Why You Shouldn’t Delay Orthopedic Surgery

Article above written by Kim O'Brien Root

Introduction

Your knee has bothered you for years. You know you should have something done to it, but you don't want to deal with the hassle of taking time off work for surgery and recovery. Or maybe your wrists ache so much they keep you up at night. You've tried a number of treatments, from cortisone shots to medications. But the pain is still there and you're afraid of surgery.

There are many reasons people have for delaying orthopedic surgery—time, money, and fear are just a few of them. However, having surgery sooner rather than later can often be the best option to help you live your best life and avoid future complications. Below are key reasons not to delay orthopedic surgery any longer than necessary.

Your Quality of Life Will Improve

Some people get so used to chronic pain that they don't see any reason to go through surgery. They figure they've made it this far—why bother? The reality is that necessary surgery can drastically improve quality of life.

• “Most (but not all) orthopedic surgery is done for quality of life,” says Dr. Michael Higgins, a hip and knee replacement surgeon at Tidewater Orthopaedics. “If you are suffering from an orthopedic problem, you owe it to yourself to become educated about all your treatment options and make an educated decision to improve your quality of life.”
• Dr. Nicholas Smerlis, a hand and wrist surgeon at Tidewater Ortho, notes that many patients with carpal tunnel syndrome—a tingling, numb, or painful feeling caused by pressure on a nerve in the wrist—endure years of poor sleep due to pain. After surgery and being able to sleep through the night without a brace, many realize how much they had been suffering.

Surgeons Use the Latest Techniques

There may never have been a better time to have orthopedic surgery. Advances have improved safety, outcomes, and convenience:

• Outpatient joint replacement and minimally invasive approaches
• Expanded use of arthroscopy (small incisions) and longer-lasting implants
• Carpal tunnel surgery now done outpatient with no immobilization
• Ankle replacement implants that last longer than ever
• Dramatically reduced infection risks:
  • Arthroscopic surgery has less than a 1% infection rate, says Dr. Nicholas Sablan, a Tidewater Ortho surgeon specializing in sports medicine and arthroscopic surgery of the shoulder, knee, elbow, and hip.
  • At dedicated outpatient facilities such as the CarePlex Orthopaedic Ambulatory Surgery Center (COASC) in Hampton, where Tidewater Ortho surgeons operate, the infection rate is below 0.0001%; patients are screened beforehand to ensure they are in good health.
• In the rare event an infection is identified, it is treatable, says Dr. Jonathan Mason, a spine surgeon at Tidewater Ortho. “If the surgery is to improve quality of life, the benefits far outweigh the risks of a rare infection that might occur.”
• Anesthesia improvements: While spine surgery generally requires anesthesia, many other orthopedic surgeries—such as carpal tunnel release, ACL repair, and rotator cuff reconstruction—can be performed with regional nerve blocks that numb only the extremity.

Recovery Time Might Not Be as Bad as You Think

Recovery time is one of the biggest reasons people delay surgery, Dr. Sablan says. Advances in techniques have made recoveries much easier:

• Small, arthroscopic incisions often mean less pain and faster recovery.
• Many procedures once requiring a hospital stay are now outpatient, allowing patients to heal at home.
• Even hip and knee replacement patients are typically up and walking the day of surgery.
• Fear of pain is common: in one study of 400 patients with preoperative fear, 77% feared postoperative pain most. But pain control is significantly better than it used to be, says Dr. Higgins.
• Tidewater Ortho uses the Healthy Patient Model, which includes general health screening before surgery and emphasizes mobility and independence afterward. Healthy, medically prepared patients are less likely to have complications.
• While some pain and unpredictability are normal with surgery, those fears can be eased when a surgeon clearly explains the process and offers reassurance, Dr. Jonathan Mason says. “I try and paint a very realistic picture of what they can expect,” adds Dr. Paul Maloof, Tidewater Ortho’s foot and ankle surgeon. “Many orthopedic surgeries can take a while to recover from and I want my patients to be as informed as possible before they make their decision.”

Your Doctor Won't Suggest Surgery Unless Needed

Unless you have an emergent issue (such as an open fracture or infection), you don’t need to rush into surgery—and your doctor won’t pressure you to.

• “Most procedures can be delayed so that conservative treatment can be attempted,” Dr. Maloof says. “This includes rest, activity moderation, immobilization, use of anti-inflammatory medications and physical therapy.”
• Many conditions can first be managed conservatively under a doctor’s care. For example, while rotator cuff tears can’t heal on their own, partial and small tears may respond to therapy and injections, Dr. Sablan notes.
• Physical therapy before surgery (“prehab”) can set patients up for more successful recoveries, adds Dr. Robert Mason, an upper extremity specialist at Tidewater Ortho.
• With arthritic conditions, less invasive or less complex procedures are often possible when problems are treated earlier.
• Even if you doubt surgery would help, seek an orthopedic evaluation. “I would much rather see a person early and get them started with non-operative management before a condition gets too severe,” Dr. Robert Mason says.

So, What If You Do Wait?

Ultimately, the decision to have surgery rests with the patient. But delays can have consequences:

• Foot fractures can heal in a crooked position if treatment is delayed.
• Ankle sprains not appropriately treated can lead to long-term pain and disability.
• “Sometimes delaying surgery or putting it off for too long can make a simple surgery to fix the initial problem a much more complex endeavor if delayed too long,” says Dr. Robert Mason.
• Some repetitive-use conditions (like tendonitis) may improve with symptomatic management, but others worsen with delay:
  • Carpal tunnel syndrome can progress to weakness, loss of sensation, and progressive neurological loss.
  • Persistent trigger finger symptoms can lead to permanent deformity.
  • Rotator cuff tears can retract, making repair much more difficult and increasing the likelihood of re-rupture.

Bottom line: If you’re tired of being in pain, see an orthopedic surgeon. Get evaluated and educate yourself on the possibilities. You might be glad you did. “Most people who don’t want to take the time to get things fixed initially often regret putting it off,” Dr. Robert Mason adds. “Once they finally see the results of the surgery and the hard work they put in during the recovery, they realize it was worth their time.”

Never Delay If You Have

• Open fractures
• Damage to your nerves or vessels
• Infections involving your joints
• Compartment syndrome—when pressure from internal bleeding or tissue swelling builds up in the muscles
• Pain and weakness in the neck or arms, which can indicate spinal cord compression

Q&A

Question: Why shouldn’t I delay orthopedic surgery if I’m “managing” my pain?

Short answer: Because timely surgery can significantly improve your quality of life and may prevent the problem from becoming harder to fix. Many patients realize after surgery how much chronic pain was limiting their sleep, function, and daily activities. Addressing issues earlier can also allow for less-complex procedures and better outcomes, rather than facing a more difficult surgery later.

Question: How safe are modern orthopedic surgeries?

Short answer: Today’s techniques are safer and less invasive than ever. Many procedures are arthroscopic (small incisions), joint replacements are more reliable and longer-lasting, and carpal tunnel release is now an outpatient procedure without immobilization. Infection risk is very low—arthroscopic surgery has under a 1% infection rate, and at specialized outpatient centers like the CarePlex Orthopaedic Ambulatory Surgery Center, the rate is below 0.0001% thanks to focused screening and protocols. Many surgeries can also be done with regional nerve blocks instead of general anesthesia, further reducing risk and improving recovery.

Question: Will recovery be long and very painful?

Short answer: Recovery is often easier and faster than people expect. Minimally invasive approaches mean less pain and quicker healing, with many procedures now done outpatient. Even hip and knee replacement patients are typically up and walking the day of surgery. Pain control has advanced significantly, and preoperative health optimization (the Healthy Patient Model) improves safety, mobility, and independence after surgery. A clear, realistic plan from your surgeon helps set expectations and reduce fear.

Question: Do surgeons push surgery, or will they try non-surgical options first?

Short answer: Surgery is rarely the first step unless there’s an emergency. Most patients start with conservative care such as rest, activity modification, immobilization, anti-inflammatory medications, injections, and physical therapy. Pre-surgery therapy (“prehab”) can set you up for a smoother recovery. Some conditions—like small or partial rotator cuff tears—may improve with non-operative care, but others won’t heal on their own; your surgeon will guide you based on your specific case.

Question: What happens if I wait too long—and when should I never wait?

Short answer: Delays can turn a fixable problem into a complex one. Examples include fractures healing crooked if untreated, ankle sprains leading to long-term pain and instability, carpal tunnel progressing to weakness and permanent sensation loss, trigger finger causing deformity, and rotator cuff tears retracting, which makes repair harder and raises the risk of re-rupture. Never delay if you have:

• Open fractures
• Nerve or blood vessel damage
• Joint infections
• Compartment syndrome (painful pressure in muscles)
• Pain and weakness in the neck or arms suggesting spinal cord compressi