As an orthopaedic surgeon, I am often asked what the difference is between what I do and what a chiropractor does. We see patients for a lot of the same conditions and often refer patients to each other when recommended care or treatment is outside of the scope of what we do, so there is quite a bit of crossover between the two types of practice. We have similarities and differences, which I will outline in this article.
I would like to mention that there is a chiropractic specialty called chiropractic orthopedists. This means a chiropractor has completed certain requirements and educational standards of the Academy of Chiropractic Orthopedists. To maintain these credentials, the doctor participates in continuing education to keep current with the latest advances in the orthopedic specialty. Compared to a chiropractor who does not carry the accreditation, these doctors have additional knowledge and training in orthopaedics. Their exposure to orthopaedics is not as extensive as an orthopaedic surgeon.
How are we similar?
Both chiropractors and orthopaedic physicians are highly educated medical professionals. Each of us complete undergraduate work, followed by years of advanced study at an accredited college or university. Orthopaedists complete four years of undergraduate study, four years of medical school, one year as an intern, and four years of residency studying the fundamentals of orthopedic surgery. In addition, many doctors choose to complete a one-year fellowship in a sub-specialty. Training to become a chiropractor requires two to four years of undergraduate education (depending on the state), a four-year chiropractic program, a clinical internship and passing scores on national and state exams before licensure.
Both chiropractors and orthopaedic physicians see patients to relieve them of discomfort caused by musculoskeletal issues. We each want to help rehabilitate patients to improve their quality of life. We see people who suffer from a myriad of conditions:
• Joint problems
• Back and neck pain
• Sciatica and leg pain
• Disc problems
• Sports injuries
• Injuries resulting from vehicle accidents
• Arm pain or numbness
• Carpal tunnel syndrome
• Pinched nerves
• Foot and ankle pain
Chiropractors also see patients for other conditions which are not typically treated by an orthopaedist: chronic headaches/migraines , allergies, asthma, Temporomandibular Joint Disorder (TMJ), muscle tightness and stiffness, general stress.
Both chiropractors and orthopaedic physicians focus on the human musculoskeletal system. This system includes your bones, muscles, joints, tendons, ligaments and nerves. This complex system requires all of its parts to be healthy and functioning in unison in order for you to move comfortably. Chiropractors diagnose and treat health problems of the musculoskeletal system and treat the effects those problems have on the nervous system. Orthopaedists focus on the prevention and correction of disorders, diseases and injuries of the joints, skeleton, muscles and other supporting structures.
Both use non-invasive treatments to help patients. We have the same goal for the patient – restore mobility and feel better. Some people think that the orthopaedic surgeons look for an opportunity to perform surgery. There may be orthopaedists who have that philosophy; however, at OSC we believe in trying many different alternative treatments if we feel a patient is not a candidate for surgery. We will try medication, physical therapy, recommend exercise and weight loss, steroid injections, and we often refer patients to our interventional pain management specialists or outside our practice to a chiropractor for alternative therapies.
Chiropractors offer non-surgical solutions for spinal and joint-related conditions. They use hands-on chiropractic treatments such as adjustment, soft tissue technique, joint mobilization, correction of posture, electronic muscle stimulation, and massage. Some chiropractors use therapies involving water, light, acupuncture and heat. We both counsel patients on nutrition, lifestyle changes, stress management, and exercise. They will also refer patients to physical therapy if necessary.
How are we different?
There are two major differences between chiropractors and orthopaedic physicians, which are:
The way we solve problems is based on different philosophies. Chiropractics is based on the philosophy that all bodily functions are connected, and healing involves the entire body. Many believe that the misalignment of the spine is the main cause of pain and disease. Some chiropractors say that they do not treat conditions, but actually remove interference from the nervous system so the body can heal itself. Orthopaedic physicians believe in the applied science of medicine to diagnose, treat, and prevent disease. The way we treat conditions evolves over time as research and technological advances occur. Orthopaedic physicians use physical examination, orthopaedic tests, X-rays, CT and MRI to form a diagnosis. Treatment may include injections, surgery, or medication. Orthopaedics is a traditional medicine, while chiropractics is considered alternative medicine.
Orthopaedic physicians perform surgery and prescribe medicine. We use surgical intervention to help our patients restore function due to disease or injury to ligaments, tendons, joints, bones, nerves, and muscles. Many of our patients’ lives are transformed due to surgery – surgery often helps people regain mobility and alleviates pain. We prescribe medicine to help our patients cope better with discomfort they are feeling. At OSC, we typically do not use prescription narcotic/opioid pain relievers as a long term fix, due to their addictive properties, but we do prescribe them as appropriate for patients who can benefit from them. Chiropractors do not prescribe drugs or perform surgery. They work on the spine to adjust the vertebrae when they have come out of alignment and could be interfering with nerve conduction, which can cause a host of issues in the human body.
So, what is best for you? It depends on your condition and personal philosophy on solving your own medical issues. Chiropractic care is great for treating certain injuries and pain, but there are many conditions that fall outside the scope of chiropractic care. Those will usually benefit from seeing an orthopaedic physician. Orthopaedic physicians are able to perform a more complete scope of care, including recommending less-invasive options (such as injections or physical therapy) and surgeries, as needed. Some patients use a multi-disciplinary approach to their condition, and we often encourage that. Keep in mind that it is important that you communicate to each health care practitioner the full scope of care and treatments you are receiving. Only you can decide which approach is best for you, but the bottom line is that if you are suffering with a condition, please seek medical attention to help you feel better.
Mark W. McFarland is a Fellowship-trained, board certified Spine Specialist who practices at Orthopaedic & Spine Center in Newport News, VA. For more information on Dr. McFarland or OSC, go to www.osc-ortho.com or call us for an appointment at 757-596-1900.