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
Highlights
Physiotherapy is considered as an adjunct therapy with other medical and surgical interventions to alleviate pain, improve quality of life, and restore patient’s maximum movements and functions
This is achieved by using special therapeutic exercises, manual techniques and modalities. 1,2 In many cases physiotherapy is a highly effective, evidencebased, and non-invasive approach that can be a good alternative approach for the cases where the need for the surgery can be avoided
Physiotherapy intervention is a great choice in the early stage of selective musculoskeletal problems to delay or prevent the future need for surgery
Summary
Physiotherapy is considered as an adjunct therapy with other medical and surgical interventions to alleviate pain, improve quality of life, and restore patient’s maximum movements and functions. Literature review: The long term clinical outcomes of many musculoskeletal problems were similar whether with physiotherapy or surgical intervention.[10] Looking at the shoulder pathologies, up to 75% of patients with atraumatic full-thickness rotator cuff tears were able to alleviate their symptoms without surgery.[11] A recent systematic review, the treatment of subacromial pain syndrome (SAPS) compared with exercise or placebo surgery and subacromial decompression surgery. A research study comparing exercise to arthroscopic partial meniscectomy concluded no difference between exercise and surgery after two years of follow-up.[2] In a systematic review and meta-analysis, the arthroscopic surgery for meniscal tear reported with a significant improvement in the short term or the long-term pain scores In such cases, the first line of the treatment option should be conservative management. The fall prevention program delivered by physiotherapists is designed to decrease the risk of fall and avoiding potential fractures. 23 A randomized clinical trial conducted on patients with pelvic floor disorders reported physiotherapy an appropriate,
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