What’s the Difference Between An Orthopaedic Physician and a Chiropractor? Part Two

Orthopaedic & Spine Center

Image of Dr. Mark McFarlandMark W. McFarland, DO

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 – to restore mobility and help them to feel better. Some people think that orthopaedic surgeons only look for an opportunity to perform surgery. There may be orthopaedists who have that philosophy; however, at OSC, we believe in trying many different conservative treatments before recommending surgery. If surgery is the only appropriate treatment to fix the problem, we let our patients know that immediately. However, our patients are always involved in any decision to proceed with surgery and that decision is never made by the Orthopaedist alone.

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 tissues manipulation, 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.  Chiropractors will also refer patients to physical therapy if necessary, but provide many of the same treatment modalities. Chiropractors do a fantastic job of educating their patients about all of the alternative treatment options available to them.

How are the two specialties different?

There are two major differences between chiropractors and orthopaedic physicians, which are:

The way we solve problems is based on different philosophies, both of which are important. 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. Chiropractors use physical examination, neurological tests and x-rays to help them diagnose musculoskeletal conditions.

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 prescribe medicine and perform surgery. We prescribe medicine to help our patients cope better with discomfort they are feeling. At OSC, we don’t use prescription narcotic/opioid pain relievers (except for immediately after surgery), due to their addictive properties. When treatment begins, if necessary, we typically prescribe NSAIDs or oral steroids for most musculoskeletal conditions. Injected steroid medications may also be used, as well as visco-supplementation injections.

For post-surgical pain relief, we often use a multi-modal drug combination which can combine very short-term, low-dose opioids, non-opioid analgesics, drugs that treat nerve pain, and may include an anti-depressant, such as Cymbalta, which has proven efficacy for treating pain.

Orthopaedists use surgical interventions when necessary to help restore our patients’ function, which may impaired by 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.

Chiropractors don’t prescribe drugs or perform surgery. They adjust misaligned spinal vertebrae which can interfere with proper nerve conduction, resulting in a host of issues for the patient. Chiropractic care is great for treating certain injuries and pain, but some conditions fall outside the scope of chiropractic care. However, they often identify patients who have issues which will require treatment by an Orthopaedist and refer them our way.

Orthopaedic physicians are able to perform a more complete scope of care, including surgery, and less-invasive options (such as injections, oral medications or physical therapy) as needed. Some patients use a multi-disciplinary approach and use both specialties to treat their condition,a practice we often encourage. It’s important that you communicate to each health care practitioner the full scope of care and treatments you are receiving from any provider. Only you can decide which (or both) may be best for you.