Bone Specialists Are Not Necessarily Medical Doctors
At birth, the human body contains approximately 270 bones but, due to natural fusions that occur during growth, this reduces to 206 by the onset of adulthood. They can be divided into four types according to shape. The femur, tibia, and fibula in the leg, and the humerus, radius, and ulna in the arm are classified as long bones, while most of those in the hands and feet are categorised as short, except for the carpal and tarsal bones which, along with the vertebrae and patellae, are designated irregular. The ribs, sternum, and scapulae fall into the remaining flat category.
In turn, the bone specialists whose area of expertise includes the musculoskeletal system are of three types – chiropractors, osteopaths, and orthopaedic surgeons. Should you experience a problem such as joint pain or muscular strain, it will be important to understand which of the three you might be best advised to consult.
In South Africa, while each of these healthcare professionals must be registered and hold a recognised degree, only the orthopaedic surgeon is required to hold the bachelor of medicine and surgery degree. Currently, no facility in the country offers a graduate osteopathy course, but both Durban University of Technology and the University of Johannesburg offer those who may wish to become bone specialists the option of a Master’s Degree in chiropractic.
Originally, osteopathy was based on a belief that most illnesses were simply indicators of an underlying problem with the musculoskeletal system and that the manipulation of bones and muscles to restore their alignment was the correct way to treat them. Modern-day osteopaths employ X-rays and blood work to arrive at a diagnosis. While these bone specialists are also permitted to prescribe medication, osteopathy treatments can often help to reduce the need for painkillers.
In common with the osteopath, the focus of chiropractors is also on the connection between body structure and one’s general state of health. Their attention is mainly on the spine and in addition to their own manipulative treatments, they also employ techniques similar to those used by physiotherapists to ease muscle stiffness and pain.
It is, however, the role of the orthopaedic surgeon that is the most comprehensive. As well as attending to fractures and dislocations, historically, much of their attention was on the correction of spinal deformities in children, which is why the name assigned to these bone specialists is derived from the Greek words “orthos” and “paidion”, meaning “straight child”. Today, their role has been expanded immeasurably. Complex fractures that would once have meant amputation are surgically repaired using screws and rods, whilst irreparably damaged joints, whether through disease or injury are routinely replaced with metal, plastic, and ceramic prostheses.
Along with X-rays and advanced medical imaging technology, arthroscopy offers the orthopaedic surgeon a minimally invasive procedure for diagnostic purposes which, in many cases, may also be extended to perform keyhole surgeries that minimise blood loss and bruising, reduce the risk of infection, and shorten post-operative recovery times.
Orthopaedic surgeons are thus the complete bone specialists and some may have even studied chiropractic and osteopathic principles, incorporating them as part of a treatment programme where appropriate. For musculoskeletal symptoms, a general practitioner will normally first refer patients to an orthopaedic surgeon.