

If you would like to discuss the decision with us, don’t hesitate to contact our practice. We’d be happy to discuss your case and consult with you about the best course of action.

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