Patients enrolled in the study need to be able to begin their assigned treatment within 2 months (8 weeks). Since treatment assignment is randomized, there is no way to know in advance which treatment arm a patient will be assigned to for the trial. If a patient’s insurance company will not pay for surgery, they should not enroll in the trial, as the study will not cover the cost of treatment. If a patient’s insurance company (or Workers’ Comp) requires them to do physical therapy first, they should wait to enroll in the trial, if desired, until after first trying physical therapy. (NOTE: It is possible this patient may later be randomized to physical therapy rather than surgery. So they should be ok with the option of receiving more physical therapy prior to being randomized.)