At its worst, back pain can often feel like a life sentence. For many, the constant discomfort erodes independence, disrupts sleep, and limits our ability to enjoy once-loved activities. When scans reveal complications such as multiple disc problems, surgery quite often feels like the only way forward.
Yet surgery is usually a last resort, and with the right care and commitment, it can sometimes be avoided. In this blog, Hardik Nimla shares the story of a 71-year-old woman who came to Marsden Health with severe back pain, a history of knee replacement, and a growing fear of movement. At first, it seemed inevitable with her condition that she would require surgery. Yet through a personalised treatment plan and structured physiotherapy sessions, her recovery was so successful that she was able to avoid the operating theatre altogether.
The challenge
This client, a retired cleaner, had been living with chronic lower back pain for years. The pain she experienced was sharp and uncomfortable – often travelling down to her legs and ankles. It restricted her mobility, undermined her confidence in her mobility, and frequently disturbed her sleep. Realising that she needed to see a specialist, scans revealed multiple herniated discs, and she was advised to undergo spinal fusion surgery.
Her medical history added another layer of complexity: she had previously undergone a total knee replacement (TKR) a couple of years earlier. Following the surgery, she was avoiding sitting on the floor or attempting certain movements. This led to kinesiophobia — a fear of movement — that made her even less active. By the time she came to Marsden Health, she was in great discomfort, anxious, and convinced she had very few options for recovery left.
The physiotherapy approach
At our first session, she hoped her back problems could be swiftly resolved in only a few weeks. We explained to her that recovery would be steady, and would demand patience, discipline, and teamwork. Her willingness to commit made all the difference.
Her treatment plan included:
• Pain relief strategies to make daily life more comfortable.
• Spinal mobility and core strengthening exercises to protect her back.
• Posture correction and gait training to restore balance and confidence.
• Progressive functional re-education to help her relearn and safely perform the movements she feared most.
One of our biggest aims was to help her overcome kinesiophobia. We needed to rebuild confidence, and step by step, she learned to trust her body again:
• First, we guided her through supported movements, helping her to feel sure-footed and steady
• Then, we gradually built towards her transferring from floor to bed, from chair to standing, until she could lift herself confidently.
Each milestone strengthened her belief that movement was no longer something to be feared. With every show of determination, courage and discipline, her body responded by granting her a renewed freedom of movement.
The breakthrough
As the weeks passed, her pain eased and her walking steadily improved. She was sleeping better, moving with more freedom, and regaining her independence.
She explained that a key factor in her progress was the unwavering support of her husband. He encouraged her during clinic sessions and helped her to stay motivated and complete her physiotherapy exercises. His involvement provided her with regular assistance, reassurance, and the confidence to persevere – even on the most challenging days.
When she returned for her surgical review, her doctor was astonished. Spinal fusion surgery was no longer necessary as her progress through physiotherapy had made it redundant.
The outcome
• No spinal surgery required.
• Pain levels greatly reduced.
• Restored mobility after years of avoidance.
• Confidence rebuilt. Kinesiophobia gone.
• Back to enjoying walks and daily activities with independence.
What we learned together
This client’s journey highlights an important truth and offered me a valuable lesson in providing care as a physiotherapist.
• Surgery is not always the only solution.
• Physiotherapy can restore mobility, strength, and confidence — even in complex cases.
• Recovery is not just about the physical: overcoming fear and rebuilding trust in the body are equally important.
In the end, the client’s determination, spirit, and willingness to complete her plan were just as crucial as the treatment itself. Together, we proved that with the right mindset and guidance, even major surgery can sometimes be avoided.
Written by Hardik Nimla, Senior MSK Physiotherapist
Takeaway for readers:
If you are ever told that surgery is your only option, it is worth seeking a physiotherapist’s assessment first. With a personalised plan and consistent support, it is sometimes possible to manage painful conditions without resorting to the theatre table. As I learned from this inspiring patient, pain is often deeply affected by lifestyle, and even small changes can make a profound difference in how we feel. A recovery-focused routine not only aids healing but also establishes good habits to help prevent future injuries.
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