In the United States, some experts worry that many popular surgeries are overprescribed for patients when physical therapy (P.T.) may be the best solution. Deciding to start with physical therapy or with surgery requires an informed approach with access to trusted data.  To choose the right option for themselves, patients must have all the facts.

Here’s what to consider if you’re debating whether P.T. or surgery is right for you.

Choosing Surgery or Physical Therapy

Many health experts believe healthcare providers are too quick to choose a “Surgery First” approach, particularly for common procedures, such as meniscus repairs, some hip operations, or those on the spine to relieve back pain.  

Santovia’s passion is to ensure that patients have access to trusted, up-to-date information to ensure that they know what choices are available to them, as surgery may not always be the best option.  Where a choice is available, the “Physical Therapy First” route should be considered and tried first. The best surgeons in the United States already discuss this with their clients every day, so patients should not be concerned about asking if this is an option for them.

There are good reasons why “P.T. First” should be considered, 

  • There are surgical risks to every surgery, no matter how minor. These can include severe infections, as well as hospital-acquired infections, such as MRSA and C. diff, that can be challenging to treat.
  • People are often surprised to learn how long they will take to heal if they opt for surgery, or P.T. First. Often, the outcome at the end of a one-year period of recovery may well be the same for most people whether they undertake Surgery or P.T.
  • Make sure surgery is appropriate. in 2017, the British Medical Journal warned that knee arthroscopies, commonly used to deal with meniscal tears, are ineffective, with lasting results unproven. Instead, they recommended rest, weight loss, P.T., and certain drug therapies. 
  • Be aware of overused surgeries and discuss having a second opinion. In 2022, the Lown Institute listed eight overused and unnecessary procedures that were undertaken during the COVID-19 pandemic 2020 when access to surgeries was challenging for all. This list included arthroscopies as well as vertebroplasty for osteoporosis, and spinal fusion for back pain.

Sometimes, surgery IS the only option, particularly for traumatic acute injuries such as tendon or ligament ruptures, or chronic conditions where other options have failed. In other cases, however, a less aggressive “P.T. First” approach may offer equal, or better, outcomes.

The important thing to remember is that patients have options when making a decision about their health. They should ask, ‘”What is important to me?” Share those views with their healthcare provider and be certain to raise questions with them about whether a different approach may be suitable for them.            

The Santovia Difference

Santovia believes in providing trustworthy educational information on conditions and procedures to patients across the U.S.  The library also includes easy-to-follow PT videos to support patient recovery and rehabilitation.

The team at Santovia recommends using the Option Grid Decision Aids that detail the choices available. The aids show answers to the key questions to help provide context as to what approach best meets their needs. They are also helpful in providing more context when the choices available have different benefits, risks, and possible harms.

In many cases, physical therapy, NOT surgery is the most appropriate solution for common injuries. Patients should take the time to make informed decisions. Santovia can help you on that journey.



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