While it might often be thought that the term bone specialist is, actually, nothing more than a layman’s way of describing an orthopaedic surgeon, this is not quite true. In practice, these two words serve as something of a catchall. As it happens, they could justifiably be used to describe a number of different healthcare practitioners, each of whom can claim to have a professional interest in some aspect of the musculoskeletal system, its condition, its performance, and its treatment.
In most cases, however, it is likely to be the orthopaedic surgeon with whom members of the general public tend to be most familiar, For example, many people in their mid to late sixties will likely, due to osteoarthritis, have either undergone a hip or knee replacement or knows someone who has. The said procedures would have been performed by the type of bone specialist who practices orthopaedics and is employed by a hospital. The same individual is equally likely to be called upon to repair a fractured femur, relocate a dislocated shoulder or to help rectify a spinal deformity in a young child.
Understandably, an orthopaedic surgeon must hold a medical degree, have completed the necessary residence requirements, and gained a higher qualification in their chosen field. The same is also true of another kind of bone specialist known as a rheumatologist. That there is an obvious connection between the work of these healthcare professionals and the condition of joints are clear to see in the relationship between their title and the condition known as rheumatism. Unlike the orthopaedic surgeon, however, their role is that of a physician. Their focus is on the diagnosis and treatment of conditions that result in inflammation of the joints, bones and associated soft tissues including muscles, tendons, and ligaments.
Despite the common focus of these two types of bone specialist, in addition to gout and osteoporosis, much of the work of the rheumatologist involves autoimmune disorders such as rheumatoid arthritis, scleroderma, myositis, Sjogren’s syndrome, and lupus erythematosus. Where joints are affected, the inflammation tends to affect multiple locations unlike the more localised pain and swelling treated by orthopaedic doctors. Also, certain autoimmune diseases tend to produce symptoms in other areas of the body. These distinctions can be significant to a general practitioner when deciding to what type of doctor they should refer a patient.
Next on the list of healthcare practitioners considered to be bone specialists is the osteopath. Although their qualifications do not include a medical degree, they must hold a Doctor of Osteopathy (DO) degree and should also be registered with the Allied Health Professions Council. In addition to holding different qualifications, their role is also quite different from those of the orthopaedic and rheumatology practitioners.
This particular discipline was established in the 19th century and, at the time, it was based on a belief that most diseases were no more than symptoms of a hidden problem with the musculoskeletal system and that by manipulating muscles and bones, they could be cured. Today, in addition to manipulation techniques, these bone specialists now employ conventional diagnostic procedures such as X-rays and blood tests, prescribe medication, and may even apply surgical treatments in their attempts to treat muscle and joint pain.
Last but not least in this line-up of practitioners is the chiropractor. In common with the osteopath, they do not possess a medical qualification but are required, instead, to hold an accredited Doctor of Chiropractic degree. Much like a physiotherapist, their role is to relieve pain, loosen stiff muscles and restore function. To achieve these goals, this type of bone specialist relies primarily on manipulation of the spine to improve the body’s alignment, but may also apply thermal treatments and relaxation techniques where indicated.