When working with patients on rehabilitation in your physical therapy jobs, there are many options for recovery. Sometimes a restoration plan involves just PT, but other times it includes both surgery and PT. But based on a 2015 study, surgery may not be the best or safest option for recovery.
Study overview
The seven-year study, lead by researchers at the University of Pittsburgh and published in the Annals of Internal Medicine, examined 169 men and women over the age of 50 with lumbar spinal stenosis.
According to the National Institutes of Health, lumbar spinal stenosis is a type of lower back pain that is common among the elderly and often treated with surgery. However, the operation can lead to life-threatening complications.
Half of the study group underwent surgery immediately, while the other half participated in a strategically designed physical therapy program. At the 10-week mark, both groups experienced rehabilitation-related benefits. After two years, the PT group had a slightly higher average improvement in physical function as compared to the surgery group. Harvard Medical School said that participants in both groups experienced obstacles, either infection or repeat surgery or, for the PT group, worsening symptoms. However, the surgery group (25 percent) encountered more problems than the PT group (10 percent).
The NIH explained that the specific PT treatment emphasized lumbar flexion exercises, conditioning exercises and self-care education. It was a six-week program, with 1-2 visits every week. The bi-weekly session included a specialized home exercise program involving general exercises, aerobics and strengthening.
The best option
Anthony Delitto, lead researcher of the study and chairman of Pitt’s Department of Physical Therapy, stressed the superiority of PT to medical procedures in many cases.
“The first thing people should strongly consider is exhausting all non-surgical options,” Delitto told the Pittsburgh Post-Gazette. “Surgery should be the last resort. The study shows that people don’t exhaust nonsurgical options. Physical therapy is one option and based on the study, it’s a good option, and people should consent to that before surgery.”
In addition to the health benefits and success rates, PT is the better financial decision for your patients. Delitto, who is also a PT, told the Post-Gazette that the cost of 12 sessions of PT is approximately $1,440, whereas the cost of decompression surgery is $24,000.