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Options without surgery
| Method | When used | What is known |
|---|---|---|
| Exercise therapy, physiotherapy | In almost all joint and spine conditions | Basis of treatment; well studied |
| Weight loss, load management, braces | Osteoarthritis, tendinopathies | Reduce joint load and pain |
| Medication (NSAIDs, topical) | Pain and inflammation | Help for a while; long-term use needs monitoring |
| Injections: cortisone, hyaluronic acid, PRP | Flares, osteoarthritis, some tendinopathies | Effects differ in strength and duration |
| Spinal injections | Radicular pain, facet syndrome | Help some patients, often temporarily |
| Shockwave therapy | Heel spur, calcific tendinitis, tennis elbow | Studied in several tendinopathies |
When surgery is still needed
- Increasing weakness in a leg or arm, bladder problems — urgent care is needed.
- Complete tendon or ligament tear in an active patient, locked joint.
- Severe osteoarthritis with constant pain that limits life despite treatment.
- No improvement after 6–12 weeks of proper treatment for a disc herniation with leg pain.
If you are unsure whether surgery is needed, get a second opinion. We send your images to several clinics and help you compare their recommendations.
Scientific evidence
Guidelines and studies this page is based on:
- Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019.
- Peul WC et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med, 2007.
- Sihvonen R et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med, 2013.
Frequently asked questions about treatment without surgery
Can a herniated disc be treated without surgery?
In many patients the pain settles within 6–12 weeks without surgery. Surgery is discussed with increasing weakness or if pain does not improve.
Can joint replacement be avoided in osteoarthritis?
In early and moderate stages often yes. In severe osteoarthritis with constant pain, replacement is usually more reliable.
How long until results?
Usually 6–12 weeks with regular exercise; osteoarthritis needs long-term treatment.
How can RegenPAS help?
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Want to know whether surgery can be avoided? Send your images — we will get clinic opinions
Send your MRI or ultrasound and describe where and when it hurts. The coordinator replies within 24 hours; a clinic physician gives an opinion in 1–3 business days.
Send images