Physio or... surgery?! The choice is pretty simple, right? WRONG! You'd be surprised by the number of people who'd rather choose surgery over physiotherapy. Let me tell you why: they want that "magic pill" or "quick fix" and don't want to (or aren't willing to) put in the time and work that's required with physiotherapy. Don't get me wrong, surgery has its place, but in my opinion, it should always be the last resort. If all other conservative therapies fail (including physio), then it should be the patient's preference how they wish to proceed. It is important to know all your options and understand all the facts before making a decision.
Research has shown that in the long run, surgery for common orthopedic conditions is no better than physiotherapy. People who avoid surgery and begin physiotherapy treatments are less likely to have surgery later down the road. Imagine how much time, money, pain, and grief you'd save simply by trying physio first. Physiotherapy is safe, whereas surgery is risky, invasive, and can result in unforeseen complications, such as infections and blood clots.
People like the idea of someone "fixing" them, but you're not Humpty Dumpty - you'll never be perfect again. Yes, surgery can help alleviate the signs and symptoms that you experience, but at what cost? You might inherit some metal detector-unfriendly nuts and bolts; you might have some tendons or ligaments released; you might have some parts cut out or shaved down; or you might have one thing removed and transposed somewhere else. In addition to that, most people don't realize that physiotherapy is usually required after surgery as well. You're not healed the moment you step out of the hospital -- the rehab after surgery is typically more extensive because you're rehabilitating a brand new or foreign body part! So why not try physio first?
Sometimes, surgery is not the magical cure that everyone is looking for. I've seen many clients after failed surgery. As a physiotherapist, I'm a huge believer of fixing the causes of people's problems instead of treating their symptoms. If you haven't read my post on this topic, you can read it here. For example, in individuals that present with pain, numbness, and tingling in their hands and fingers, carpal tunnel release surgery is usually what doctors order. However, the outcomes for this surgery aren't what they should be. It's great for those people who actually have "true carpal tunnel syndrome," but what about those whose symptoms are referred from another area, such as the neck? The type of population who develop carpal tunnel (i.e. office workers, dental hygienists, etc.) is the same type of population who is prone to neck issues. It means that most of the time, people who have carpal tunnel also have neck problems ("double crush syndrome" occurs when a nerve is trapped in more than one area of the body). So how is wrist surgery going to help if the nerve is pinched in the neck?
I can't deny that sometimes, people absolutely do require surgery for their injuries, and it cannot be avoided. However, even in cases where physiotherapy did not demonstrate to solve the problem, patients who had physio before surgery have better outcomes than those who only have surgery.
You may ask... in what situations is surgery the better option? If there was an accident or trauma, and your bones and joints are unstable, surgery might be required to fixate or stabilize it. This could mean bony fractures or fully torn ligaments/tendons/muscles/cartilage. However, I've seen many cases where people are still fully functional with full substance tears. Would you still get surgery if these tears are not affecting your daily activities? It's a tough call, and it goes back to the idea of people wanting to be "fixed" because they're "broken." Sometimes, the power of words really affects one's recovery. Just telling somebody that they have (insert scary medical term here) will have them running for a "cure."
Another reason for surgery is if it was a medical or life threatening emergency (i.e. compression of the spinal cord causing incontinence, numbness, paralysis, etc., or a brain bleed following a concussion). Immediate surgery is recommended for these situations. Finally, if someone was not responding to conservative therapy (physiotherapy/chiropractic/massage/acupuncture, medications, injections, etc.), surgery may be the last option.
If you want to optimize your recovery, it's logical to get physiotherapy first. The pros of physiotherapy dramatically outweigh the cons. There are no major side effects, and we can help you manage your symptoms and prevent future flareups. Even if you don't respond to our treatments, you still gain the advantage of developing strength and flexibility, which anyone could benefit from. You never know what works until you try it!
P.S. please don't go to physio for 1 or 2 sessions and say that you tried it and it doesn't work... really give it a shot for at least 6 to 8 weeks before deciding whether it works or not.
