Whether caused by injury, disease, or aging, millions of Americans live with pain or limited movement in their back, legs, shoulders, wrists, or other musculoskeletal areas. Modern medicine has many solutions for these nagging problems. The specialist to see is an orthopedic surgeon who can properly diagnose the trouble and offer a variety of remedies to fix it. At Plymouth Bay Orthopedic Associates in Plymouth, MA, we can solve your orthopedic issues and have you living freely again.
Don’t Ignore Pain
There are only four official vital signs for the human body, but doctors have been lobbying for years to classify pain as a fifth. This is because even an otherwise healthy person is unwell if they are living with pain. Pain is a symptom of disease or injury and should never be ignored.
Issues that cause pain rarely get better without diagnosis and treatment. Some pains are a distinct warning sign of a serious condition. Many is the unfortunate cancer patient, for example, who wishes they had investigated a new pain when they first felt it, perhaps weeks or months earlier than it was diagnosed.
The Meaning Behind Pain
Some pains, such as from a slipped spinal disk or a dislocated shoulder, are completely debilitating and impossible to ignore. These typically lead to an immediate medical visit. Other pains, like joint soreness, are more subtle: an annoyance at first, but eventually a constant companion. Many people take these lesser pains in stride and simply live with them, much to the detriment of their well-being.
Probably the most important way to classify pain for both patient and doctor is whether it is something new versus something long experienced by the patient. New pain is often (though not always) due to an acute origin. There may have been an injury while working or playing, or an unlucky twist of the foot or back.
The other type of pain is called chronic, defined as pain experienced most days or every day for at least the past six months. The Centers for Disease Control and Prevention estimates that 50 million American adults — 20.4% of the U.S. adult population — live with chronic pain. Whether acute or chronic, pain should always be investigated by a professional.
Your Musculoskeletal System
The musculoskeletal system is the structure in our bodies that gives us the ability to move. It is made up of many networks of bones (your skeleton), held together by muscles, joints, ligaments, tendons, and other connective tissue. Besides allowing us to walk, stand, sit, and perform everyday activities, the system is designed to protect our internal organs. The rib cage, for example, is an excellent protector for our heart and lungs.
The musculoskeletal system is so complex that it requires a medical specialist to treat it. These specialists are called orthopedic doctors, and many of them specialize even further into specific musculoskeletal regions, such as the knee or the back. The most sophisticated doctors in this class are orthopedic surgeons. They are not only able to diagnose and treat orthopedic problems, but they are also able to perform corrective surgery if and when that becomes the appropriate medical option.
What Causes Musculoskeletal Pain?
Wear vs Injury
In the orthopedic world, acute pain is often caused by an injury. In many cases, acute injuries can heal on their own, given proper attention, treatment, and rest. However, acute injuries may often be more serious than they seem and include damaged tissues or bones. If the pain from an injury doesn’t go away in a reasonable time frame, you should see a physician.
Other types of pain may have an origin that’s not as obvious as an injury. For example, joint pain and stiffness are often caused by degenerative diseases, such as osteoarthritis. These pains start out as infrequent discomfort, but chronic conditions don’t heal on their own.
Chronic pain in a musculoskeletal region is not only difficult to live with on a physical level, but it is also demoralizing as well. Knowing the pain will be there tomorrow, and every day, can cause depression and even lead to an addiction to pain medication.
Sports are notorious for causing orthopedic injuries. A bad landing from a jump, a twisted foot while running, a wrenched back from bowling: these are, as athletes say, “all in the game.” There are so many common sports injuries that many of them have their own names.
Sports injuries are often underdiagnosed by amateur athletes, which is to say that they are not looked at by a professional. What appeared to be a simple sprained ankle or knee might actually include micro-tears of ligaments or cartilage.
The unsuspecting athlete applies some ice to bring down the swelling, takes some ibuprofen for the inflammation and the next day (or sooner!) goes back to normal activity. The injury doesn’t get a chance to heal and symptoms become worse.
When Does the Orthopedic Surgeon Come In?
Most people are sensible about immediately dealing with severe pain or injury. A surprising number, however, take lesser pains in stride and assume it’s just something that will go away or that they will learn to live with. Many aches and pains do go away by themselves, but when there’s an unseen medical issue, any relief is only temporary.
Worse, underestimating an injury as if nothing were seriously wrong can exacerbate the damage, making it harder to treat. When pain or lack of full movement hasn’t abated in a reasonable time frame – days, not weeks – it’s time to see an orthopedist. While there are many orthopedic specialists, an orthopedic surgeon will have the most insight into both the problem and available solutions.
It is possible for people to treat some obvious problems on their own with simple cures like rest and specialized exercise. However, orthopedists will make a more thorough inquiry into the source of the problem and deliver a full medical diagnosis.
When you’re serious (or worried!) about orthopedic pain or restriction of normal movement, it’s time to see an orthopedic specialist. The doctor will ask questions about the history of the pain or condition. Is it something that just happened (acute) or is this an old injury or condition (chronic)?
The doctor will do a thorough examination for abnormalities around the trouble, looking at joints, misalignments, and pain points. The patient will be asked to demonstrate normal movement or the lack thereof. Diagnostic tests can start out very simply, with talk and observation being the key tools.
Some conditions, such as arthritis, aren’t terribly difficult for the patient to demonstrate and are common enough for the doctor to make a knowledgeable first diagnosis. The patient may be asked to do a test for gait analysis, which lets the doctor see abnormalities in the ability to walk. This is an observational test, done with experience and a stopwatch.
Taking a Closer Look
If the orthopedist suspects injury or disease that isn’t obvious and wants to investigate in more detail, they will typically order imaging for the patient. There are different types and levels of imaging, ranging from quick and simple to thorough and time-consuming. The doctor makes a determination of imaging needs through a physical exam, and, if called for, will usually start with simple imaging tests.
A blood test may also be ordered to ensure that chronic pain isn’t a sign of encroaching disease. The most basic imaging test is a common X-ray. Other more detailed tests include magnetic resonance imaging (MRI), which uses strong magnets and radio waves to create pictures from inside the body; bone scans, which entail a small injection to visualize the loss of bone tissue; and computed tomography scans, better known as a CAT or CT scans, which essentially create a 3D X-ray of the inside of the body part being imaged.
Even though the orthopedic surgeon is the most authoritative source of diagnosis and treatment for orthopedic problems, not every pain or injury calls for a surgical solution. For example, many orthopedic injuries can be healed with time and physical therapy. The doctor will determine if this first, non-invasive course is right for you and your problem.
Most physical therapy sessions take place in a specialized setting with guidance from a clinician called a physical or occupational therapist. These facilities have specialized equipment to work the problem area and measure key metrics, such as range of motion and recovery progress. Some physical therapy routines are so basic that the patient can do them at home, with no more equipment than a resistance band – essentially an oversized rubber band.
Types of Treatments
In the event that more involved medical treatment is necessary to solve the problem, orthopedic surgeons have many tools at their disposal. In addition to their own specialized experience, these doctors use a variety of cutting-edge technologies and techniques that have revolutionized orthopedic medicine.
Many injuries and diseases that once required extensive, full-open surgeries can now be performed through less invasive means. These “lighter” techniques are performed with the assistance of medical technologies such as arthroscopy. In this technique, a tiny camera, brought inside the body through small incisions, guides the surgical inspection and procedure.
Because the incisions are small, they cut into less tissue, and because the cameras see the damage up close, highly precision work is made easier. Recovery time for the patient is also faster because there has been less trauma to the surrounding area.
Common Surgical Procedures
Orthopedic surgeons have a broad variety of remedies at their disposal for treating orthopedic issues. Some of the more common procedures include:
Through arthroscopic visualization, the surgeon can repair torn or damaged tissues or bone using one of several techniques. The surgeon can mend torn tissues, shave painful bone spurs, and anchor weak ligaments so that they have greater structural integrity. An arthroscopic repair can be used in practically any joint in the body and is a preferred method over open surgery in most cases because it causes the least trauma.
In some cases, when tissue has been damaged, the surgeon’s task is to rebuild, or “reconstruct” the original integrity of the ligament or cartilage using one or more stitching and bracing techniques. One of the most common sports medicine procedures is ACL reconstruction. In this operation, the surgeon actually performs a grafting procedure. Healthy tissue from elsewhere in the patient’s body (or in some cases, from someone else’s body) is moved into the injured area and used to repair the ACL tear, bracing it for structural integrity.
Fusion is a surgical procedure that is used to correct problems with disconnected or damaged bones by “fusing” them together and creating a single healthy bone, much as a welder might join together two pieces of metal. Fusion procedures try to emulate the body’s own power to heal itself, the way a broken bone will eventually mend together.
Fusion surgery is quite common for spinal problems, especially in the vertebrae. Fusion procedures are also used in ankles, wrists, and other areas where small bones can cause outsized problems.
In some cases, a major joint cannot be repaired and a replacement is in order. The most frequent candidates for this surgery – called replacement arthroplasty – are the knee and the hip. Hip replacements are quite common for seniors and the elderly. One in three people aged 65 and older suffer a fall each year and fractured hips are one of the most common outcomes.
Joint replacements can be partial or total. Knee replacements are also a popular procedure, and replacement surgery is also making inroads into ankle treatments as well, taking its place alongside fusion as a technique of choice.
The old saying goes that an ounce of prevention is worth a pound of cure. A prophylactic fixation aims to fill this strategy by supporting a weak or damaged bone before it can fracture and cause serious problems. This procedure is performed by strategically placing metal into the affected bone area with the idea of bracing and strengthening it.
This operation not only staves off future problems: it also typically provides immediate relief for the pain. Because the procedure is minimally invasive, there’s typically only a short recovery time.
How Can I Get Started?
Pain is difficult to live with, yet millions do it every day, to their own detriment. To get by, they take pain medications that they wouldn’t otherwise need. Some of these pain remedies, often prescribed by a general practitioner, are extremely powerful and highly addictive. Even without medications, pain has a negative effect, not only on daily activity but on mood, outlook, work, and even family relations.
There’s no reason to have to live with orthopedic pain when there are many effective medical treatments available. An orthopedic specialist can diagnose the problem and provide a variety of answers. If your condition can be addressed through therapy and non-invasive strategies, that will usually mark the starting point of getting back to pain-free normality. If you suffer from pain in your legs, arms, hands, back, or shoulders, you owe it to yourself to investigate the source and eliminate the problem. Reach out today for a consultation at Plymouth Bay Orthopedic Associates in Plymouth, MA.