In most cases, Physical Therapy is enough to help with the pain and recovery. But it’s important to remember that each person is different, and an individual clinical assessment is required. Two patients with “identical” injuries may need different treatments. In osteoarthritis, the first step would be physical Therapy which is in many cases very effective. People can completely reduce their pain symptoms with only PT and movement and functioning. However, for example, knee or hip replacement surgery is very common as well and is absolutely needed in some cases.
Surgery is usually the last resort and is required primarily if the joint is too painful to ambulate with a normal gait pattern. So again, in many cases, Physical Therapy alone won’t work, and PT and Surgery are not on the opposite sides. They complement each other. One helps improve the result of another.