How Long Should You Try Physical Therapy Before Considering Surgery?

If you’re dealing with ongoing joint pain, stiffness, or limited mobility, one of the most common questions patients ask is:

“How long should I try physical therapy before thinking about surgery?”

Most patients should try physical therapy first—but not indefinitely. Knowing when PT is helping (and when it’s not) can prevent months—or even years—of unnecessary discomfort.

Why Physical Therapy Is Often the First Step

Physical therapy (PT) is a cornerstone of orthopedic care because it can help:

• Reduce pain and inflammation

• Improve strength, flexibility, and stability

• Restore function and mobility

• Delay—or sometimes eliminate—the need for surgery

For many knee, hip, shoulder, and spine conditions, PT is an effective and proven first-line treatment.

The Typical Physical Therapy Timeline

While every patient and condition is different, a general guideline is:

4–6 weeks of consistent physical therapy, including:

• Attending sessions as prescribed

• Doing home exercises regularly

• Modifying activities that worsen symptoms

During this period, many patients begin noticing meaningful improvement—less pain, better movement, and more ease with daily activities.

Signs Physical Therapy Is Working

PT is usually worth continuing if you notice:

• Steady improvement week to week

• Increased strength or range of motion

• Pain that’s improving or easier to manage

• Greater confidence using the joint

Even gradual progress is a good sign.

When Physical Therapy May Not Be Enough

It may be time to re-evaluate if:

• Pain remains severe or worsens after 6–8 weeks

• You’ve plateaued with little to no improvement

• Daily activities are still significantly limited

• Pain interferes with sleep or work

• Imaging suggests advanced joint damage or structural issues

At that point, continuing therapy alone may not lead to better results.

Does Considering Surgery Mean PT Failed?

Not at all.

Physical therapy can still be a win because it often:

• Helps confirm whether surgery is the right next step

• Improves strength before surgery (which supports recovery)

• Leads to better post-surgical outcomes

Think of PT as part of the decision-making process—not a failure.

Conditions Where Surgery May Be Considered Sooner

Some situations may call for an earlier surgical discussion, such as:

• Advanced arthritis with bone-on-bone changes

• Large rotator cuff tears

• Meniscus tears causing locking or instability

• Severe ligament injuries

• Persistent pain despite well-executed therapy

Your provider will consider your symptoms, exam findings, imaging, and response to PT to guide the best recommendation.

The Most Important Question Isn’t “How Long?”—It’s “How Am I Doing?”

Instead of focusing only on the calendar, ask:

• Am I improving?

• Is my quality of life getting better?

• Can I do the things I want to do?

If the answer is consistently “no,” it may be time to explore additional treatment options.

A Conservative, Patient-First Approach

The goal is never surgery for surgery’s sake—it’s lasting pain relief, restored function, and getting you back to living your life.

If physical therapy helps—great. If it doesn’t, we can help you understand why and discuss next steps based on your needs, goals, and imaging.

Need guidance on whether PT is still the right option for you?