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Conservative Treatment in Orthopedics

 

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Immobilization

Orthopedic treatment options on the conservative track include refraining from activity, particularly that which may have prompted an injury or condition. A period of immobilization will allow the limb to re-strengthen and recover on its own, without the possible complications introduced by more invasive procedures.

The length of time for immobility is determined by the severity of the injury or condition and may only refer to the aggravating activity or activities. It may or may not also entail a course of anti-inflammatory medication if swelling and inflammation is involved.

Many patients underestimate the healing abilities of their own bodies when it is allowed to rest and recover. The period of immobility is carefully monitored in order to ensure that the limb does not become stiff. A balance of immobilization and adequate movement to ensure range of motion and muscle strengthening in the affected limb is key with this type of conservative treatment.

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Medication

Often common musculoskeletal injuries and conditions can be managed with anti-inflammatory medication, steroids and non steroidal anti-inflammatory drugs (NSAIDs), enabling the limb to strengthen and recover without more invasive treatment. This type of conservative treatment relieves pain and reduces inflammation. It can be particularly effective in arthritis, bursitis and tendonitis cases.

Conservative treatment is preferred and generally the first type of treatment option approached for mild to moderate injuries or conditions.

Anti-inflammatory medication may simply be a course of Ibuprofen, Motrin or Aleve. Cortisone is an effective and often used steroid medication. Steroid medications are generally a derivative of a naturallyproduced hormone and can be administered orally, systemically or as a localized injection. And NSAIDs are medications used to block the effect of cyclooxygenase, an enzyme critical to the body’s production of prostaglandins - which cause the swelling and pain often associated with arthritis and bursitis.

The right medication and appropriate course to effectively address the injury or condition is determined by the orthopedic specialist. Every case and every patient is different. There is no "standard" and each patient’s plan is designed specifically for them.

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Injections

Viscosupplementation
Viscosupplementation is an injection involving a thick fluid (hyaluronate) into the affected joint. It is frequently used in the treatment of osteoarthritis of the knee, serving as a type of replacement for the diminishing synovial fluid and cartilage cushion preventing the connecting bones from rubbing directly against one another at the joint.

Recently, pharmaceutical companies developed three hyaluronic acid-based products (one of the two natural lubricants in synovial fluid) specifically for injection into the knee joint. These are today known by the medical brand names of Hyalgan, Synvisc , Supartz and many others.

While Viscosupplementation injection is not a cure for osteoarthritis, it has been effective in improving joint function and reducing the rapidity of joint degeneration - by improving the lubrication provided by the synovial fluid, reducing the pain from the arthritis, and improving mobility which subsequently maintains muscle strength and ensures joint flexibility.

Viscosupplementation is administered under close supervision of an orthopedic specialist aware of your personal health history.

Cortisone
A type of steroid, Cortison is released naturally from the adrenal gland when the body is under stress. 
Natural cortisone is released into the blood stream and relatively short-acting.

The anti-inflammatory medication used to treat many common orthopedic injuries and conditions, Injectable Cortisone, is synthetically produced and has a variety of different trade names (Celestone, Kenalog, etc.). While it is similar to the body's own naturally made cortisone product, synthetic cortisone is not injected into the blood stream but rather directly into the area of inflammation. The synthetic cortisone is also designed to act more potently and for a longer period of time (days rather than minutes).

Synthetic cortisone injections do not serve as pain relieving medication. They are designed to address inflammation only, which may subsequently ease pain. These types of injections have proven effective for such injuries and conditions as arthritis, bursitis, carpal tunnel syndrome, tennis elbow syndrome and trigger finger.

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Physical Therapy

The powerful effects of physical therapy and rehabilitative exercises are not to be underestimated. They can in some cases serve as the only treatment necessary for some mild injuries and conditions. They are always used in conjunction with other treatment - both conservative, minimally invasive and surgical. Movement and the manner in which a limb moves is key in preventing injury, avoiding a recurrence of injury and overcoming the stiffness and loss of motion that immobility following surgery may impose.

Orthopedic physical therapy and rehabilitation are significant components in musculoskeletal health and longevity of joint function - as well as the overall balanced conditioning for the optimal performance of our bodies in both the prevention and recovery of injuries.

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RICE( Rest,Ice,Compression and Elevation)

One of the most commonly known forms of conservative treatment is RICE - Rest, Ice, Compression and Elevation. This combination has for decades proven a powerful treatment plan for the athlete, weekend warrior and accidentally injured alike.

The Rest gives the injured limb an opportunity to recover from the activity that may have prompted the condition. Cold compression (Ice and Compression) will reduce any affiliated swelling and inflammation, which subsequently reduces pain and risk of stiffening affecting resumption of full range of motion. And Elevation, raising the injured limb above the heart level, assists in preferred blood flow to help all affected soft tissue and overall limb function.

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Ultrasound Therapy

Ultrasonics have been used in rehabilitation and physical therapy since the 1940s and today represent a strong conservative treatment option for mild conditions and injuries.

The advancement of ultrasound equipment and technique has made it an effective treatment option for a number of soft tissue injuries and conditions, including muscle sprains, bursitis, tennis elbow and other tendinopathies.

The advancement of ultrasound equipment and technique has made it an effective treatment option for a number of soft tissue injuries and conditions, including muscle sprains, bursitis, tennis elbow and other tendinopathies.

Orthopedic ultrasound therapy is administered with a sound head from an ultrasound machine moved in circular motion softly over the affected area. A gel is used to help the waves travel into the body rather than reflect off the skin. The waves are transferred in either a "pulse" mode, which prevents tissues from heating, or a "continuous" mode, which transfers the heat to the body tissues.

 

Laser Therapy

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Magnetic field Therapy

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