Surgery vs conservative treatment

Being evidence informed in relation to your healthcare is integral to your journey to recovery. We are often provided with options and opinions in relation to our treatment and take the advice at face value, instead of equipping ourselves with credible information and knowledge.

What’s best for me – surgery vs conservative

Surgery is often looked upon as the ‘cure-all’ option or  a ‘quick fix’ to get us back on track, but sometimes it is not the best option, based on its invasive measures.

This is not to say that surgical interventions should be disregarded. What it does mean however, is that everyone’s injury and situation is different, and the ideal recovery journey is varied.  Therefore, the approach to rehabilitation needs to be tailored to suit the individual’s needs.

What do you mean by ‘Conservative Treatment’?

Conservative treatment is a type of medical treatment defined by the avoidance of invasive measures such as surgery, usually with the intent to preserve function.

So how do you make the best treatment decision for your recovery?

Do your research

Firstly, ensure you do adequate research around the specifics of your surgery compared to conservative (non-surgical) options. Refer to a couple of examples below:

  • Early surgery (6-12 weeks) in patients with sciatic pain from disc herniation leads to faster pain relief when compared with prolonged conservative treatment. However, there were no differences after 1 and 2 years.
  • Based on the review of seven randomised controlled trails (RCTs), the evidence on the effectiveness of surgical or conservative treatment of shoulder impingement was found to be limited – therefore indicating there was moderate evidence that surgical treatment is not more effective than active exercises on reducing pain intensity caused by shoulder impingement.

Get expert advice

Secondly, seek expert advice from your treatment providers (GP, Exercise Physiologist, Specialist, Physiotherapist) who will inform you around latest evidence-based practice, but also customise the advice based on your individual situation. Our job is to inform you of your options in relation to your recovery.

Ask questions

Lastly, be assertive and empowered to ask questions in relation to the treatments/interventions being proposed to you. Knowledge based decision making is critical when it comes to your overall health.

The takeaway message is – ‘quick fixes’ are not always going get you back on track, and it’s important to investigate all options before making a decision. A conservative option may be simpler and safer in the long term. Therefore, it is important to talk to your treatment providers and make an informed decision in relation to your recovery.

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References:

Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A., … & Wald, J. T. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology

Gugliotta, M., da Costa, B. R., Dabis, E., Theiler, R., Jüni, P., Reichenbach, S., … & Hasler, P. (2016). Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study. BMJ open

Jacobs, W. C., van Tulder, M., Arts, M., Rubinstein, S. M., van Middelkoop, M., Ostelo, R., … & Peul, W. C. (2011). Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. European Spine Journal

Negendank, W. G., Fernandez‐Madrid, F. R., Heilbrun, L. K., & Teitge, R. A. (1990). Magnetic resonance imaging of meniscal degeneration in asymptomatic knees. Journal of orthopaedic research

Saltychev, M., Äärimaa, V., Virolainen, P., & Laimi, K. (2015). Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis. Disability and rehabilitation

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