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Do you have tennis elbow or a herniated disc in your lower back? Or maybe you have lingering pain from an ankle sprain or another sports-related injury. If so, it may be hard for you to find the right type of care. You may bounce between physical therapy and sports medicine without seeing long-term improvement.
But you shouldn’t just accept this as your fate. Being proactive and communicating with your doctor about how you’re healing is vital to making sure you get the care you need.
Maybe you need different physical therapy exercises. Or your injury could require surgery — or a different approach altogether. Sometimes, it’s difficult to determine what will work best, says Joseph Ihm, MD, a UW Medicine physical medicine, rehabilitation and sports medicine specialist.
“There’s substantial data that supports the effect that physical therapy and exercise can have. But I’ve also seen people say they still have pain after completing several weeks of physical therapy treatment,” he says. “Surgery isn’t always the answer either, however. I do not commonly refer people to a surgeon as a first-line treatment.”
So, how can you decide the best way to heal quickly?
The upside of physical therapy
If your pain doesn’t limit your daily activities, physical therapy can be a good initial step, Ihm says.
“Although physical therapy isn’t right for everyone, I think it’s a very reasonable first option,” he says. “Unless your imaging suggests that surgery is more appropriate, physical therapy is a good place to start.”
Physical therapy can be a long-term process, but it offers several benefits: Physical therapy exercises can improve your range of motion and joint function without incisions or anesthesia. If you have surgery, you face the risks of surgical and anesthesia complications, infection and post-surgery pain. Recovery can be slow and pain management difficult.
And for the most part, it’s easy to fit physical therapy exercises into your daily or weekly routine. You can return to your regular activities every day after you complete your regimen. Unlike surgery, there’s no extended recovery time.
Finally, the exercises teach you ways to move that strengthen your body and prevent re-injury. As a result, you may be able to stop your current injury from getting worse and learn how to avoid other injuries in the future.
When to consider surgery
Physical therapy works for many people. But there will be times when surgery is your best option, Ihm says. He points to spine and back problems to explain when surgery may be most effective.
“Surgery is usually the best option if your spine injury causes unbearable leg pain or weakness to the degree that this makes it hard to move,” he says. “But the decision to have surgery will still depend on multiple other factors, including your personal preference, age, general health and current activity level and abilities."
If your pain, weakness or ability to complete daily activities worsens, and other options like physical therapy and steroid injections like cortisone haven't helped your condition, surgery may reduce your discomfort.
Typically, your doctor may order a CT, MRI or X-ray to identify the root cause of your pain or weakness. If these scans show you have a severe injury or damage, surgery could be the best treatment option.
What to ask your doctor about the best way to heal your injury
Everyone’s healing journey is different and, ultimately, the treatment option you choose comes down to your symptoms and how they impact your quality of life. A conversation with your doctor can help you decide. Here are some questions to ask:
- What are my physical therapy options?
- How could physical therapy help my condition?
- Will physical therapy be painful?
- How long will I need physical therapy?
- What are my next steps if physical therapy doesn’t improve my condition?
- How can surgery help my condition?
- What surgery options do I have? Would the surgery be minimally invasive?
- What are the possible risks and complications of having surgery?
- What will my post-surgical recovery be like?
- What options do I have if surgery doesn’t work?
“Talking with your doctor before you make a decision is extremely important,” Ihm says. “A discussion can reveal whether you have a simple or more complex problem. With that knowledge, you and your doctor can create a plan you feel will lead to your best outcome.”
