A Surgeon’s Case for Conservative MSK Treatment – Benedict Nwachukwu, MD, MBA | Hip, Knee & Shoulder Specialist | Orthopedic Surgeon

Point of view by Dr. Benedict Nwachukwu
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Surgery Is Not Always the Fastest Path to Healing

When most people think about recovering from musculoskeletal (MSK) problems, they assume surgery is the quickest solution. However, according to Dr. Benedict Nwachukwu, orthopedic surgeon at the Hospital for Special Surgery, a conservative approach is often a more effective and safer starting point.

Scope and Fees of MSK Provisions

MSK conditions are the leading cause of long-term disability in Americans, with back pain alone being the leading cause of disability worldwide. This carries a growing economic burden, costing nearly $1 trillion annually.

Patients Often Skip First-Line Conservative Treatment

Although there is strong evidence supporting physical therapy and other nonoperative treatments, many patients expect surgery without ever trying these less invasive treatments. Nwachukwu sees this as a systemic problem where conservative treatment is wrongly considered optional or secondary.

Lessons from the NBA Bubble

During the COVID-19 pandemic, Dr. Nwachukwu served as a team doctor in the NBA’s isolated environment. With limited access to surgery, athletes recover effectively using conservative therapy guided by a multidisciplinary team. This is a powerful example of what can be achieved without resorting to surgical intervention.

A Vision for Hybrid, Personalized MSK Care

Nwachukwu envisions a future where care pathways include both in-person and digital options, making conservative care more accessible and tailored to the individual. He also emphasized the importance of connecting patients with the right specialists, including non-surgical ones, before considering operative treatment.

A Call to Reframe the Role of the Surgeon

Rather than a starting point, the surgeon should enter the treatment journey after conservative options have been explored. This ensures that surgery is used appropriately and provides better results, especially when there is decreased function and therapy is ineffective.

Conclusion: “You Don’t Need Me Yet”

The future of MSK care is hybrid, evidence-based and personalized. By shifting focus to conservative services first, healthcare providers can close treatment gaps, reduce unnecessary surgeries, and help patients recover in a smarter and safer way. Sometimes, as Dr. Nwachukwu, the most valuable thing a surgeon can provide is reassurance, not a scalpel.