Comprehensive Review Finds That Surgery Is No More Effective
Than Nonsurgical Interventions For Musculoskeletal Disorders
A musculoskeletal disorder is an injury or condition that involves the musculoskeletal system—which includes the bones, muscles, joints, ligaments, and tendons. These disorders are extremely common, as about 30% of Americans and 1.5 billion people throughout the world are currently affected by one.
Musculoskeletal disorders can develop anywhere in the body, but the spine is by far the most common location, as low back pain and neck pain are among the leading causes of disability in the U.S. Other common musculoskeletal disorders include osteoarthritis, tendinitis, strains, sprains, fractures, and tears of ligaments and tendons.
Physical Therapist Directed Care is Often the Best First Choice
Patients with a musculoskeletal disorder are faced with several potential options when determining how to address their condition. Among these is whether to have surgery, which is often seen as a last resort, although many patients decide to have it much sooner. Patients should be educated on the risks and benefits of surgery versus other interventions when evaluating if it’s the right choice; however, high quality studies comparing interventions with and without surgery are less common for musculoskeletal conditions than in other medical fields.
100 Trials Covering Nine Areas of the Body are Analyzed
Researchers performed a systematic review and meta-analysis to estimate the benefits and harms of interventions involving surgery versus those with no surgery for various musculoskeletal disorders.
For this type of study, researchers performed a search of five major medical databases for randomized-controlled trials that evaluated the effects of a surgical intervention to a nonsurgical intervention for patients with a musculoskeletal disorder. Once collected, the results from these trials were analyzed to determine how surgical interventions compared to nonsurgical interventions.
Researchers identified 100 trials that fit the necessary criteria and provided data on pain, patient-reported function, quality of life, and adverse events. These trials covered 28 different types of conditions at nine areas of the body: the neck, shoulder, elbow, hand, lower back, pelvis, hip, knee, and foot.
Surgery is No Better…So Why Wouldn’t You at Least Try Physical Therapy First?
Of these, in all studies that evaluated function, all studies that evaluated quality of life, and nearly all studies (9 of 13) that evaluated pain, no clinically relevant differences were found between surgical and nonsurgical interventions.
The results of this high-powered systematic review and meta-analysis are aligned with another similar study, which found that surgical interventions were superior to nonsurgical interventions in only 14% of the trials analyzed.
Patients Need to Know Their Options
Patients should continue to educate themselves on the risks versus the benefits of surgery and consider this information when determining if surgery is right for them. And for those of you with a musculoskeletal disorder who are interested in trying a nonsurgical intervention first, we strongly advise you to visit us at Bacci & Glinn Physical Therapy for a comprehensive physical therapy program.
