Is physiotherapy an underused approach to prevent surgery in selective musculoskeletal disorders?

Abstract

Objectives: The purpose of the literature review was to appraise the evidence that an early physiotherapy intervention helps to prevent the surgery in selective musculoskeletal disorders. A search of Google Scholar, Web of Science, Scopus, and PubMed was carried out utilizing the terms (“physiotherapy”, “surgery” OR “exercise, surgery” OR “rehabilitation”, “surgery”).
 Methods: The article titles and abstracts were screened for eligibility and included in the review. The recent literature evidently emphasized that physiotherapy has opted in selective musculoskeletal problems to avoid and delay surgeries.
 Results: Regardless of recommended conservative treatment option and effectiveness of physiotherapy, a massive gap can be observed between its evidence and practice. Conversely, overuse of diagnostic imaging, surgeries, and medications is present in clinical practice. In most of the clinical problems the long-term outcomes were reported the same with surgical and physiotherapy intervention. Likewise, patients can also get the advantage of better clinical outcome and cost-effectiveness with physiotherapy as compared to surgical intervention.
 Conclusion: The cost-effectiveness is an important factor in low-income countries where economic aspects of health care are highly considered. These advantages of physiotherapy should be considered by the clinicians, policymakers, patients, and included in the clinical guidelines.
 Bangladesh Journal of Medical Science Vol.20(2) 2021 p.409-413

Intra-rater and inter-rater reliability of cranio cervical flexion test in symptomatic subjects of neck pain using pressure biofeedback

“…The cost-effectiveness is an important factor in low-income countries where economic aspects of health care are highly considered. These advantages of physiotherapy should be considered by the clinicians, policymakers, patients, and included in the clinical guidelines 29 . Augmenting conventional physiotherapy with lumbar stabilisation exercises achieved better reduction in disability than conventional therapy alone in patients with NSCLBP 30 .…”

Identifying Conservative Interventions for Individuals with Subacromial Pain Syndrome Prior to Undergoing a Subacromial Decompression: A Scoping Review

“…6 PT intervention has high-level supportive evidence to treat individuals suffering from SAPS. 11 Several randomized control trials exist highlighting equivalent outcomes and cost savings when individuals receive supervised exercise compared to receiving a SAD. 12,13 Additional authors have found enhanced benefits from combined manual therapy (MT) and exercise over exercise alone.…”

“…[14][15][16][17] However, to date, PT is not always delivered to individuals with SAPS prior to undergoing a SAD. 11,18 Therefore, identifying the PT interventions offered to people with SAPS prior to undergoing a SAD is needed in the attempt to understand why individuals continue on to surgery. 19 Based on the current evidence, it is unclear if adequate conservative management is provided to individuals with SAPS prior to considering a SAD.…”