The world of orthopaedics can be confusing at times.
Stepping into it as a newcomer is a bit like going for a hike without a map. You may start out with a vague idea of what to expect… but then things get a little perplexing.
Orthopaedic consultant? Orthotist? Osteopath? When it comes to knee and shoulder issues, there are some unfamiliar roles and terms to grapple with.
So today I want to outline some of the most common ones – the practitioners you may encounter as you seek treatment for a knee or shoulder condition.
The name ‘orthopaedic’ comes partly from a Greek word meaning ‘correct’ or ‘straight’. That’s a good starting point! Orthopaedic consultants are surgeons who diagnose and correct – ie treat – problems involving the musculoskeletal system, in my case knees and shoulders. We focus on repairing joints, ligaments, bones, muscles, tendons and nerves – both with and without surgery.
Orthopaedic surgeons work closely with anaesthetic specialists. Here at Chris Bailey Orthopaedics we have the excellent Drs Goldsmith, Townley and Batistich. They’ll advise you, explain the risks and side effects of particular anaesthetics, and help to plan the right pain control for your operation. They keep a close watch on you during and immediately after the procedure.
Pain clinics have become an important feature of the modern hospital. They focus on helping people to manage pain in its many different forms – chronic, long-term, or following recent operations, for example. Pain specialists provide a wide range of tailored treatments, from radiofrequency therapy to injections; they can also advise on alternative medication when other pain relief has lost its effectiveness, or is causing side effects.
Orthotics is a field of medicine that makes and fits external devices (or orthoses) for the body, to improve mobility, aid recovery, avoid injury or provide support for long-term conditions. The devices range from splints and callipers to spinal jackets and helmets. An orthopaedic consultant might refer you to an orthotist for a shoulder brace, or for insoles to relieve knee pain.
Podiatrists (also sometimes known as chiropodists) are health care professionals who specialise in feet. They diagnose and treat a wide range of conditions, from foot infections to deformities such as bunions. They also work on mobility, and can advise on foot-related orthotics like insoles and arch supports, which can be particularly important in recovery from knee conditions.
Physiotherapy aims to restore mobility and function to tissues, bones and muscles that have been affected by illness, injury or disability. It’s a holistic discipline, in that it encourages patients to be involved in their own care, with advice and exercise plans alongside manual therapy by the physio himself. We often refer our patients for physiotherapy to improve conditions or to aid recovery after surgery.
Sports therapy is a healthcare discipline that uses the principles of sport science to prevent and treat injuries, and to improve performance. It has similarities with physiotherapy, often using physical therapy techniques – particularly massage – and exercise programmes as part of treatment.
Radiographer / radiologist
Radiographers take x-rays; radiologists are doctors who perform some radiological interventions and report radiographic images. (Neither should be confused with radiotherapists, who treat diseases like cancer using radiation.) Orthopaedic consultants work with both practitioners to identify issues; the most common kinds of imaging scans are x-rays (primarily used for bone injuries) and magnetic resonance imaging (MRI; used for soft tissue injuries).
Rheumatologists are medically trained doctors who diagnose, treat and manage inflammatory joint diseases – the wide range of illnesses caused or characterised by inflammation. These diseases can affect joints all over the body, including knees and shoulders, so in certain cases an orthopaedic consultant may refer you to one for specialist treatment.
‘Chiro’ is the Greek for hands, which is the basis of chiropractic treatment. It’s a complementary or alternative medicine where the practitioner uses his hands to manipulate bones and muscles – especially around the spine – in order to relieve pain and restore mobility. Chiropractors aren’t trained in conventional medicine, so they don’t prescribe medication or injections, or perform surgery.
Osteopaths also use physical manipulation to treat problems with joints and muscles, although their focus tends to be on the body as a whole rather than the spinal area. Although the National Institute for Health and Care Excellence (NICE) recommends manual therapy for certain kinds of back pain, osteopathy is not widely available on the NHS. Like chiropractic treatment, it is an alternative rather than a conventional field of medicine.