When you’re dealing with persistent joint pain, a torn meniscus, or a problem with your spine, it’s natural to wonder whether surgery might be necessary. But before assuming an operation is the next step, consider talking with an experienced physical therapist. For many orthopedic conditions, effective nonsurgical treatments are available. In fact, clinical guidelines frequently recommend conservative care, including physical therapy, before considering surgery.
Of course, surgery is sometimes the best option. Orthopedic surgeons provide remarkable treatments that restore mobility, relieve pain, and help people return to activities they love. But physical therapists and surgeons also share an important goal: helping patients achieve the best possible outcome with the treatment that is most appropriate for their condition.
Research offers some encouraging examples of what physical therapy can accomplish, even for conditions that might sound like they require surgery.
A Torn Knee Meniscus: Can Exercise Really Help?
The meniscus is a piece of cartilage that cushions and stabilizes the knee. When it tears, patients may experience pain, swelling, stiffness, or difficulty moving comfortably. Although some meniscal tears require surgical treatment, others respond well to physical therapy. A 2022 study published in JAMA Network Open followed 321 adults, ages 45 to 70, with degenerative meniscal tears. Researchers compared arthroscopic knee surgery with an exercise-based physical therapy program.
After five years, the researchers found that physical therapy produced improvements in knee function comparable to those achieved with surgery.
Some participants who began with physical therapy eventually underwent surgery. Nevertheless, the study demonstrated that a structured exercise program can be an effective initial treatment for many patients with this type of knee injury.
Spinal Stenosis: Another Surprising Example
Spinal stenosis occurs when spaces within the spine narrow, potentially putting pressure on nearby nerves. Symptoms may include back pain, leg pain, numbness, or difficulty walking. Because spinal stenosis involves changes to the structures of the spine, patients may assume that exercise cannot make much difference.
However, a randomized clinical trial published in Annals of Internal Medicine compared surgical treatment with physical therapy for patients with lumbar spinal stenosis who were considered candidates for surgery. At two years, the researchers found no statistically significant difference in physical function between the treatment groups. Although some participants initially assigned to physical therapy eventually underwent surgery, others improved without an operation.
The findings illustrate an important point: Even when physical therapy cannot reverse an underlying structural change, it may help people improve their function and manage their symptoms.
Physical Therapy and Surgery Work Together
Choosing physical therapy does not mean ruling out surgery. Physical therapists help patients improve strength, flexibility, mobility, and movement patterns. They also monitor progress and recognize when symptoms or limitations warrant further medical evaluation. Surgeons bring specialized expertise to conditions that require operative treatment. When surgery is appropriate, physical therapy often plays an essential role in preparing patients for the procedure and supporting their recovery afterward. Together, these professionals help patients navigate treatment decisions and work toward better long-term outcomes.
Start by Exploring Your Options
Not every orthopedic condition can be treated successfully without surgery. The right approach depends on the diagnosis, severity of the problem, symptoms, overall health, and individual goals.
But if you’re experiencing an orthopedic problem, an experienced physical therapist may be able to identify conservative treatment options you haven’t considered.
Before assuming surgery is inevitable, find out what physical therapy might be able to do for you.
Research References
Noorduyn JCA, et al. (2022). Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears: Five-Year Follow-up of the ESCAPE Randomized Clinical Trial. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2022.20394
Delitto A, et al. (2015). Surgery versus Nonsurgical Treatment of Lumbar Spinal Stenosis: A Randomized Trial. Annals of Internal Medicine. https://pubmed.ncbi.nlm.nih.gov/25844995/
