March 2013

Physical Therapy May Be Effective Surgery Alternative

Physical therapy may be an effective alternative to surgery in treating meniscus tears or osteoarthritis, according to a new study.

The meniscus is a disc that cushions the knee. It is responsible for maintaining steadiness by balancing the weight of the body across the knee. Tears in the meniscus tears are a common injury that may result from playing sports or lifting heavy objects. The risk of this injury may increase with age, since the meniscus gets worn as people get older.

Osteoarthritis occurs when the cartilage in the joints begins to break down. The cartilage serves as a cushion between bones, allowing the joint to move without pain. People who have this condition often experience pain and reduced mobility in their joints where cartilage is degrading. Osteoarthritis may affect any joint in the body.

In the current study, researchers recruited 351 people over the age of 45 who either had a tear in the meniscus or knee osteoarthritis. They randomly assigned the subjects to receive either surgery or physical therapy, and evaluated results at six and 12 months after the intervention. To compare the effects of the two treatments, they used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which measures physical function by assigning scores of 0 to 100, with higher numbers denoting more severe symptoms.

Six months after the intervention, WOMAC improved in the surgery group by 20.9 points and in the physical therapy group by 18.5 points. About 30 percent of people who received physical therapy opted to undergo surgery during the first six months, and after 12 months, they reported similar outcomes to those who initially underwent surgery.

According to the researchers, significant differences in functional improvement for surgery and physical therapy were lacking six months after intervention.

According to the American Physical Therapy Association, the goal of physical therapy (PT) or physiotherapy is to improve mobility, restore function, reduce pain, and prevent further injury by using a variety of methods, including exercises, stretches, traction, electrical stimulation, and massage. Special tools are used, such as hot or cold packs, crutches, braces, treadmills, prosthetics, compression vests, computer-assisted feedback, lasers, and ultrasound. Patients range in age from newborns to the elderly.

Physical therapy is commonly used for musculoskeletal injuries, joint pain or disorders, low back pain, cerebral palsy, and rehabilitation after injury or surgery, including heart surgery or mastectomy. Physical therapy, especially early physical therapy, can be painful, and many patients use medications for pain during therapy.

For more information about physical therapy, please visit Natural Standard's Health & Wellness Database.


  1. Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. N Engl J Med. 2013 Mar 18. [Epub ahead of print] 
  2. Natural Standard: The Authority on Integrative Medicine. 

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2024 NatMed. Commercial distribution or reproduction prohibited. NatMed is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.