The Orthopedic Treatment Team

What is orthopedics?

Orthopedics is a medical specialty that deals with the treatment of bones and muscles. Orthopedic surgery is the branch of medicine concerned with diseases, injuries, and conditions of the musculoskeletal system relating to the body's muscles and skeleton, and including the joints, ligaments, tendons, and nerves.

Who treats orthopedic conditions?

Orthopedic conditions may be treated by your doctor or other medical specialists and healthcare providers. Several doctors from different medical specialties may be involved in the treatment at the same time. This approach is important to manage the symptoms of an orthopedic condition, especially as many symptoms are chronic and change over time. Some of the more common medical professionals involved in the treatment of orthopedic conditions may include:

Primary care doctor

A primary care doctor has specialized education and training in general internal medicine, family practice, or another first-level-of-care area. Primary care doctors are those who provide patients with any/all of the following:

• Routine healthcare (including annual physical exams and immunizations)

• Treatment for acute medical conditions

• Initial care for conditions that may become more serious or chronic in nature

While your primary care doctor may treat and diagnose your disease, he or she may refer you to a specialist for more specialized treatment of certain aspects of a disease.

Orthopedic surgeon

This doctor specializes in orthopedic surgery. He or she may also be called an orthopedist. Orthopedists are educated in the workings of the musculoskeletal system. They can diagnose bone, muscle, joint, tendon, or ligament conditions, treat an injury, provide rehabilitation, and advise on how to prevent further damage to a diseased area.

The orthopedist may have completed up to 14 years of formal education. After becoming licensed to practice medicine, the orthopedic surgeon may become board-certified by passing both oral and written exams given by the American Board of Orthopaedic Surgery. Many orthopedic surgeons choose to practice general orthopedics. Others specialize in certain areas of the body such as the foot, hand, shoulder, spine, hip, or knee. Other specialize in an area of orthopedic care such as sports medicine or trauma medicine. Some orthopedists may specialize in several areas and may collaborate with other specialists, such as neurosurgeons or rheumatologists, in caring for patients.

Primary care sports medicine doctor

This is a primary care doctor who has extra fellowship training in musculoskeletal injuries and other problems that affect athletes. This type of doctor can manage many orthopedic problems while also recognizing which cases need surgery.

Rheumatologist

A rheumatologist is a doctor who specializes in the treatment of arthritis and other rheumatic diseases that may affect joints, muscles, bones, skin, and other tissues. Most rheumatologists have a background in internal medicine or pediatrics and have received additional training in the field of rheumatology. Rheumatologists are specially trained to identify many types of rheumatic diseases in their earliest stages. This includes arthritis, many types of autoimmune diseases, musculoskeletal pain, and disorders of the musculoskeletal system. In addition to 4 years of medical school and 3 years of specialized training in internal medicine or pediatrics, a rheumatologist has had an additional 2 or 3 years of specialized training in the field of rheumatology. A rheumatologist may also be board certified by the American Board of Internal Medicine.

Physical therapist

Physical therapy is the health profession that focuses on the neuromuscular, musculoskeletal, and cardiopulmonary systems of the human body, as these systems relate to human motion, health, and function.

Physical therapists, or PTs, are very important members of the healthcare team. They evaluate and provide treatment for people with health problems resulting from injury, disease, or overuse of muscles, ligaments, or tendons.
PTs have an undergraduate degree in physical therapy, and many have a master's degree or doctorate. All graduates must be licensed by their state by passing a national certification exam before they can practice.
PTs may practice in a variety of settings, including:

• Hospitals

• Rehabilitation centers

• Home health agencies

• Schools

• Sports facilities

• Community health centers

• Private practice

As related to orthopedic conditions, PTs provide comprehensive training such as:

• Functional mobility

• Balance and gait retraining

• Soft-tissue mobilization

• Body mechanics education

• Wheelchair safety and management

• Neuromuscular re-education

• Exercise programming

• Family education and training

• Help with pain relief and management

• Instruction in walking safely

• Pre- and post-surgical rehabilitation 

Occupational therapist

Occupational therapy is a healthcare profession that uses "occupation," or purposeful activity, to help people with physical, developmental, or emotional disabilities lead independent, productive, and satisfying lives.
An occupational therapist often coordinates the following in the care for a person with a debilitating condition, such as an orthopedic condition:

• Evaluating children and adults with developmental or neuromuscular problems to plan treatment activities that will help them grow mentally, socially, and physically

• Helping children and adults learn how to carry out daily tasks

• Conducting group or individual treatment to help children and adults in a mental health center learn to cope with daily activities

• Recommending changes in layout and design of the home or school to allow children and adults with injuries or disabilities greater access and mobility

Occupational therapists work in a variety of different settings, including:

• Hospitals

• Rehabilitation centers

• Schools

• Home care agencies

• Private practice

• Government agencies

Physiatrist

Physical medicine and rehabilitation, also known as physiatry, is a medical specialty that involves the process of restoring lost abilities for a person who has been disabled as a result of disease, disorder, or injury. Physiatry provides integrated, multidisciplinary care aimed at recovery of the whole person by addressing the patient's physical, psychological, medical, vocational, and social needs. The doctor who specializes in physical medicine and rehabilitation is called a physiatrist.

Podiatrist

A podiatrist specializes in foot care and is licensed to prescribe medicine and perform some surgery.

Nurses/nurse practitioners and physician assistants

Other providers who specialize in the care of orthopedic conditions may assist your doctor in providing care.

Other providers

Depending on the specific condition involved, other doctors and healthcare professionals, such as pain specialists, may be involved in treating orthopedic conditions. For example, a neurologist or neurosurgeon may help treat problems involving the spine because of involvement of the spinal cord. Occupational therapists may be involved in treating conditions that require rehabilitation. Occupational therapists often work with physical therapists.