The Orthopedic Treatment Team

What is orthopedics?

The word orthopedic comes from two Greek words:

• Ortho meaning straight

• Paedia meaning children

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 and/or other medical specialists and health are providers. Several doctors from different medical specialties may be involved in the treatment at the same time. This multidisciplinary team approach is particularly important in managing the symptoms of an orthopedic condition, especially as many symptoms are chronic and change in severity over time. Some of the more common medical professionals involved in the treatment of orthopedic conditions may include the following:

• Primary care doctor. A primary care doctor is one who 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 health care (including annual physical examinations 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/or diagnose your disease, he or she may refer you to a specialist for more specialized treatment of certain aspects of a disease.

• Orthopedic surgeon. The doctor who specializes in orthopedic surgery is called an orthopedic surgeon, or sometimes, simply, an orthopedist. Orthopedists are educated in the workings of the musculoskeletal system, which includes (but is not limited to) diagnosing a bone, muscle, joint, tendon, or ligament condition or disorder, treating an injury, providing rehabilitation suggestions for an affected area, and establishing prevention protocols to minimize further damage to a diseased area or component of the musculoskeletal system.

  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 examinations given by the American Board of Orthopaedic Surgery. Many orthopedic surgeons choose to practice general orthopedics, while others specialize in certain areas of the body (i.e., foot, hand, shoulder, spine, hip, or knee), or in a specialized area of orthopedic care (i.e., sports medicine, trauma medicine). Some orthopedists may specialize in several areas and may collaborate with other specialists, such as neurosurgeons or rheumatologists, in caring for patients.

• 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, including arthritis, many types of autoimmune diseases, musculoskeletal pain, and disorders of the musculoskeletal system. In addition to four years of medical school and three years of specialized training in internal medicine or pediatrics, a rheumatologist has had an additional two or three 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 health care team. They evaluate and provide treatment for persons with health problems resulting from injury, disease, or overuse of muscles, ligaments, or tendons. Physical therapists have an undergraduate degree in physical therapy, and many have a Master's degree. In order to practice, all graduates must be licensed by their state by passing a national certification examination. Physical therapists may practice in a variety of settings, including the following:

  • Hospitals

  • Rehabilitation centers

  • Home health agencies

  • Schools

  • Sports facilities

  • Community health centers

  • Private practice

  As related to orthopedic conditions, physical therapists provide comprehensive training that includes, but is not limited to, the following:

  • 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

  • Assistance with pain relief and management

  • Instruction in safe ambulation

  • Pre- and post-surgical rehabilitation 

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

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

  • Assisting children and adults in learning 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 the following:

  • 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 medication and perform surgery.

• Nurses/nurse practitioners. Nurse practitioners who specialize in the care of orthopedic conditions may assist your doctor in providing care. In addition, these nurses will help you to understand your treatment plan and can answer many of your questions.

Depending on the specific condition involved, other doctors and health care professionals may be involved in treating orthopedic conditions. For example, a neurologist or neurosurgeon may assist in treating 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 in conjunction with physical therapists.