As the owner of a wellness clinic incorporating chiropractic, exercise therapy, acupuncture, and nutritional counseling I am often asked why one would choose natural holistic medicine in place of drugs and surgery.
My reply is often that as Americans we make up 5% of the world’s population and yet we consume 80% of the world’s pharmaceuticals in the U.S.. We spend over 2.5 times that of other developed countries per person on healthcare and yet in a recent study, we ranked 31 out 34 countries for overall health and wellness. In summary, if we are spending more on healthcare per capita than any other nation then why are we still so unhealthy? Some would say diet and smoking and yet many European countries eat a great deal more processed meats and grains than we do and smoke a great deal more and are still deemed healthy and live longer. Could it be that our “medicine” is killing us and making us sick? It’s a question that will require serious research and in a depth look.
Choose Exercise Therapy over Surgery
One of the most often complaints we get in our office is for knee and low back pain. Because I have already posted a great deal on chiropractic and acupuncture I would like to focus on exercise-based physical therapy for this article and why you should choose it over surgery.
The two most common reasons we see for knee pain are due to arthritis and torn meniscus. Below is a well-published research article showing that physical therapy was found to be as effective as surgery for these types of knee pain with much less possible deleterious side effects than surgery. The second bit of research I am posting below is also well regarded finding that physical therapy is as effective for certain types of back pain than surgery, once again, with much less possibly harmful side effects. If you are into research like me take a gander, if not just take my word for it ; )
Study Finds Physical Therapy Just as Effective as Surgery in Patients with a Torn Meniscus and Arthritis of the Knee
Alexandria, VA, March 21, 2013 — A New England Journal of Medicine (NEJM) study showing that physical therapy is just as effective as surgery in patients with meniscal tears and arthritis of the knee should encourage many health care providers to reconsider their practices in the management of this common injury, according to the American Physical Therapy Association (APTA).
The study, published March 19, showed no significant differences in functional improvement after 6 months between patients who underwent surgery with postoperative physical therapy and those who received standardized physical therapy alone.
“This study demonstrates what physical therapists have long known,” explained APTA President Paul A. Rockar Jr, PT, DPT, MS. “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.”
According to lead physical therapist for the trial and American Physical Therapy Association (APTA) member Clare Safran-Norton, PT, PhD, OCS, “our findings suggest that a course of physical therapy in this patient population may be a good first choice since there were no group differences at 6 months and 12 months in this trial. These findings should help surgeons, physicians, physical therapists, and patients in decision-making regarding their treatment options.”
Researchers at 7 major universities and orthopedic surgery centers around the country studied 351 patients aged 45 years or older who had a meniscal tear and mild-to-moderate osteoarthritis of the knee. Patients were randomly assigned to groups who received either surgery and postoperative physical therapy or standardized physical therapy. Within 6-12 months, patients who had physical therapy alone showed similar improvement in functional status and pain as those who had undergone arthroscopic partial meniscectomy surgery.
Patients who were given standardized physical therapy—individualized treatment and a progressive home exercise program—had the option of “crossing over” to surgery if substantial improvements were not achieved. Thirty percent of patients crossed over to surgery during the first 6 months. At 12 months these patients reported similar outcomes as those who initially had surgery. Seventy percent of patients remained with standardized physical therapy.
According to an accompanying editorial in NEJM,”millions of people are being exposed to potential risks associated with a treatment [surgery] that may or may not offer specific benefit, and the costs are substantial.” Physical therapist and APTA member Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT, chief of physical therapy at Harvard University, said, “Physical therapists are experts in improving mobility and restoring motion. The individualized treatment approach is very important in the early phases of rehabilitation in order to achieve desired functional outcomes and avoid setbacks or complications.”
The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants, and students of physical therapy nationwide.
Exercise Therapy Equals Surgery for Some Back Pain
Less risky treatment viable for older patients with lumbar spinal stenosis
WebMD News from HealthDay
By Alan Mozes
Standard treatments for lumbar spinal stenosis — a painful, often disabling narrowing of the spinal canal — are an operation known as surgical decompression or physical therapy.
But physical therapy is much less invasive and less risky than surgery.
“Adverse events from surgery range from 15 to 20 percent, with half of those being serious or life-threatening,” said study author Anthony Delitto.
“The risks of physical therapy are considerably less, and one would be hard-pressed to consider any of the risks serious,” said Delitto, a professor of physical therapy and associate dean of research with the school of health and rehabilitation sciences at the University of Pittsburgh.
Results of the study, funded by the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, appear in the April 7 issue of the Annals of Internal Medicine.
According to the American Academy of Orthopaedic Surgeons, spinal degeneration and wear and tear (often due to chronic arthritis) can narrow the space surrounding the spinal cord, drying out spinal discs and compressing the cord and its nerve roots. This is called lumbar spinal stenosis.
The condition, which causes pain, numbness and/or weakness across the lower back, rear and legs, mostly appears in patients aged 60 and older.
Non-surgical treatments, such as anti-inflammatory medicine and physical therapy, do not reverse spinal narrowing, but can provide a notable degree of pain relief and restored mobility, experts say.
Surgical options include spinal decompression (or laminectomy), which involves removal of the bones, bone spurs and ligaments that exert pressure on spinal nerves. Spinal fusion, sometimes coupled with decompression, is another option. Delitto noted that both surgery and physical therapy are covered by Medicare, meaning that while surgery looks far more expensive on paper, physical therapy patients sometimes face slightly higher actual out-of-pocket costs.
To assess the comparative benefits of each treatment, investigators focused on nearly 170 patients with lumbar spinal stenosis who sought care in western Pennsylvania. On average, participants were in their late 60s, and none had undergone prior surgery for the condition. All demonstrated similar mobility impairment, and on a pain scale of 1 to 10 all were rated 7 prior to treatment.
With our new wellness center expansion on Parker Road and Mainstreet, we are thrilled to have enough room to now offer physical therapy for Parker residents. Click the link to schedule an appointment to see which approach will work best to enhance your health and quality of life.