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Spectrum of Orthopedic Healthcare Without Surgery

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

spectrum-of-orthopedic-healthcare-without-surgery

New Treatments by Orthopedic Doctors

Orthopedic physicians, particularly those who specialize in sports medicine, have many new healing modalities that may help their patient avoid surgery. There has been an improvement of the many treatments with scientific research ongoing.

Red blood cells are extracted that include growth factors and cells involved in the healing process for tendon healing, cartilage regeneration, ligament repair and bone formation. There are currently several research studies for many of the chronic musculoskeletal ailments. However, there is not a clear consensus of the most effective treatments for some problems or injuries.

“Orthobiologics” is the term that refers to using biological substances aiding in healing of musculoskeletal injuries. Fractured bones, injured muscles, tendons and ligaments may have their healing process aided by naturally occurring substances found in the body when they are concentrated.

First Orthopedic Doctor Visit

As a patient it all begins with the doctor's diagnostic evaluation of the injury or the recurring pain for numerous areas of the body. The newer treatment plans may treat youth or the older patient.

Some of the most commonly treated areas include:

  1. Acute ligament and muscle injuries
  2. Acute and chronic muscle strains or tendon tears
  3. Ligament Sprains
  4. Tendonitis/Tendonosis - Chronic tendon injuries (especially tennis elbow)
  5. Muscle Fibrosis
  6. Osteoarthritis of Joints
  7. Joint Capsular Laxity
  8. Labral Injuries: Shoulder and Hip
  9. Lumbar Disc Disease

Receives Stem Cells

Acupuncture

Acupuncture

Determining Treatment: Diagnostic Procedures

Of course, the physician will do an initial thorough physical examination that examines your area of the injury or your chronic pain. The physician has a vast number of possible diagnostic tests from which to choose, but probably an exam an x-ray or the painful area will come first.

A flexibility tests may be done as it is geared to specific joints and muscles as it evaluates range of motion. The physician will look for a warm or swollen area around your painful area, plus redness or bruising.

Since muscle weakness is not revealed on an x-ray; the doctor may ask the you to move in a particular way while the doctor applies a resistive force. It could be just lifting your knee when you are in a sitting position while the doctor presses down on your upper leg.

Some of the more common tests include:

  1. Blood tests, which can reveal a disease such a rheumatoid arthritis.
  2. Arthrography may be used to determine the cause of unexplained joint pain.
  3. Two different types of bone scans, the first is used to determine bone density and diagnoses osteoarthritis; the second will pinpoint stress fracture sites, infections, arthritis or some types of cancer.
  4. Doppler ultrasounds are used is a blockage in the blood vessels is suspected in the arms or les.
  5. CAT scans and a MRI are used when a very detailed scan is warranted. They can diagnose torn muscles, ligaments and cartilage, herniated disks, hip or pelvic problems.
  6. An electromyography (EMG) records and analyzes the nerve activity, so if any nerve damage is suspected when a limb is fractured or for other suspected.
  7. Joint aspiration with diagnosis may be used for conditions like bursitis.
  8. A Nerve Conduction Study (NCS) may be ordered when nerve damage is suspected. Some reasons for this study include carpal tunnel syndrome or ulnar nerve entrapment. I can tell you from personal experience that this test is rather uncomfortable.

This is a list of some of the more common tests, but there are other specialized tests that you might require.

Stem Cell Clincal Trials

Acupuncture: Western View

Western practitioners typically view the acupuncture points for thin needle insertions as a place to stimulate the nerves, muscles and connective tissue. In contrast, the traditional Chinese view of acupuncture as a way to balance the energy life force. This stimulation may boost your body's natural painkillers.

Acupuncture should only be done by a competent, certified acupuncture practitioner. It is used to treat a variety of problems, including headaches, migraines, back pain and a variety of other problems. As sterile needles are used the most common side effect is some soreness where needles were inserted.

Facts About Stem Cell Therapy

There is great potential using stem cell for healing as they have the stem cells have the potential to develop into a large variety of different types of cells to treat several medical problems. Stem cells are capable of renewing themselves by cell division, and in the right physiologic or experimental conditions they can become tissue or organ cells with specific functions. They have the capability to divide and repair worn or damaged tissues, such as bone marrow.

A vast amount of clinical research is ongoing for stem cells as they may heal tissues and avoid painful surgeries. Insurance may not cover this treatment, and it can be expensive.

Stem Cell Injections Treat Osteoarthritis

What Is Prolotherapy?

Prolotherapy is used as a treatment for torn or stretched ligaments by placing a mild irritant injection precisely at the site, which stimulates the body’s natural healing mechanisms. The injections are typically a sugar solution, and more than one injection is often required. It may be good to check your health insurance to make sure they cover any of these newer procedures.

Prolotherapy is currently a recognized orthopedic procedure, which causes the injured area to strengthen and repair your injured or painful joints and connective tissue. However, the American Pain Society recommends against this treatment, but it is certainly accepted by many physicians.

My son had a torn ligament and used this procedure, which was effective. The surgical consult doctor stated that would cut the ligament, which would relive the pain, but do you want a ligament permanently cut when there is other options?

Research is being done to evaluate the effectiveness of this procedure. In one study of treating low back pain the results were mixed, but they found a combination of the therapy along with spinal manipulation or back exercises was the most effective treatment.

What Is Platelet Rich Plasma Therapy?

Platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries is a newer therapy that have been effectively used over the past few years. Several well-known athletes, such as Tiger Woods, tennis star Rafael Nadal and others have used this therapy for sprained knees or tendon tears with success.

In this therapy your physicians utilizes your own blood cells by extracting blood. The platelets in your blood are actually separated from the other blood cells, and their concentration is increased during a process called centrifugation

Then, they are injected into the affected body region to stimulate the bodies natural healing process. The concentration of these growth factors speeds up healing. RPR is also used to speed up healing after surgery as well.

The RPR process seems to work best in chronic tendon injuries. It is being used to treat professional athletes for common sports injuries, such as a injuries to the hamstring muscle, thigh or knee sprains. More research needs to be completed to have more definitive results.

In Summary

There are many new and exciting procedures available that may prevent surgery. As I have had two back surgeries, primarily due to cortisone treatments for Systemic Lupus. This caused severe osteoporosis, so I have experienced many medical procedures and tests.

I am excited that maybe cortisone will be used less for shoulder pain and other joint issues, as the side effects are not good. I hope these procedures will heal and prevent surgeries as well. I will watch new research studies to see how all of these treatments are evaluated.

References

  1. https://orthoinfo.aaos.org/en/treatment/glossary-of-orthopaedic-diagnostic-tests/
  2. https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763
  3. https://stemcells.nih.gov/info/basics/1.htm
  4. https://www.spoc-ortho.com/services/orthobiologics-and-joint-preservation
  5. https://www.mayoclinic.org/prolotherapy/expert-answers/faq-20058347
  6. https://www.mayoclinic.org/prolotherapy/expert-answers/faq-20058347

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2018 Pamela Oglesby

Comments

Pamela Oglesby (author) from Sunny Florida on June 11, 2018:

Pop, Thanks for your comments. I had rotator cuff surgery as I had several torn igaments and was in severe pain, and believe me it was no picnic! Glad you had such a good outcome. I sure agree about trusting your instincts.

breakfastpop on June 11, 2018:

I agree with everything you said. I came very close to surgery with a torn rotator cuff. I went to PT and after a while I determined that the therapy was making things worse. The doctor said I needed surgery, but instead, I went home and did the kind of exercise I thought would help. That was quite a long time ago, and my shoulder is fine. It's important to trust your instincts.

Pamela Oglesby (author) from Sunny Florida on June 11, 2018:

Peggy, I certainly agree wholeheartedly as I have had numerous surgeries. When my son had that procedure and avoided surgery I got interested in these modalities.

Thanks so much for your comments.

Peggy Woods from Houston, Texas on June 10, 2018:

Hi Pamela,

I hope they keep doing research with regard to the efficacy of using stem cells, etc. in lieu of surgery. That would be wonderful if those treatments and others will be effective treatments and can avoid surgery.