Many orthopaedic conditions have non-surgical treatment options. And to the patient’s benefit, rehabilitation times with these conservative methods are typically shorter and carry less risk than undergoing a surgical procedure.
Dr Bhimani will explore all the possible options to avoid surgery, but sometimes it becomes the only option for effectively treating and managing pain. Dr Bhimani will also consider if avoiding surgery could result in long-term impairment, pain or dysfunction.
Non pharmacological Treatments
Physical and Occupational Therapy
Through a range of motion exercises, strengthening techniques and patient education, physical and occupational therapy can help patients with orthopaedic injuries, diseases or changes in physical conditions.
Weight reduction and physical exercise
The lifestyle changes resulting in weight loss in obese individuals and doing appropriate physical exercises plays an important role in prevention and management of knee and hip conditions.
Platelet-rich plasma therapy (PRP)
This procedure uses the patient’s own blood chemistry to heal tendon and ligament injuries, as well as osteoarthritis.
These injections of steroids are given directly into the affected joint for severe pain when use of non-steroidal anti-inflammatory drugs does not bring much relief. Steroids are very strong anti-inflammatory drugs and if used orally cause various side effects on other body systems. Local analgesics that prevent the sensation of pain are sometimes given along with steroids in the same shot to bring relief quickly.
To manage pain throughout recovery, we often prescribe patients with anti-inflammatories, acetaminophen, muscle relaxants, topical medications and other types pain relievers. Prescription of medication is most often used in combination with other non-surgical orthopaedic treatments.
Non-steroidal anti-inflammatory drugs are found to be effective in reducing pain and inflammation . Caution must be taken while using NSAIDs for overdosing as they are known to cause hepatotoxicity. Patients with liver diseases must take extreme care while using them. They can cause a range of side effects, chances of which increase with the concomitant use of diuretics, angiotensin converting enzyme inhibitors, angiotensin 2 receptor blockers, anticoagulants or oral corticosteroids.
These are special cells in your body that can turn into other types of cells. During the healing process, stem cells are called to the area of your body that needs repair. Factors in the area influence the stem cells to become repair cells. Note that the same stem cell that repairs bone can also repair a tendon or ligament.
Of all the types of cells, stem cells have the greatest potential for promoting healing. As discussed above, stem cells are immature cells that are influenced by their surroundings. When brought to an injury site, a stem cell can develop into the kind of cell needed to help in healing - bone, muscle, ligament, and cartilage.
Because of the healing capabilities of stem cells, doctors have developed ways to bring stem cells to an injury site faster and in greater numbers. The first step in this process is to retrieve the stem cells. This can be done by harvesting them from the patient, or through a stem cell donor program.
Stem Cell Harvesting:
There are many sources of stem cells in the human body. The most important source is bone marrow. Bone marrow is located in the centers of long bones, such as the bones in your arms, forearms, thighs, and legs. The pelvic bone contains the highest concentration of stem cells. Therefore, the bone marrow in your pelvic bone is the most common source for harvesting stem cells.
The doctor draws the stem cells out of the bone marrow with a needle, in a similar way that blood is drawn from your arm for tests. An orthopaedic surgeon then inserts this large supply of stem cells into the injury site. This eliminates the time it would take for the stem cells to reach the injury on their own and delivers them in a higher concentration, which speeds the healing process.
Stem Cell Donation:
Orthopaedic surgeons can also use donor stem cells to promote healing. In much the same way that blood transfusions help millions of patients each year, stem cells taken from donors after they pass away help millions of orthopaedic patients. When these cells are harvested, they are treated so that they will not create an immune or allergic reaction in the patient.