Physical Therapy as an Effective Alternative to Surgery

Physical therapy is “the treatment of disease, injury, or deformity by physical methods”. It is something that many people go through after a significant injury or when they are recovering from surgery. Not only does physical therapy help with the individual’s overall health, but it also helps them retain their complete physical mobility. A physical therapist is someone who improves the quality of life by providing hands-on care and exercise. They teach patients how to prevent further injuries and how to maintain or take care of themselves with their current injury, as well as improve flexibility. To discuss the benefits of physical therapy, this essay provides examples of how it is a healthier and more effective alternative to surgery.

Physical Therapy is a healthier alternative to surgery because it decreases drug and/or steroid use or dependence. Post-surgery patients are given prescribed medicine to alleviate their pain and treat current as well as pre-existing conditions. Some patients can become addicted to the medication rather quickly which can affect their current and future procedures; as time goes on it could also negatively affect their health.

Janet Callahan is a Doctor of Physical Therapy that is studying cervical dystonia: a condition in which the muscles in the next involuntarily contract which leads to the head twisting or turning to one side or tilting forward or backward. She is currently working on a book titled: 'Non-surgical and Non-pharmacological Interventions for Cervical Dystonia. Callahan graduated with a Bachelor of Science in Physical Therapy from the University of Vermont, Masters of Science in Physical Therapy, and Doctor of Physical Therapy from Massachusetts General Hospital: Institute of Health Professions. She has peer-reviewed numerous publications, abstracts, and many different book chapters.

The article “Non-surgical and non-pharmacological interventions for cervical dystonia” refers to two ways that can decrease the pain associated with cervical dystonia: botulinum toxin therapy and physical therapy. The first option is any neurosurgical procedure or operation which includes Botulinum Toxin Therapy, also known as Botox, which is a drug prepared from the bacterial toxin botulin, used medically to treat certain muscular conditions and cosmetically to remove wrinkles by temporarily paralyzing facial muscles; the patient would receive injections periodically over the course of a few months to several months. Botox could arise in conversation as being the main option of treatment for individuals; however, receiving the injections could potentially produce neutralizing antibodies which make it difficult to receive the full benefits of botox. Based upon a large study of 379 subjects from 9 countries (the United States excluded) completed the study; they previously received at least one Botox injection. The botox was tolerated well and 97.5% met the criteria for no severe treatment-related AEs which is injury, death, etc related to treatment caused by healthcare management. Like any surgery or procedure, there is a possible negative aspect of the side effects; they include but are not limited to the following: dropping of the head, postoperative respiratory distress or postoperative respiratory failure, stroke, infection, electrode breakage, et cetera.

The second option is physical therapy with or without botox. According to Callahan et al., research and studies have shown that there is a large amount of evidence supporting that there was a “significant reduction in pain with physical therapy than there was with Botox”. It has been shown that in a study of 173 people and certain demographics, females weren’t involved in physical activity as much as males because of employment, physical activity, self-efficacy, and education level. Physical therapy not only helps with the quality of life for the suffering individual but also helps with the long-term effects of cervical dystonia pain.

Botox can affect areas that are not related to the injection site. There could be life-threatening side effects; this includes loss of strength, blurred vision, loss of voice, and difficulting swallowing or breathing. Physical therapy allows the patient to gain their quality of life back without having surgery; it is a healthier and more effective alternative to surgery because it decreases the use of drugs and or steroids which prevents opioid dependencies. The recovery process of surgery can sometimes take up to many years. Physical therapy is also easier on the body rather than surgery; it allows for a slightly faster rehabilitation period because the patient is not being sedentary unless it is absolutely imperative.

Bart Visser is a graduate from Vrije Universiteit Amsterdam. He has a degree in Human Movement Sciences from the Faculty of Behavioural and Movement Sciences. He has done research on more than 100 topics as well as written about “80 publications and reports”. In 2011, Visser became a professor at the Amsterdam University of Applied Science and was made a program manager of the university's Mensendieck Exercise Therapy program. He co-wrote “Diagnosis and Treatment of Dystonia” which explains the effectiveness of a standard physical therapy program and how different levels of physical therapy affect patients with low to high cervical dystonia pain; two randomized control trials and one open study trial reviewed the effects of physical therapy. According to the article “Diagnosis and Treatment of Dystonia,” it was shown that the individual’s pain decreased significantly with Botulinum Toxin and physical therapy; therefore, physical therapy is more beneficial.

Physical Therapy is more beneficial in some cases because there are many different types a patient can receive. In regards to cervical dystonia, patients can sometimes have impaired speech; this can result in the need of speech therapy; speech therapy for cervical dystonia includes electrical stimulation, kinesiotherapy, deep brain stimulation, biofeedback, and neck exercises. Hyder A. Jinnah is a specialist in Human Genetics and Neurology and has been practicing in the field for 28 years. Jinnah received his Bachelor of Science in Zoology and Psychology from Duke University. He later went to medical school at the University of California where he obtained his Medical Doctorate and Doctor of Philosophy in Zoology and Psychology.

In Baltimore, Maryland, at John Hopkins University, Jinnah did his neurology training, and he has published nearly 200 articles; many of which are based upon dystonia and neurological disorders and or neurogenetics. In this article, Jinnah states that there are many minor benefits for patients suffering from cervical dystonia; there have only been small studies done where the outcome could not be duplicated. Physical therapy exercises and techniques are customized to fit the patient’s needs. There are multiple resources or websites for patients to refer to such as dystoniasociety.org and dystonia-foundation.org.

Physical therapy is a more effective and healthier alternative to surgery because it decreases the potential drug and/or steroid dependence, provides a faster rehabilitation period, and is more beneficial. If everyone had to have surgery and physical therapy was not an option: opioid addiction rates would increase extremely fast. People who were not taking any prescribed opioids before surgery would be at a higher risk of becoming an addict. Unlike surgery, physical therapy is not able to be completed with one procedure within a certain amount of time. Physical therapy is a slow, gradual healing process that takes time to help the body gain its normal function back; A single physical therapy session can last between 20 minutes to 1-hour multiple times a week. For some people, surgery is a better option because it is taken care of at one time in most cases, and they do not have to see a physical therapist on a weekly basis; their diagnosis can be treated through surgery.

Physical therapy can also help with the recovering individual’s mental health. When someone has sustained an injury or gone through surgery being stationary can cause people to become depressed; getting up and exercising, this can increase the individual’s mood.

Overall, as seen from the exmaples in this essay, physical therapy is something that individuals need. It is important to humans because people that are recovering need to gain full mobility of an impaired appendage. As this relates to journeys, the definition of a journey is different for everyone, some journeys that are deemed unfinished or failed could really be complete.

References

1. Callahan, Janet. “Non-Surgical and non-pharmacological interventions for cervical dystonia: A systematic review.” Physiotherapy practice and research, vol.36. No.1 (2015) 1-14. Print.
2. Visser, Bart. “Cervical dystonia: effectiveness of a standardized physical therapy program; study design and protocol of a single-blind randomized controlled trial.” BMC Neurology, vol.13. No.85 (2013). Print.
3. Jinnah, H.A. 'Diagnosis And Treatment Of Dystonia.' Neurologic Clinics 33.1 (2015): 77-100. Print.
4. “Hyder A. (Buz) Jinnah, MD | Emory School Of Medicine.' Med.emory.edu. N. p., 2019. Web.
5. Zetterberg, Lena, et al. “Exploring factors related to physical activity in cervical dystonia.” BMC Neurology, vol.15. No. 247 (2015). Print.
6. Misra, Vijay, et al. “Factors influencing response to Botulinum toxin type A in patients with idiopathic cervical dystonia: results from an international observational study.” BMJ Open, vol.2. No. 3 (2012). Print.