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PHYSIOTHERAPY: AS EFFECTIVE AS SURGERY?
Recently released studies suggest physiotherapy is at least as effective as surgery in treating arthritic knees. Whether you’re squeamish about scalpels and knobby kneecaps or not, this is great news. A study from the New England Journal of Medicine finds that surgery is no better than medication and physiotherapy for relieving the pain and stiffness of moderate or severe arthritis. Another study, from the University of Western Ontario, reveals that tears in knee cartilage - which often prompt such surgeries - are very common without causing symptoms.
RESEARCH
Following the same breakthroughs, CTV aired the following: “Popular surgery does little for arthritis pain: study” on Sep. 10 2008, and it explained the following:
Physiotherapy provided by those with formal manual therapy training, like our North Shore Sports Medicine Clinic physiotherapists, often produced clinically significant functional benefits for patients with knee osteoarthritis which resulted in less reliance on medication.
Researchers at the University of Western Ontario and Lawson Health Research Institute found that arthroscopic knee surgery, whereby surgeons remove cartilage fragments and smooth joint surfaces, does little to improve osteoarthritis symptoms.
"For the group that we studied, it's a waste of time," researcher Dr. Bob Litchfield told CTV's Avis Favaro.
Arthroscopic surgery is a widely used treatment for osteoarthritis, which affects one in 10 Canadians, making it the most common form of arthritis.
"We need to change practice," said Litchfield, "We need to be honest with our patients (and say), 'This operation is not going to help the condition you have.”
Osteoarthritis is caused by the breakdown of cartilage in the joints, which causes pain and swelling.
The University of Western Ontario study included 178 men and women with an average age of 60. Each patient received physiotherapy and anti-inflammatory medications (e.g. ibuprofen or acetaminophen). Eighty-six patients also received arthroscopic surgery.
The researchers found that all of the study subjects had similar improvements in joint pain, stiffness and function. However, the patients who had surgery did not experience any additional benefits. Physiotherapy’s non-invasive treatment was as useful as surgery’s invasive procedure.
Patient Steve Studenny had surgery to minimize knee pain. He said the procedure helped at first, but over time, the pain returned. He added, "They did go in, clean it up -- it was good for about a year and then it started hurting again."
The importance of this latest finding is that physiotherapy can replace invasive surgery in this particular kind of case and is a reminder to always get a second opinion.
For more information on knee pain, see:
http://www.physiotherapy.ca/publicuploads/595368physiotherapy%20effectiveness.doc
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