Orthopedic injuries encompass a broad category of medical conditions involving musculoskeletal system damage. This includes the bones, joints, ligaments, muscles, tendons, and nerves.
These injuries may stem from accidents, falls, sports activities, overuse, or age-related wear and tear or deterioration. They may lead to strains, sprains, fractures, and limited function and mobility.
Doctors who treat musculoskeletal injuries include orthopedic surgeons (also known as orthopedists), physiatrists (physical medicine and rehabilitation doctors), rheumatologists, and sports medicine physicians. There are differences in the focuses of each of these specialists, although their approaches often complement and support one another.
The good news is that the majority of orthopedic issues can be treated non-surgically. From physical therapy and medications to injections and regenerative medicine, non-surgical orthopedics offers a wide range of treatments that cater to each individual’s specific needs.
Here’s a breakdown of common non-surgical orthopedic treatments:
Medications
Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen are most effective for mild to moderate pain with inflammation and swelling. They are typically used for arthritis and pain resulting from muscle sprains, strains, and back and neck injuries.
Corticosteroids: These powerful anti-inflammatory medications can be injected directly into the joint or tissues to reduce pain and inflammation. They are most effective when precisely injected using fluoroscopic (x-ray) guidance. However, they should be used only on a limited basis, as repeated use carries a risk of cartilage damage or bone loss.
Small amounts of anesthetic and corticosteroids can also be effective for trigger point injections, which help relieve myofascial pain syndrome.
Physical Therapy
Doctors, particularly those specializing in Physical Medicine and Rehabilitation, often prescribe Physical Therapy as part of their treatment plans. Physical therapists will work with patients for:
Strengthening and Range of Motion Exercises: Strengthening and range of motion exercises are crucial for regaining function and preventing further injury, often used to improve mobility and strength.
Manual Therapy: Manual therapy is a specialized approach within physical therapy where therapists use their hands to assess and treat musculoskeletal issues, aiming to reduce pain, improve joint mobility, and enhance overall function.
Aquatic Therapy: Aquatic therapy is a specialized form of physical therapy conducted in a pool. It is used to treat a wide range of conditions, focusing on pain reduction, muscle strengthening, and improved range of motion. It often benefits those with injuries, chronic conditions, or difficulties with weight-bearing exercises.
Other Injections
In addition to corticosteroid injections, other types of injections can be effective for treating musculoskeletal conditions. These include:
Hyaluronic (Viscosupplementation) Injections: Viscosupplementation is a procedure in which a thick fluid called hyaluronate acid is injected into a joint, most often a knee joint. Hyaluronic acid mimics the properties of healthy, young synovial fluid, including its molecular weight, elasticity, and viscosity. The injection helps lubricate the joint and reduce pain with conditions like osteoarthritis.
PRP (Platelet-Rich Plasma) Injections: Platelet-rich plasma (PRP) therapy involves taking a patient’s blood, concentrating the platelets within that blood, and then reinjecting them to accelerate the healing of injured tendons, ligaments, muscles, spinal discs, and joints. It utilizes substances naturally found in the body to stimulate healing and regrowth at an injured site.
Stem Cell Therapy: Stem cell therapy, also known as regenerative medicine, stimulates the repair response of diseased, dysfunctional, or injured tissue by utilizing stem cells. Stem cells are unique because they can generate more cells like themselves and develop into different tissues.
Other Options
Ultrasound Therapy: Ultrasound therapy is a non-invasive treatment that uses high-frequency sound waves to penetrate deep into the body’s tissues. It is used to treat various musculoskeletal conditions, including pain, inflammation, and muscle spasms.
RICE (Rest, Ice, Compression, Elevation) or RICE alternatives: RICE and its alternatives are home-care, first-aid approaches for helping to recover from strains or sprains.
Minimally Invasive Interventional Procedures
In recent years, a variety of additional minimally invasive procedures have been developed to treat orthopedic injuries. These procedures utilize small incisions or punctures to access the body, offering benefits such as reduced pain, shorter recovery times, and a lower risk of complications compared to traditional surgery.
Depending on the nature of an underlying orthopedic issue or condition, additional outpatient, minimally invasive alternatives offer additional paths to recovery without major surgery, including:
- The Intracept procedure
- Basivertebral Nerve Ablation
- The MILD procedure
- Interspinous Spacers
The core takeaway is that many, if not most, orthopedic and sports injuries can be treated without surgery, except in cases of severe trauma or when conservative care options have been exhausted.