To Cut or not to Cut: Surgery and Conservative Management

The purpose of this blog today is because we’ve had so many patients ask about surgery and/ or are referred by surgeons with the daunting task before them in dealing with their injury.

Most people are extremely fearful of going under the knife, it is highly invasive and scary. However if you are experiencing ongoing sever musculoskeletal pain then the first step I would say is to see your GP or Physio. At which point many practitioners would try conservative management first based on a physical assessment.

However there are times where we need a clearer picture if your symptoms aren’t improving so at this point we would send you for some imaging. This is done in conjunction with your GP – Most doctor’s would advise against too much imaging though due to radiation exposure etc. It’s like you’d be sent for an ultrasound (soft tissue, muscles and ligaments), x-ray (bone and joints), or CT scans (discs and fluid) or a comprehensive MRI (everything basically).

However if your GP refers they should know places that will bulk bill you a free ultrasound and xray so we would normally start there.

If your injury is sever enough and we don’t think physio can help only then we would send you to a surgeon. Alternately your GP may send you straight to a surgeon who would assess if surgery is necessary or if it is worth seeing a physio first to try.

After surgery you’ll probably need physiotherapy anyways to rehabilitate the area.

The health system is very complex, it’s so important to have good communication with your physio, GP and surgeon in these situations, it can be daunting but if handled carefully can make for a smooth healing process. If you are seeking conservative treatment please be aware it is a team effort! You must be compliant with your home exercise program as well as your manual sessions (if you don’t have a home program than find another physio). This is important because your surgeon or specialist needs to know if conservative management would work, if you are not compliant then we wouldn’t have a proper picture.

Finally I think the last lesson is honesty. Be honest with your health practitioner about what’s happening. Also be honest with yourself. If you’ve had an injury or been in pain for months and it’s not better, chances are you probably need help. Many of the cases we see could have been addressed earlier or not been as severe had action been taken sooner.

Please note this blog is a brief overview just to help provide some clarity, it also is based on the health system in Perth, Western Australia, and hence may vary state to state or country to country. It does not in any way represent or replace a proper assessment or consult with a health practitioner, if you’re a reading this and want to know more then i definitely recommend speaking to your GP or allied health professional if you have any queries.