Physical Therapy as an Alternative to Surgery

Physical therapy and surgery are the most often used methods of recovery when it comes to any major injury. Surgery is a must with certain injuries that have shown extensive damage to the body, while physical therapy has normally been used as a way for rehabilitation but in some injuries can be the only method needed. A great example of an injury that can have either physical therapy (PT) or surgery at its start to the healing process is a torn meniscus. Although both can help to heal the injury, physical therapy provides a much smoother way of recovery and how the overall injury’s appearance is afterward. 

Most if not all surgeries leave some sort of scar on the body. Many will argue that the scar left on the body should be the least of one's worries and all that should matter is that the injury has been repaired. Surgeries can also be extremely risky. They can lead to infection, blood loss, and in the worst possible cases loss of a limb or even death. Another major factor between PT and surgery is the overall cost of the healing process. Neither of them is cheap, you will be expected to spend upwards of at least a couple thousand dollars but depending on the severity of one's injury, PT may be more cost-effective and worth giving a try. On top of that, doctors usually prescribe pain medication after surgery and most patients will require physical therapy if the injury was a part of a limb or another important movement mechanism. The pain medication can become detrimental to someone especially in the case of addiction happening. 

Physical therapy instead of surgery is a safer way of rehabilitation and building the body back to its best possible state. When one thinks of surgery, one of the biggest things they think of is “how big of a scar is this going to leave on my body?” Many patients may have surgery for their appendix getting taken out or may have surgery to “beautify” themselves. While others may have surgery for an injury caused by a sports accident, car accident, or an incident that involved more emotional trauma. The scar left on the body may be a reminder to them of their possible life-changing injury. Scarring can also lead to keloids, which are raised scars where the skin has healed after an injury, and cause a person to struggle more with moving a part of the body. The body can scar very easily especially if “stitches aren’t removed before the top layer of skin heals around them, the entry points of the stitches may become permanent features, resulting in a ‘railroad scar’” (NYU Langone Health). Scars can be hard to get rid of and if they are there, most people consider scar revision. If the risk of getting a scar can be reduced by trying physical therapy, then there shouldn’t be a reason to not try it. 

There have been many studies and research done on how much more effective surgery can be over physical therapy or vice versa, but many of these trial groups have proved otherwise. In some of the groups “in the intention-to-treat analysis, [we] did not find significant differences between the study groups in functional improvement 6 months after randomization” says Jeffrey Kate of the New England Journal of Medicine. These studies have given time for the injuries to heal and show the after-effects of the recovery process and in most cases, the ones who got surgery still have the scar that hadn’t faded very much. In many cases scars after surgery also require intensive care. Many people have to come back and get check-ups every so often just to check up on the scar that was left and to see if it may end up needing a scar revision. Those more prone to getting keloids may even be administered “a corticosteroid injection if it appears that a hypertrophic scar or keloid is forming after surgery”(NYU Langone Health). Hypertrophic scars are when the skin where the scar becomes very raised unlike that of a keloid which appears more like a pimple. These scars will need revision and will need another surgery for them. The scars are not worth it unless it is an absolute must that you get surgery. Physical therapy leaves you scarless and does not cause you to develop these major scars that are hard to hide especially on a part of the body that is more shown. 

Surgeries are full of risks when the doctors come to have a consultation with you one of the biggest things they talk about is all the possible risks involved. Physical therapy is a great solution to these risks and prevents them from happening. Barbara Brody speaks about a torn meniscus and claims “While physical therapy is generally very safe, surgery carries a possible risk of complications like infections, nerve damage, and blood clots. Is it really worth the risk?” If PT can give the same if not a better outcome to the problem, then it should be the first solution a patient thinks about, especially if it can be a good way of healing the injury like that of a torn meniscus. Surgeries are done almost every day. Many people get injured and need repair but “each year around the world, 4.2 million people die within 30 days of surgery, more than the death toll from malaria, tuberculosis, and HIV combined, researchers found” (Jennifer Bieman). The biggest thing that can happen is the number of complications and infections that can come during and after surgery. It isn’t worth the risks if it can kill you in the end. 

There are always different trials and studies being done to show how effective PT and surgery really are. Dr. Kamaroff performed a study with PT and surgery and he came to the assumption that by being “given these results, [I] think it’s worth giving physical therapy a try before surgery. If your symptoms do not improve, then talk with your doctor about whether and when to have surgery.” Although PT may not always be the best option for your injury, why risk anything before you need to. PT consists of a number of exercises and stretches that can be helpful to someone who is hurt and is in need of rehabilitation. Costs are what tend to drive people to and from certain things. Some prices can just be too much for lower-income families. Some injuries can cost anywhere from the low thousands to tens of thousands of dollars depending on the severity of the injury.  When it comes to surgeries, there are many things that need to be taken into account. Surgeries require a fully staffed medical team that are properly trained and ready for the task at hand beginning with the head physician. The costs begin with those “who are paid for their expertise. Depending on the procedure, this fee actually accounts for like 40-50% of the bill” says Dr. Hafeez Oluwa. The rest of the expenses can include the surgery room, medications, pre-surgery testing and care, hospital care, recovery care, and that is just the bare minimum of it all. Due to the extensive amount of people and items needed for these surgeries, it all adds up very quickly even if it is a smaller surgery. CBS News has looked into how the costs of PT and surgery compare and “surgery costs about $5000, compared with $1000 to $2000 for a typical course of physical therapy.” Surgery usually ends up with one needing physical therapy anyways to rebuild the muscles and strengthen the body to what it once was before. Although surgery does require the costs of the doctor themself, the room the surgery is performed in, the medication used, and many other factors. In the end, these costs are not cheap no matter which way you go. 

Another way of saving more money is by using the exercises and stretches you learn while in PT at home. Many patients do not want to go through the pain of risking surgery and do not want to spend all the money that comes with it, “you can do exercises on your own at the gym… but if you go to a physical therapist first, the therapist can do an evaluation… and can design a personal exercise program and can teach you the exercises” (Treat Me, but no Tricks Please). So much money can be saved if you are willing to put the time in yourself to try and heal and get through the rehabilitation process. Even for those who find themselves in lower-income families, already have to try to avoid spending money as much as possible. Some families who cannot spend as much can catch themselves going to doctors that are not as educated in their field of study or may decide on different countries or states just to find the cheapest price. Especially those already in lower-income countries face much higher risks beginning with properly sanitized surgery tools all the way to the actual medical staff’s expertise. 

Opioid addiction is a major problem around the United States, especially those using them post-surgery. These medications are most often prescribed for the recovery process after surgery so that patients can get rid of some of their pain. Many incidents that deal with “back pain, sports injuries, dental procedures, and common surgeries are among the ailments that have led to opioid painkiller prescriptions, but increasingly health care providers are being encouraged through continuing education to reduce their reliance on the narcotics” says Ann Meyer of Savannah Morning News. These addictions can lead to issues in the brain and can cause long term damage. As well as damage, if the dosage of the medication you are given continues to rise, your body may adjust to it and you may want more to relieve the pain. The more you take the higher chance you have of dying from an overdose. Opioid abuse makes your “brain and body believe the drug is necessary for survival” (Anesthesia, Pain Management & Surgery). The brain is such an important part of the body that if it is messed with by these drugs it can change your life. Opioids are not something that should be messed with, they can impact your life forever.   

Surgery and physical therapy are the most used methods of recovery for an extensive injury but physical therapy’s way of being less invasive and much less risky makes it a better and safer option for those in need of injury recovery and rehabilitation. Surgeries are not always the best option due to people’s incomes and their financial stability. Surgeries cause thousands of dollars and many people especially in lower-income countries are unable to afford these thus preventing them from getting the care they need. Physical therapy also is expensive but it is not nearly as much as the cost of surgery. Many people can take the exercises they learn from PT and use those at home for recovery and to be more cost-efficient. Also scarring is a long term effect of surgery. They can leave marks all over that you have for the rest of your life. Keloids and hypertonic scars can form and have a worse appearance on the body. Many scars need revision and it just takes more time out of your life and more money out of your pocket. There is also an extreme number of risks involved in the surgery. There can be complications before surgery with the anesthesia, there can be things that happen during the surgery such as blood loss and blood clots. Problems can occur even after surgery such as scar reopening, losing function or movement in a part of the body, and infection to the healing sight. Opioids also can be detrimental to the brain. They can cause mental issues and if not taken correctly even death. Surgery can be used for certain things. Many injuries require surgery as a must for the type of fixing that needs to be done. Physical therapy should be used if possible, it is safer and can be a better way of recovery for the mind and the body.