Welcome back! If you have read the previous 2 posts, you know where I am going. If you haven't, no worries! Welcome! Though if you'd like to do a quick read, you'll find the intro here, and the lead in to this post here.
This week I'd like to talk about the differences between the surgery route for managing chronic pain vs. the exercise rehab route. Right off the bat, the exercise route sounds like a longer time frame with more work involved. And you are partially correct. You do have to put in the work. Though if you factor in the timeline of getting into the surgery, you'll notice that if you start working with a good trainer now, you'll likely be way better off by the time the surgery option is scheduled.
Now, practicality wise, if you look at the work you have to do post surgery... it is all work. You need to do something to get your body working better. Doing nothing and 'resting' really doesn't get us anywhere.
So, what is going to give you a better outcome? Just like the first post, showing how complex pain can be... this answer is the same. One study [1] showed that if you have moderate knee OA (osteoarthritis) physical therapy is an excellent option rather than surgery. Another study on meniscus repair [2] showed that exercise therapy yielded significant improvement in strength vs. surgery, though to be honest... of course it would. If you work/load your muscle tissue it is going to adapt by getting stronger. If you just have surgery, the muscle will not have to adapt. However, the exercise therapy group did have statistically better results over all measurements. Another study in the Netherlands [3] reported that physical therapy is a valid alternative to surgery for patients with nonobstructive meniscal tears.
However, within all of these studies, there were also benefits for people who did the surgery. You will also find these same results within back pain [4] and shoulder pain [5]. Some patients responded well to physical therapy and had no need for surgery, while there were others who did respond well to surgery. So where does that leave us?
We are always learning more and here it is clear that surgery is overused to treat pain where a safer, less expensive treatment of physical therapy can be just as effective given the correct matching of patient/treatment.
One thing that is clear, starting with physical therapy is a solid first step. And just as I mentioned in the previous post, finding the right physical therapist may just be the golden ticket.
Next week we'll talk about the fear/pain cycle. Really, I could talk about this for hours!
Interested to see where you are in the range of pain management?
Or maybe your level of kinesiophobia (fear of moving your body)?
Want to learn more? Click on the next post, or contact Amber and let's start building your path back to wellness!