Should You Have Surgery? Get an Unbiased Second Opinion First

Should You Have Surgery?

If you’ve been told you might need surgery, getting an unbiased second opinion—and starting pre-surgical rehab when appropriate—can clarify your options and improve your outcome. In many cases, the right evaluation can confirm whether surgery is truly necessary, and if it is, targeted pre-surgical rehab can help you go into surgery stronger and recover faster.

Why we often recommend a second opinion before surgery

When you’re hurting, it’s completely normal to want the quickest “final answer.” But surgery is a major decision, and not every condition that feels severe actually requires an operation right away.

At Back and Body Pain Relief in Springfield Township, New Jersey, we see this situation every week—especially with sports injuries, back pain, and nerve-related symptoms. Because we offer chiropractic care, physical therapy, sports rehab, acupuncture, medical care, and pain management under one roof, people often come to us first to sort out what’s going on and what the smartest next step really is.

What “unbiased” really means in real life

Here’s the key point: if someone needs surgery, we’ll still be part of the recovery process. If someone doesn’t need surgery, we’ll be part of the recovery process.

So our job is to help you choose the option that best fits your condition—not the option that best fits one specific type of practice.

• If surgery is clearly indicated, we want you with the right specialist quickly, with the right information.
• If conservative care is still appropriate, we want you to avoid unnecessary risk, cost, and downtime.
• If you’re “in the middle”, we want you to understand timelines, red flags, and what to try first—without guessing.

How we help you decide: our “surgery vs. rehab” decision framework

When we evaluate you, we’re not trying to win an argument against surgery. We’re trying to answer a practical question: What is most likely to get you safely better?

Step 1: We start with a thorough assessment (not a quick glance)

In our clinic, we look at:

• Your symptom pattern (what makes it worse/better, what’s changed over time)
• Your function (walking, lifting, stairs, sports, sleep)
• Strength, mobility, and stability—above and below the painful area
• Neurologic “red flag” signs when nerve involvement is possible

When appropriate, we can also use advanced diagnostics available in our office—like NCV/EMG and diagnostic ultrasound—to help pinpoint what’s driving symptoms and guide a more targeted plan. (Not everyone needs these tests, but when they’re indicated, they can reduce guesswork.)

Step 2: We look for “surgical candidate” red flags

There are situations where we’ll tell you clearly: “This looks like it needs a specialist evaluation now.” We don’t ignore those signs, and we don’t “treat through” problems that should be seen by a surgeon or medical specialist.

Examples of reasons we may recommend prompt specialist evaluation include:

• Progressive neurologic symptoms (for example, worsening weakness)
• Severe symptoms that don’t match a typical rehab course
• Findings that suggest structural compromise requiring surgical input
• Cases where delaying the right care may worsen outcome

We’ll also explain what we’re seeing and why we’re recommending the next step—so you’re not left in the dark.

Step 3: If surgery is likely, we help you prepare (and that’s where pre-surgical rehab matters)

Even when surgery is the correct decision, there’s often a waiting period. Getting on the surgeon’s calendar can take time. Insurance authorization can take time. Pre-op medical clearance can take time. Blood work and other testing can take time.

And during that “waiting window,” many people unintentionally get weaker and stiffer. That’s where pre-surgical rehab can make a huge difference.

What is pre-surgical rehab, and why does it work?

Pre-surgical rehab (sometimes called “prehab”) is a structured plan designed to help you go into surgery in the best possible condition—within the limits of your injury. It’s not about ignoring pain or forcing movements that aren’t safe. It’s about building the foundation your body will rely on after the procedure.

The simplest way to think about it

• Surgery addresses a structural problem.
• Rehab teaches your body how to function well again afterward.
• Pre-surgical rehab makes the “rehab afterward” easier by reducing avoidable weakness, stiffness, and loss of control before surgery happens.

The risks of doing nothing while you wait

We see it all the time: people get injured, learn they may need surgery, and then they stop moving because they’re afraid of making things worse. Sometimes that’s understandable—but it can create its own set of problems.

Common consequences of “waiting without a plan” include:

• Disuse atrophy (muscle loss around the injured joint)
• Loss of range of motion (stiffness that lingers after surgery)
• Reduced endurance (simple tasks become harder)
• Compensation patterns (your body loads other areas and creates new pain)

When you go into surgery deconditioned, you typically have a steeper climb on the back end.

A real-world example: why an unbiased opinion matters

A situation we see often is when an established patient returns after years away and says, “I need your honest opinion—does this look like surgery?”

We recently had exactly that: a long-time patient came in, and based on what we saw right away, we felt they were a true surgical candidate. In that case, there wasn’t much we should do before they were evaluated by the appropriate specialist.

So we contacted a specialist (in that scenario, a neurosurgeon), discussed the case while the patient was still in the office, and helped ensure they were seen quickly the next morning with the right information to make an informed decision.

That’s what an unbiased second opinion should look like:

• You get clarity fast.
• You get guidance without pressure.
• You keep control over where you go and what you choose.

How we help you choose the right surgeon (without choosing for you)

One advantage we have that most people don’t is that we see what happens after surgery—every day.

Because we provide post-surgical rehab and ongoing rehab for spine and joint issues, we get feedback in the real world: outcomes, complication patterns, communication quality, and how conservative or aggressive different specialists tend to be.

What we’ve learned from post-surgery rehab

Over time, you notice patterns:

• Some surgeons do consistently excellent work and communicate clearly.
• Some are appropriately conservative and want rehab attempted first when safe.
• Some are quick to recommend surgery for nearly everyone who walks in.

Our role is not to “sell” you on a particular provider. Our role is to help you get a high-quality evaluation and understand your options with someone who fits your situation.

Evidence-informed pre-surgical rehab: the ACL example

From a research and outcomes perspective, pre-surgical rehab is strongly associated with better post-op recovery in many scenarios. One commonly discussed example is ACL reconstruction.

In ACL cases, pre-surgical rehab commonly focuses on:

• Maintaining or restoring as much knee range of motion as possible
• Keeping the quadriceps and hamstrings strong (as tolerated)
• Improving balance and neuromuscular control
• Reducing swelling and improving gait mechanics before surgery

Why does that matter? Because after surgery, you’re temporarily limited. If you go into the procedure with major weakness and stiffness, the early rehab phase can be slower and more frustrating. If you go in prepared, you often progress faster.

What pre-surgical rehab looks like in our clinic

At Back and Body Pain Relief, we tailor pre-surgical rehab to your injury, your procedure plan (if known), and your timeline. Our team includes chiropractors, physical therapists, medical doctors, and acupuncturists collaborating under one roof, which helps us build a plan that’s both practical and safe.

Goals we typically focus on before surgery

• Strength: maintain muscle around the affected area and key supporting areas
• Range of motion: protect and preserve mobility where appropriate
• Swelling and inflammation control: reduce unnecessary irritation
• Movement strategy: teach safe mechanics so you don’t flare symptoms
• Conditioning: keep your overall capacity up when possible
• Education: help you understand what to expect post-op

Tools we may use (based on your needs)

Because we’re multidisciplinary, your plan may include a mix of services, such as:

• Physical therapy with progressive strengthening and mobility work (including our on-site gym)
• Chiropractic care to support joint mobility and movement quality when appropriate
• Pain management modalities such as electric stimulation or Class IV laser therapy to help calm symptoms and support healing
• Acupuncture for pain modulation, muscle tension, and stress-related components of recovery
• Medical massage to address soft tissue restrictions and improve tolerance to movement
• Spinal decompression therapy when appropriate for disc-related complaints (e.g., certain cases of sciatica or disc irritation)

Not everyone needs every service. We choose what matches your presentation and goals.

Pre-surgical rehab for spine, shoulder, hip, and knee: common priorities

Different surgeries have different “make or break” rehab factors. Below are practical examples of where pre-surgical rehab commonly helps.

Back or neck surgery considerations

• Building hip and trunk strength to reduce strain on the spine
• Improving walking tolerance and basic endurance
• Addressing nerve irritation patterns (when safe and appropriate)
• Practicing posture and movement strategies for daily tasks

Shoulder surgery considerations

• Scapular control (shoulder blade mechanics)
• Rotator cuff and upper back strength as tolerated
• Maintaining safe range of motion without provoking instability
• Preparing for sling use and post-op sleeping strategies

Hip surgery considerations

• Glute strength and balance training
• Improving gait mechanics and stair strategy
• Mobility work for surrounding joints (ankle, spine) to reduce compensation

Knee surgery considerations (including ACL)

• Quad activation and strength (within pain/swelling limits)
• Hamstring and hip stability work
• Restoring extension/flexion range of motion
• Reducing swelling and normalizing gait

What a great “pre surgery consultation” should include

When local patients look for a pre surgery consultation, they’re often looking for two things: clarity and a plan. We believe a strong consultation should leave you feeling more confident—not more confused.

In a solid Back and Body Pain Relief pre surgery consultation, we aim to cover:

• What we think is happening (in plain English)
• What we’re concerned about (including any red flags)
• What conservative care could reasonably accomplish (and how long it should take to know)
• What would make surgery more likely (and what would make it less likely)
• How to use the waiting period wisely with pre-surgical rehab

Our practical checklist: deciding whether to move forward with surgery

We can’t make the decision for you—and we wouldn’t want to. But we can give you a framework so you’re not relying on fear, frustration, or internet guesses.

1. Confirm the diagnosis (or at least confirm the most likely pain generator).
2. Ask what happens if you wait: is delay safe, or does it risk worsening?
3. Understand the goal of surgery: pain relief, stability, nerve decompression, function, etc.
4. Clarify the realistic recovery timeline and restrictions.
5. Decide what conservative care has been tried (and whether it was done thoroughly).
6. Start pre-surgical rehab early if surgery is likely and safe to prep for.
7. Choose your surgeon intentionally (experience, communication, approach, fit).

What we do differently as a multidisciplinary clinic

Many people feel like they’re forced to bounce from office to office—one place for rehab, another for imaging, another for medical guidance, another for pain control.

Our clinic in Springfield Township is designed to reduce that runaround. At Back and Body Pain Relief, we collaborate across disciplines so your plan can be coordinated, not fragmented.

Why that matters before and after surgery

• Faster clarity: we can coordinate evaluation steps more efficiently.
• Better continuity: your pre-surgical rehab and post-op rehab can follow a consistent logic.
• More options: if one approach isn’t enough, we can adjust without starting over elsewhere.

Common myths we hear (and what we tell patients instead)

Myth 1: “If I’m injured, I should stop moving until surgery.”

We usually recommend the opposite: move safely with a plan. The right pre-surgical rehab can protect you from avoidable weakness and stiffness.

Myth 2: “If a surgeon mentioned surgery, it’s already decided.”

Often, surgery is one option on a spectrum. A second opinion can confirm the need—or reveal that structured rehab is the best first step.

Myth 3: “Rehab is only for after surgery.”

Prehab is real. Pre-surgical rehab can improve readiness, confidence, and in many cases shorten recovery time.

Key Takeaways

• Getting an unbiased second opinion can help you avoid unnecessary surgery—or confirm when surgery is truly the best option.
• We often help patients connect with appropriate specialists quickly while keeping the decision fully in the patient’s hands.
• Pre-surgical rehab uses the waiting period before surgery to preserve strength, range of motion, and function.
• Doing nothing while waiting can lead to disuse atrophy and stiffness that make post-op rehab harder.
• A coordinated team (chiropractic, physical therapy, medical care, acupuncture, and pain management) can streamline both pre-op prep and post-op recovery.

Where to Go From Here

If you’re local to Springfield Township and you’re stuck wondering whether surgery is truly necessary, we can help you sort it out with a clear, practical plan. Not sure if you need surgery? Call us first. We’ll give you an honest second opinion, help you understand your options, and—if surgery is the right next step—build a personalized pre-surgical rehab program so you go into the procedure stronger and come out recovering faster.

You can find us at Back and Body Pain Relief at 355 Route 22 E, Suite D, Springfield Township, NJ 07081, and our team is here Monday through Friday to help you get out of pain—fast—and get back to living life.

Dr David Perna DC, CCSP, CCEP

Dr. David Perna DC, CCSP, CCEP is the founder and practice overseer at Back and Body Pain Relief in Springfield, NJ. A graduate of Life University Summa Cum Laude, Dr. Perna holds certifications in Active Release Technique (ART), Graston, SFMA, Neuro-Diagnostics (NCV/EMG), and Manipulation Under Anesthesia, among others. He is a Board Certified Sports Physician, a Certified Strength and Conditioning Specialist, and a United States Olympic Committee Sports Medicine Volunteer.

A competing athlete himself — a 2x Ironman 70.3 finisher with a background in Olympic weightlifting, CrossFit, and martial arts – Dr. Perna brings firsthand athletic experience to his patient care.

He has treated presidents, royalty, diplomats, and professional athletes across MMA, baseball, tennis, and football, and has appeared on Dr. Oz demonstrating chiropractic therapies. His approach is diagnostic-first, combining evidence-based chiropractic care with rehabilitation to help patients get out of pain and back to full function.