Conditions That A Pediatric Orthopedic Surgeon Treats

What Is a Pediatric Orthopaedic Surgeon?

A pediatric orthopaedist is the best-trained and most experienced doctor to properly evaluate and treat musculoskeletal (bone, joint, or muscle) problems in a child who is still growing. This includes newborn babies through teenagers.

What kind of training do pediatric orthopaedic surgeons have?

Pediatric orthopaedic surgeons choose to make the care of children the focus of their medical practice. The unique nature of medical and surgical care of children is learned from advanced training and experience in practice. Pediatric orthopaedic surgeons are doctors who have the following education and training:

  • Graduated from an approved medical school (typically four years)
  • Graduated from an approved orthopaedic surgery residency program (typically five years)
  • Completed additional subspecialty training in pediatric orthopaedics and pediatric spinal deformity (typically one year) 

What types of problems do pediatric orthopaedic surgeons treat?

A child’s musculoskeletal problems are different from those of an adult. Because children are still growing, the body’s response to injuries, infections, and deformities may be quite different than what would be seen in a full-grown person.

Sometimes, what is thought to be a problem in a child is just a variation of growth that will resolve with time. A good example of this is intoeing in a toddler. Some of the problems children have with their bones and joints that are due to growth do not even occur in adults. In addition, the evaluation and treatment of a child is usually quite different than for an adult — even for the same problem.

Children with complex pediatric problems are best managed by a medical-surgical team approach. Pediatric orthopaedic surgeons diagnose, treat, and manage children’s musculoskeletal problems, such as:

  • Limb and spine deformities noted at birth or later in life (clubfoot, scoliosis, limb length differences)
  • Gait abnormalities (limping)
  • Broken bones
  • Bone or joint infections and tumors 

Pediatric Orthopedic Surgeons — The Best Care For Children

Children are not just small adults. They cannot always say what is bothering them. They cannot always answer medical questions, and are not always able to be patient and cooperative during a medical examination. Pediatric orthopedic surgeons know how to examine and treat children in a way that makes them relaxed  and cooperative. In addition, pediatric orthopedic surgeons often use equipment specially designed for children. Most pediatric orthopedic surgeons’ offices are arranged and decorated with children in mind. This includes the examination rooms and waiting rooms, which may have toys, videos, and reading materials  for children. This helps create a comfortable and nonthreatening environment  or your child.

If your pediatrician suggests that your child see a pediatric orthopedic surgeon, you can be assured that he or she has the widest range of treatment options, the most extensive and comprehensive training, and the greatest expertise in dealing  with children and in treating children’s orthopedic disorders.

Children are NOT simply little adults.

What separates pediatric orthopedics from adult orthopedics? Adults need hip replacements and children get fractures on the playground, right? Well, there is a little more to the difference between the two in the world of orthopedics. Even with the similar injuries adult and children’s bodies often have a different response. Pediatric orthopedic surgeons are specifically trained to evaluate and treat children.

Children’s Bone Anatomy
First of all, children’s bones are substantially different than adults. Infants start off with a skeleton made of cartilage that matures into calcified bone during the early years of development. In fact, during the first few weeks of life, ultrasounds are frequently used to examine children’s bones instead of x-rays. As children grow and develop, their bones have a softer structure than adults. The softer characteristic allows their bones to fracture or break in different ways than adult bones do. The biggest difference is the presence of growth plates in children’s bones. This greatly changes the ways doctors treat and care for injuries as well as bone and joint disorders in children.

Growth Plates
Children’s growth plates are the center for bone growth. Growth plates consist of developing cartilage tissue near the end of long bones. Bones grow from the ends where the growth plates are located. Fractures can occur within and near the growth plates. These require different types of treatment compared to similar injuries in adults to avoid later problems with growth. At times the growth of a bone near a fracture can even assist in the bone healing and correcting the fracture which adds to differences in treating kids versus adults. A pediatric orthopedic surgeon is specifically trained to care for and understand these differences which results in better care and outcomes for the patients.

Children’s Injuries
Because children’s bones are different from adult bones, fractures need to be treated differently. For instance, children’s bones heal quicker than adults. This means that children need to be evaluated by a pediatric orthopedic surgeon promptly to ensure that the fracture does not need to be manipulated. If a child’s fracture heals improperly a surgery may be needed to correct it. Also, children’s fractures do not typically need to be casted as long as adults due to the faster healing potential. Not only are fractures different in pediatrics, but also in sports injuries. For example, ACL tears in pediatrics require special surgical techniques that are completely different from adult ACL surgeries.

ORTHOPEDIC DOCTORS CAN HELP REDUCE PAIN

Pain is one of the most common reasons people visit orthopedic doctors. These doctors specialize in the entire musculoskeletal system, understanding the various types of joints and how they work. This includes muscles, nerves, bones, joints, tendons, ligaments, cartilage, and other connective tissue. There are many musculoskeletal conditions and injuries that can cause pain, and often, orthopedic specialists can help reduce or eliminate pain.

If you have pain, consider making an appointment. Orthopedic doctors diagnose and treat many types of pain all over the body, including:

  • knee pain
  • hip pain
  • shoulder, elbow, wrist or hand pain
  • ankle or foot pain
  • back or neck pain

Whether your pain is dull or sharp, chronic or acute, an orthopedic doctor may be able to help.

What are the most painful surgeries?

In general, research has found that orthopedic surgeries, or those involving bones, are the most painful.

However, researchers also found that some minor surgeries or those classed as keyhole or laparoscopic could also cause significant pain. Regardless of the type of surgery, a person should speak to a doctor about the procedure and a plan to manage any discomfort. It is also helpful to relate any past experiences with pain medications, as some people are more or less sensitive to these drugs.

Here, we outline what are considered to be Three of the most painful surgeries:

1. Open surgery on the heel bone

If a person fractures their heel bone, they may need surgery. An operation is not always necessary if the bone has not moved too far out of place. To repair the fracture, a surgeon must cut into the skin to get to the broken bone. They can then fix the bone back together, using plates or screws. The skin around the heel is thin, and this area does not have a lot of soft tissue. It is easy to damage the nerves around the heel bone during surgery. Along with the attachment of screws to the bone, this can make the operation and recovery painful.

2. Spinal fusion

The bones that make up the spine are known as vertebrae. Scoliosis and degenerative disc disease are among the medical problems that may affect the vertebrae. If movement between vertebrae is causing pain, a doctor may recommend spinal fusion surgery. This process connects two or more vertebrae to stop them moving against each other.

Sometimes, surgery will involve a bone graft. This is when bone is taken from the hip and put into the spine to help the vertebrae fuse together. Bone grafts may cause significant and even chronic pain following surgery.

3. Myomectomy

A myomectomy is an operation to remove fibroids from the uterus. Although these muscle fibers are almost always harmless, they can be a cause of infertility. The operation is usually done using keyhole surgery. Open surgery may be needed if the fibroids are large. An open surgery procedure is usually more painful than keyhole surgery and will have a longer recovery time. During a myomectomy, a surgeon will cut into the belly and remove the fibroids. Once they have removed the fibroids, they will close the cut with stitches.

Pain Management Myth Busters

What to look for in a Pain Management Job?

My Journey through Anesthesia

After graduating from my pain management fellowship at NYU in 2007, I wrestled with the idea of going into a full-time pain practice or anesthesiology/pain management hybrid position.

After going on multiple job interviews I realized that I did not want to be a full-time anesthesiologist for the rest of my career.  So, I wound up taking a position in the anesthesiology department at Maimonides Medical Center.  I opted for this position, as I was offered the chance to build a pain practice from scratch.

I started with one afternoon per week in the pain office and otherwise functioned as a full-time anesthesiologist.  I took a call like everyone else.  In fact, my first call was on my birthday in the same OB ward where I was born.  My parents even kept the anesthesia bill from 1976.  They were charged $88.  

Anyway, I did it all.  Peds (which I dreaded), ruptured AAA repairs, ECT, endoscopy, all while building a pain practice and seeing pain consults between, before and after my OR cases.  With the help of my chairman, vice-chairman, and the orthopedics dept., I had the opportunity to build a regional anesthesia service, test out Onc Q pumps, Exparel, learn TAP blocks, Quadratus Lumborum Blocks and more.

The first week of my attending job

Money is not how I measure success. Don’t get me wrong, money is quite important, but it’s not everything. I learned this during my first week as an anesthesiology attending.   We were short-staffed and I had to take extra- call, then stay late working the post-call day.  This went on while having an Anesthesiology Oral Examination and Pain Managment Board Certification Exam looming in the back of my head.  In addition, I had a 1-year old that was allergic to sleep and was coming out of a pain fellowship in which I did not administer anesthesia to anyone for a full year.   Did I mention that all 3 of us lived in a  studio apartment?

HOW TO CHOOSE A PAIN MANAGEMENT PROFESSIONAL

When it comes to musculoskeletal pain, professional care can replace pain medication as your first line of defense. Hands-on healthcare professionals such as physical therapists, chiropractors, occupational therapists, massage therapists and athletic trainers are the experts in the assessment, correction and prevention of musculoskeletal dysfunction and the treatment of acute and chronic pain. Not only do they have the knowledge to guide you through the full range of options for muscle and joint pain relief and the associated risks and side effects, but they have access to the best, professional-grade products to complement their care. In fact, research shows working with hands-on healthcare professionals can result in better outcomes for musculoskeletal pain

PHYSICAL THERAPY FOR PAIN

According to the American Physical Therapy Association (APTA), physical therapists are “highly-educated, licensed health care professionals who can help patients reduce pain and improve or restore mobility – in many cases without expensive surgery and often reducing the need for long-term use of prescription medications and their side effects.”

WHEN TO SEEK OUT A PHYSICAL THERAPIST FOR PAIN RELIEF

The APTA defines the role of a physical therapist as:

Diagnosing and managing movement dysfunction and enhancing physical and functional abilities

Restoring, maintaining, and promoting not only optimal physical function but optimal wellness and fitness and optimal quality

 of life as it relates to movement and health

Preventing the onset, symptoms and progression of impairments, functional limitations and disabilities that may result from

 diseases, disorders, conditions or injuries.

WHERE TO FIND A PHYSICAL THERAPIST

Physical therapists can be found in a variety of settings, including outpatient clinics, hospitals, private practices, home health care, extended care, occupational environments, fitness centers and more. Use the Professional Finder to search for physical therapists in your area!

CHIROPRACTIC FOR PAIN RELIEF

According to the American Chiropractic Association (ACA), chiropractic is “a healthcare profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health.” Furthermore, the ACA promotes that chiropractors “practice a hands-on, drug-free approach to health care that includes patient examination, diagnosis and treatment.”

How to Choose the Safest Over-the-Counter Painkiller for Older Adults

If your mother has been complaining, you’ll want to make sure she gets a careful evaluation from her doctor. After all, frequent pain can be the sign of an important underlying health problem that needs attention. You’re also more likely to help your mom reduce her pains if you can help her doctors identify the underlying causes of her pain.

That said, it’s a good idea to ask what over-the-counter analgesics are safest for older people. That’s because improper use of OTC painkillers is actually a major cause of harm to older adults.

What’s the safest OTC painkiller for an older parent?

For most older adults, the safest oral OTC painkiller for daily or frequent use is acetaminophen (brand name Tylenol), provided you are careful to not exceed a total dose of 3,000mg per day.

It is processed by the liver and in high doses can cause serious — sometimes even life-threatening — liver injury. So if an older person has a history of alcohol abuse or chronic liver disease, then an even lower daily limit will be needed, and I would strongly advise you to talk to a doctor about what daily limit might be suitable.

The tricky thing with acetaminophen is that it’s actually included in lots of different over-the-counter medications (e.g. Nyquil, Theraflu) and prescription medications (e.g. Percocet). So people can easily end up taking more daily acetaminophen than they realize. This can indeed be dangerous; research suggests that 40% of acetaminophen overdoses cases are accidental.

Tips to control patient pain

A number of studies and surveys on pain management have all come to the same conclusion: Despite strides in therapies to ease pain, too many inpatients experience significant levels of continuous pain during the course of their treatment. A recent report from the World Health Organization, for example, found that at least 25% of all cancer patients who die in a hospital die without adequate pain relief.

The good news is that several other studies have shown that physicians can manage pain effectively in most patients by using some relatively simple strategies. Of particular interest to inpatient physicians, researchers say that pain management plays a critical role in the recovery process.

Assessing pain

At the Heart Hospital of New Mexico in Albuquerque, hospitalists follow an institution-wide pain management model that relies on two basic elements: regular assessments of patient pain and ongoing adjustments to reflect patient input.

Every patient room, for example, has a pain intensity chart with both a numeric scale and a color scale. Physicians re-assess the patients on an ongoing basis, and they respond immediately to any change in the level of pain

To determine what kind of pain management is appropriate, you need to start with an assessment. A popular tool is an intensity scale that asks patients to rate pain from 0 to 10. Pictorial scales are particularly good for patients with low literacy levels.

Choosing The Right Shoes For Back Pain

Back pain is one of the most common ailments in the United States and affects eight out of 10 people at some point throughout their life. Back pain might be a small sharp pain or a dull ache that persists all day. Many different factors can cause back pain from poor posture to lack of exercise. However, sometimes back pain is linked to sore feet and uncomfortable shoes.

If your feet are causing or contributing to back pain, a change in shoes might make a huge difference. The right pair of shoes can provide the support you need for your back while you’re at work, at the gym or running errands. The wrong pair can cause or exacerbate back pain symptoms.

How do you know which shoes are best for back pain relief? In this post, we will show you how to pick the best shoes for back pain and the factors you need to consider when shopping for new shoes. Once you have the right shoes for your feet, you may notice reduced back pain right away.

Why Shoes Are Important For Back Pain

Your feet provide the base for the rest of your body. When you wear uncomfortable shoes, they create a chain reaction on your ankles, knees, hips and ultimately, your back. Your feet need adequate support to prevent pain while you stand, walk or run. Without proper support, you might adjust your gait or posture and set your spine out of alignment to compensate for the lack of support in your shoes. You also need shoes that absorb impact as your foot hits the ground so that other parts of your body do not have to bear the force of the impact.

Overall, a good pair of shoes improves and stabilizes the position of your feet, which, in turn, improves your gait and posture. Good posture helps prevent muscle strain and pain in the back because it keeps everything in correct alignment and allows muscles, bones and joints to work efficiently

Finding A Chiropractor Online For Back Pain

How To Choose The Right Chiropractor

It is estimated that Doctors of Chiropractic treat over 27 million Americans annually, with a chiropractic adjustment being performed around 1 million times every business day in the US

There are many known benefits of chiropractic treatment, which has made it such a popular treatment. However, when choosing the right chiropractor you can be overwhelmed with the options, and with the average session costing around $65, it’s an expensive decision to make.

To ensure you get the most from your treatment, take a look at our frequently asked questions. We hope they will help inform you, not simply about how to choose a chiropractor but most importantly, how to choose the right chiropractor.

Tips for Choosing a Chiropractor

A Personal Decision

If you prefer a hands-on approach to healthcare that promotes healing without medications or surgery, chiropractic care may be the prescription for you. Your chiropractor is your partner in spine, muscle and joint health. You depend on your chiropractor’s knowledge and expertise to help you stay healthy or recover from an injury or spine condition. How do you find the best chiropractor who is right for you? Here are some important factors to keep in mind.

Get Referrals

Start by asking your primary care doctor for a referral list of chiropractors. You can also ask family, friends and other healthcare providers for recommendations. Take the time to research the chiropractors’ credentials and experience on Healthgrades.com. As you narrow down your list, call each chiropractor’s office to see if he or she is accepting new patients. If so, ask for an appointment to meet and interview the chiropractor

Research the Chiropractor’s Credentials

Licensure is one of the most important factors to consider when you are choosing a chiropractor. It tells you that the chiropractor has the necessary training, skills and experience to provide chiropractic care. Also confirm that the chiropractor has no history of malpractice claims or disciplinary actions. You can find the chiropractor’s medical school, training hospital, certifications, and malpractice and disciplinary history on Healthgrades.com and state websites.

Consider the Chiropractor’s Experience

Experience matters when you’re facing musculoskeletal or spine health issues. The more experience a chiropractor has with a condition or procedure, the better your results are likely to be. Ask how many patients with your specific condition the chiropractor has treated. If you need a specific procedure, ask how many of the procedures the chiropractor has performed and find out about complication rates—complications the chiropractor has encountered as well as your own risk of complications.

Consider Gender

It’s important to feel comfortable with your chiropractor’s gender because you will need to openly discuss personal information. When it comes to chiropractic care, your own gender is also an important consideration. Chiropractors are becoming more skilled in caring for women and men differently. Ask the chiropractor about his or her recent training and experience specifically related to your condition and your gender.

How to choose a chiropractor

Though there are many great resources for obtaining valuable information to assist you in your search for a chiropractor, it can be overwhelming, particularly if you are new to chiropractic. To help guide you in making an educated choice regarding your health care professional, keep the following five points in mind as you sort through the mass of information.

Honesty and confidence

The first thing to look for in a chiropractic doctor is honesty. An honest doctor has both trust and confidence in each and every one of his patients, and that confidence is a reflection of his pride in providing proper treatment and getting successful results for the patient. A good chiropractor will recommend only the best treatment for your quickest and best results; not-so-good chiropractors will recommend you sign up for a package of long-term treatment even before seeing how you respond to treatment. If chiropractic is not the proper treatment for you, a good chiropractor will have no problem referring you to another health care professional to manage or co-manage your case.

Techniques

There are a variety of techniques and methods of treatment in chiropractic, with no two being exactly alike. Each specific technique can work well with a specific patient, but no single technique will work perfect and heal everyone. This being said, any chiropractor that states her particular technique is superior to others or that absolutely guarantees results should be avoided. Although her techniques may be effective with certain patients, guaranteeing results is actually against the Laws of Chiropractic. 

Word of mouth

This is always a great place to start. Positive word of mouth in every profession is a good sign. If you are considering chiropractic for the first time, or considering choosing a different chiropractor, listen to others in your community more than the ads in the phone book, on TV or placed on Facebook. It is easy to look good in a well thought out advertisement, but the right chiropractor for you may be more successfully found by listening to others around you that have experienced chiropractic practice firsthand.

Appropriate examination, diagnosis, and treatment

This is extremely important. Doctors of chiropractic have been through extensive training and education to become health care providers. This training included proper examination, proper diagnosis and proper treatment protocols. If a doctor lacks in any one of these three essential areas, he should not be treating you, period! What does this mean for you? If a chiropractor doesn’t talk to you about your health history and your current condition, doesn’t give you an initial physical examination (checking posture, reflexes, etc.), doesn’t give you a diagnosis regarding your condition, and won’t explain your treatment plan, find another chiropractor.

Helpful Tips for Choosing a Chiropractor

If you are looking for a health care provider that promotes healing without medications or surgery, Chiropractic Care may be the right fit for you. In the field of Chiropractic Care, our main focus in on the cause of your problem

Check Reviews

When deciding which Chiropractic Clinic will be the right fit for you, it is always important to look up reviews of the doctor and clinic before making an appointment.

Research the Chiropractor’s Credentials

Making sure the Chiropractor you are about to see has the proper licensure is a very important factor. It will tell you if the chiropractor has the proper training, experience, and skills to provide chiropractic care.

Ask About Experience

A Chiropractors experience matters when you are facing musculoskeletal or spine health issues. The more experience the chiropractor has with a particular condition or procedure, your results are likely to be better.

Schedule a Free Consultation

The majority of Chiropractors will offer a free consultation so you can meet with them and discuss your injury or pain condition. During your consultation, you will have the opportunity to ask any questions that will help you with deciding if they are the right fit for you

What to Look For When Choosing a Chiropractor

How To Choose The Best Chiropractor For You

Chiropractic is a profession with a wide range of practice philosophies and techniques, which can make it difficult to select the top chiropractor. Because the treatment process involved in chiropractic is a physical process, you should seek a doctor you feel is competent and trustworthy.

What to Look For Before Choosing Your Chiropractor

There are a variety of techniques and joint manipulation styles in chiropractic practice, with no two being exactly alike. Understanding the chiropractor’s spinal manipulation technique, education, and overall style, is vital to your treatment.

Potential Red Flags and Chiropractic Techniques

While on your search for your ideal doctor, it’s also important to look out for unsafe or risky techniques that you may come across while seeking potential candidates. There are a few chiropractor techniques that most chiropractors agree doubtful.

Seeking Medical Treatment at the Chiropractor’s Office

Now that you have criteria to evaluate potential chiropractors and the best corrective chiropractic care, the best thing to do is narrow down your choices. For example, pick around three chiropractic clinics you would like to try or feel you would like to try.

Set up the right time to meet each of the chiropractors (most clinics offer a free consultation,) and ask them questions about your problem areas, will they help with pain treatment, can they help with a slipped disc, and what treatment methods they offer.