Surgery Isn’t Always the Shortcut: A Physiotherapist’s Perspective in Brighton & Hove
When people come into Life is Movement Clinic in Hove, one of the most common things I hear is:
“Do you think I need surgery?”
It’s an understandable question. If you’ve had persistent back pain, shoulder pain, knee pain or sciatica for months, or even years, surgery can feel like the quickest, most definitive option.
But the truth is more nuanced.
As a physiotherapist in Brighton & Hove, my role is not to be “anti-surgery.” Surgery can be life-changing and absolutely the right decision in certain situations. But it is also a serious medical intervention, and for many common musculoskeletal problems, it is not automatically the best route.
The Long-Term Evidence: Surgery Often Doesn’t Outperform Conservative Treatment
For many common conditions such as:
Persistent lower back pain
Shoulder impingement / rotator cuff pain
Degenerative meniscus knee pain
Some disc-related pain without severe neurological loss
General wear-and-tear joint pain
Research consistently shows that long-term outcomes (often 2–5+ years later) can be similar between:
Surgical intervention
vsConservative treatment such as physiotherapy, exercise rehabilitation, strength work, and lifestyle changes.
That matters.
Because if outcomes are similar in the long run, then unnecessary surgery may mean taking on the risks of:
General anaesthetic
Infection
Scar tissue complications
Failed surgery / incomplete symptom relief
Long recovery times
Time off work
Financial and emotional stress
…without necessarily ending up in a better place years later.
Surgery Is Powerful — But It Must Be Used Wisely
Surgery is one of the most powerful tools in modern healthcare.
But powerful tools should be used carefully.
It should not be chosen simply because:
It feels quicker
Rehab sounds hard
Someone wants a “fix” rather than a process
Pain has gone on a long time and frustration is high
These are understandable emotions, but not always good reasons for surgery.
My Own Experience With Surgery
I’m not writing this from an ivory tower.
I had spinal surgery myself.
Why? Because I had significant nerve compression that was causing progressive weakness in my right leg, particularly my ankle and foot. If I had continued to “wait it out” and rely only on conservative treatment, the nerve damage would have become permanent and disabling.
That is exactly where surgery can be brilliant:
Protecting nerve function
Preventing disability
Creating space where structures are compromised
Resolving urgent neurological issues
In that case, surgery wasn’t optional, it was appropriate.
The Real Truth: Surgery Often Buys You a Chance to Rehabilitate
This is the part many people miss.
Even when surgery is successful, it usually does not remove the need for rehabilitation.
In many cases, surgery simply creates a better starting point for the rehab process.
For example:
Disc Surgery
Someone has a discectomy, feels better, then does no rehab.
They don’t improve strength, movement habits, trunk control, fitness or load tolerance.
A few years later? The disc above or below becomes the next problem.
Shoulder Surgery
Someone has decompression or cuff surgery, but never restores strength, movement quality, or progressive loading.
Pain returns or function remains limited.
Surgery is rarely the final chapter. It is often chapter one of the real work.
So When Should You Consider Surgery?
A referral to a specialist may be appropriate when:
Progressive weakness or nerve loss
Loss of bladder/bowel control (medical emergency)
Severe structural trauma
Major instability
Persistent symptoms despite excellent rehab over time
Clear imaging findings that match symptoms and function loss
Daily life significantly impaired despite doing the right things properly
What We Do at Life is Movement Clinic (Hove)
At Life is Movement Clinic, we help people across Brighton and Hove make smart decisions before rushing into surgery.
That may include:
Thorough movement assessment
Understanding what is truly driving pain
Strength and mobility rehabilitation
Load management
Return-to-gym planning
Running and sport rehab
Honest conversations about when referral is appropriate
Sometimes our job is helping you avoid unnecessary surgery.
Sometimes our job is helping you prepare for surgery.
Sometimes our job is helping you recover properly after surgery.
All three matter.
Final Thought
If surgery is genuinely needed, it can be one of the best decisions you ever make.
If it is not needed, it can be an unnecessary risk.
That’s why the real question is not:
“Can I get surgery?”
It’s:
“Have I properly explored the best route first?”
Looking for Physiotherapy in Brighton & Hove Before Surgery?
If you’re dealing with back pain, sciatica, shoulder pain, knee pain or recurring injuries and wondering whether surgery is the next step, we’d be happy to help you assess the smartest path forward.
Life is Movement Clinic
📍 Hove, East Sussex
Helping people move better, get stronger, and make better long-term decisions.
