If Not Surgery, Then What?

What comes to mind when someone says 'surgery'? For most people, it is a fear of pain, of having to stay in the hospital, and the amount of time required to recover.

It is true that surgery is a lifesaving advance of modern medicine, and that without it many lives would be lost or would be of significantly less quality. However, it is also true that for some people, surgery may not be an option due to health problems they already have, or because they are not ready to have surgery.

There are also conditions where the need for surgery can be delayed, or in some cases even avoided by using non-invasive treatments called conservative management of injury.

What is conservative treatment for an injury? 

Any method of treating a disease or condition that involves medicine, physiotherapy or bracing rather than surgery is called conservative treatment.

Basically, any mode of treatment that is 'non-invasive' and does not involve cutting into the body is referred to as conservative management.

What conditions can be treated conservatively with the involvement of physiotherapy?

  • Herniated Discs: Commonly referred to as a 'slip disc', they commonly make patients worry and feel like surgery is the only option. Although the symptoms are painful and extremely scary, most herniated discs have been shown to heal without surgery. Physiotherapy focuses on building core (stomach, back and pelvic floor muscle) strength to support the spine and reduce the amount of load on the vertebrae and discs.
  • Arthritis: In osteoarthritis, the cartilage that makes your joints move smoothly is worn down and damaged, causing stiffness, pain, and difficulty in walking. It is commonly seen in the joints that support your weight (knees, hips, spine). Strengthening the surrounding muscles, improving the flexibility and working on the gat pattern in addition to bracing, painkiller medications as needed, and pain relieving modalities like ice/heat or electrotherapy can significantly improve quality of life and may delay - or even prevent- the need for joint replacement surgery if it is started early enough.

In other types of inflammatory or infective arthritis, similar plans of treatment can also prevent deformities from occurring.

  • Sprains and Strains: After allowing for enough time to heal in an immobilized position, physiotherapy helps to regain strength. Research has also shown that applying gentle loads to collagen tissue as it heals helps to develop stronger tissue that is better able to resist forces.
  • Fractures: If a fracture is not serious enough to need surgery, it is managed by applying a plaster cast for a few weeks. Following cast removal, physiotherapy is necessary to recover range of motion and build muscle.

Even if a fracture has been managed surgically, physiotherapy is more often than not required afterward to return the limb to full function. 

These are just a few examples; non-surgical treatments are numerous and varied, even within the domain of physiotherapy.

For example, it has been shown to improve blood sugar control in diabetics, correct mild spinal curvatures, teach movement to children with cerebral palsy, relieve pain without the use of addiction causing opioid medications, strengthen weak pelvic floor muscles that cause leakage of urine and even stop symptoms of vertigo. 

So the next time a healthcare professional tells you that there may be options you can try before surgery...don't be wary! It is always worth trying conservative treatment if it's approved for your condition.

Our physiotherapists at Healyos are extremely experienced with treating these cases, and have delivered incredible results with a large number of patients. With over 80,000 patients treated till date, you can be sure your recovery and rehabilitation is in the very best of hands with us. Click the Book option below to get in touch with one of our experts today. 

Case Study

When Dr. Sarita Karsh first saw Mr. Navlakha in the beginning of January 2020, he had already been living with a large tear in his supraspinatus tendon for nearly four months. It didn't slow him down much - at 78, he is a businessman working 15 hour days with enthusiasm and energy.

It did, however, cause him to be almost completely unable to move his dominant arm, and that meant he could not sign his name to important documents related to his work. He told Dr. Sarita that that was his priority. The strength of his shoulder muscles was also severely reduced by the injury, but despite being recommended surgery by two separate surgeons, Mr. Navlakha was determined to recover with as little invasive intervention as possible - he refused to take a single painkiller, and was set on having a natural recovery.


Armed with her skills and a warm, encouraging personality, Dr. Sarita started his treatment. With half-hour sessions every day, they gained 30 degrees of movement in his arm, and even improved his strength. When the COVID-19 lockdown was imposed in Pune on the 22nd of March, it didn't stop him at all - he simply did the exercises he had been taught by himself until the 17th of May, when Dr. Sarita was able to reach him again. A testament to the bond of trust that had sprung up between them, he insisted that she be the one to continue his treatment, and when she was unable to travel to him due to public transport bring closed, he sent a car to make sure she got there.

And all that hard work paid off; he now has almost complete movement in his shoulder, and is able to do all of his work with no pain. With a few nudges from Dr. Sarita, he's even adopted a healthier diet despite his sweet tooth.

"He contributed to 80% of his own recovery," Dr. Sarita says. The same determination and drive that pulled him through two cardiac surgeries and keeps him going to this day is what enables him to do 2 minute planks and military pushups, a challenge for a person half his age.

Mr. Navlakha says, " I am very thankful to HealYos and Dr. Sarita. She gave me hope that I would recover, and now I can confidently use my arm as I could before my injury."