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A chiropractor is a health care professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine.

Most chiropractors seek to reduce pain and improve the functionality of patients as well as to educate them on how they can account for their own health via exercise, ergonomics and other therapies to treat back pain.

Chiropractors: Fundamental Beliefs and Goals

Chiropractors focus on the intimate relationship between the nervous system and spine, and hold true the following beliefs:

  • Biomechanical and structural derangement of the spine can affect the nervous system
  • For many conditions, chiropractic treatment can restore the structural integrity of the spine, reduce pressure on the sensitive neurological tissue, and consequently improve the health of the individual.

The treatment concept of chiropractic is to re-establish normal spinal mobility, which in turn alleviates the irritation to the spinal nerve and/or re-establishes altered reflexes.

Massage therapy is a type of treatment in which a trained and certified medical professional manipulates the soft tissues of your body — muscle, connective tissue, tendons, ligaments and skin — using varying degrees of pressure and movement.

Massage is generally considered part of complementary and integrative medicine. It’s increasingly being offered along with standard treatment for a wide range of medical conditions and situations.

Studies of the benefits of massage demonstrate that it is an effective treatment for reducing stress, pain and muscle tension. At Synergy Pro Wellness, massage therapy may be recommended to help people cope with the pain and stress of cancer, heart disease, stomach problems, fibromyalgia or other conditions.

Acupuncture is a form of treatment that involves inserting very thin needles through a person’s skin at specific points on the body, to various depths.

Research suggests that it can help relieve pain, and it is used for a wide range of other complaints.

An acupuncturist will insert needles into a person’s body with the aim of balancing their energy.

This, it is claimed, can help boost well being and may cure some illnesses.

Conditions it is used for include different kinds of pain, such as headaches, blood pressure problems, and whooping cough, among others.

How does it work?

Traditional Chinese medicine explains that health is the result of a harmonious balance of the complementary extremes of “yin” and “yang” of the life force known as “qi,” pronounced “chi.” Illness is said to be the consequence of an imbalance of the forces.

Qi is said to flow through meridians, or pathways, in the human body. These meridians and energy flows are accessible through 350 acupuncture points in the body.

Inserting needles into these points with appropriate combinations is said to bring the energy flow back into proper balance.

There is no scientific proof that the meridians or acupuncture points exist, and it is hard to prove that they either do or do not, but numerous studies suggest that acupuncture works for some conditions.

Some experts have used neuroscience to explain acupuncture. Acupuncture points are seen as places where nerves, muscles, and connective tissue can be stimulated. The stimulation increases blood flow, while at the same time triggering the activity of the body’s natural painkillers.

In 2003, the World Health Organization (WHO) listed a number of conditions in which they say acupuncture has been proven effective.

These include:

  • high and low blood pressure
  • chemotherapy-induced nausea and vomiting
  • some gastric conditions, including peptic ulcer
  • painful periods
  • dysentery
  • allergic rhinitis
  • facial pain
  • morning sickness
  • rheumatoid arthritis
  • sprains
  • tennis elbow
  • sciatica
  • dental pain
  • reducing the risk of stroke
  • inducing labor

Introduction to pain management

Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:

  • Interventional procedures
  • Medication management
  • Physical therapy or chiropractic therapy
  • Psychological counseling and support
  • Acupuncture and other alternative therapies; and
  • Referral to other medical specialists

All of these skills and services are necessary because pain can involve many aspects of a person’s daily life.

Orthopedics is a medical specialty that focuses on the diagnosis, correction, prevention, and treatment of patients with skeletal deformities – disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin. These elements make up the musculoskeletal system.

Your body’s musculoskeletal system is a complex system of bones, joints, ligaments, tendons, muscles and nerves and allows you to move, work and be active. Once devoted to the care of children with spine and limb deformities, orthopedics now cares for patients of all ages, from newborns with clubfeet, to young athletes requiring arthroscopic surgery, to older people with arthritis.

The physicians who specialize in this area are called orthopedic surgeons or orthopedists.

Role of the orthopedist

Orthopedists use medical, physical and rehabilitative methods as well as surgery and are involved in all aspects of heath care pertaining to the musculoskeletal system. It is a specialty of incredible breadth and variety. Orthopedists treat a immense variety of diseases and conditions, including fractures and dislocations, torn ligaments, sprains and strains tendon injuries, pulled muscles and bursitis ruptured disks, sciatica, low back pain, and scoliosis knock knees, bow legs, bunions and hammer toes, arthritis and osteoporosis, bone tumors, muscular dystrophy and cerebral palsy, club foot and unequal leg length abnormalities of the fingers and toes, and growth abnormalities.

In general, orthopedists are skilled in the:

  • Diagnosis of your injury or disorder
  • Treatment with medication, exercise, surgery or other treatment plans
  • Rehabilitation by recommending exercises or physical therapy to restore movement, strength and function
  • Prevention with information and treatment plans to prevent injury or slow the progression of diseases

Typically, as much as 50 percent of the orthopedist’s practice is devoted to non-surgical or medical management of injuries or disease and 50 percent to surgical management. Surgery may be needed to restore function lost as a result of injury or disease of bones, joint, muscles, tendons, ligaments, nerves or skin.

The orthopedist also works closely with other health care professionals and often serves as a consultant to other physicians. Orthopedists are members of the teams that manage complex, multi-system trauma, and often play an important role in the organization and delivery of emergency care.

A field known for innovation

Like other branches of medicine, remarkable technological advances have significantly shaped the field of orthopedics in recent years.

  • Arthroscopy – the application of visualizing instruments to assist in the diagnosis and surgical treatment of internal joint diseases – has opened new horizons of therapy
  • Exciting cellular research may enable orthopedic surgeons to stimulate the growth of ligaments and bone in patients someday in the future
  • Great advances have occurred in the surgical management of degenerative joint disease. For example, orthopedic surgeons can replace a diseased joint with a prosthetic device (total joint replacement)
  • Research is progressing on “growing” articular cartilage in joints, which may one day reduce the need for some people to get joint replacements

Specialties

While most orthopedists practice general orthopedics, some may specialize in treating the foot, hand, shoulder, spine, hip, knee, and others in pediatrics, trauma or sports medicine. Some orthopedists may specialize in several areas.

Treatments

Orthopedic patients have benefited from technological advances such as joint replacement, and the arthroscope that allows the orthopedist to look inside a joint. But your visit will start with a personal interview and physical examination. This may be followed by diagnostic tests such as blood tests, X-rays, or other tests.

Your treatment may involve medical counseling, medications, casts, splints, and therapies such as exercise, or surgery. For most orthopedic diseases and injuries, there is more than one form of treatment. Your orthopedist will discuss the treatment options with you and help you select the best treatment plan to enable you to live an active and functional life.

Training

Your orthopedic surgeon is a medical doctor with extensive training in the proper diagnosis and treatment of injuries and diseases of the musculoskeletal system.

Orthopedics facts

  • Injuries to the musculoskeletal system (bones, joints, muscles, ligaments, tendons) or conditions like arthritis, osteoporosis rank number one in visits to physicians’ offices.
  • One in seven Americans has a musculoskeletal impairment.
  • The number of persons incurring musculoskeletal injuries is 28.6 million annually — accounting for more than one-half of all injuries in one year.
  • Musculoskeletal conditions and injuries account for 137.6 million visits to physicians’ offices and hospital outpatient and emergency departments every year.
  • Approximately 7.5 million musculoskeletal procedures are performed by physicians every year.
  • Arthritis is the leading chronic condition reported by the elderly.
  • Back or spine injuries are the most prevalent musculoskeletal impairments.
  • Sprains or dislocations and fractures account for almost one-half of all musculoskeletal injuries.
  • More than 15.3 million visits were made to physicians’ offices due to back problems in 1999.
  • More than 10.1 million visits were made to physicians’ offices due to knee problems in 1999. The knee is the most often treated anatomical site by orthopedic surgeons.
  • More than 5.9 million visits were made to physicians’ offices due to shoulder problems in 1999.
  • More than 5.3 million visits were made to physicians’ offices due to foot and ankle problems in 1999.
  • More than 2.4 million visits were made to physicians in office-based practices in 1999 because of carpal tunnel syndrome. Of these visits, more than one million were made to orthopedic surgeons.
  • Data from the Bureau of Labor Statistics indicates in 1997, 29,200 episodes of carpal tunnel syndrome were reported in private industry that resulted in an average of 25 days of work loss.
  • Each year, musculoskeletal injuries in the U.S. cause children to stay home from school 21 million days.
  • Currently employed workers in the U.S. lose more than 147 million days of work because of musculoskeletal injuries.

What is Neurosurgery?

Neurosurgery is surgery of the nervous system. 

Most people think of neurosurgery as brain surgery — but it is much more!
It is the medical specialty concerned with the diagnosis and treatment of of patients with injury to, or diseases/disorders of the brain, spinal cord and spinal column, and peripheral nerves within all parts of the body. The specialty of neurosurgical care includes both adult and pediatric patients. Dependent upon the nature of the injury or disease a neurological surgeon may provide surgical and/or non-surgical care.

Who is a Neurosurgeon?

A physician who specializes in neurosurgery. Neurosurgeons are not just brain surgeons, they are medically trained neurosurgical specialists who can also help patients suffering from back and neck pain as well as a host of other illnesses ranging from trigeminal neuralgia to head injury and Parkinson’s disease.

To become a neurosurgeon, at OHSU a physician must accomplish the following:

  • graduate from an accredited medical school (four years);
  • complete a six month to one-year surgical internship in the Department of Surgery, this builds fundamental clinical skills;
  • complete seven years in the neurosurgical residency program accredited by the American Council on Graduate Medical Education (ACGME).

During this residency training, neurosurgeons are trained in all aspects of neurosurgery, including the cerebrovascular system, the spine and spinal cord, trauma, tumors, pain management and pediatric surgery. Residents complete a minimum of 60 months of training in the neurological sciences, with at least 36 of those months are devoted to clinical neurosurgery and a minimum of 3 months devoted to clinical neurology.

Some neurosurgeons opt to complete an additional fellowship in a particular specialized area of study after their residency.
Following residency training, neurosurgeons become board certified, and continue with relevant training.

What is the role of the Neurosurgeon?

Neurosurgeons provide the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care and rehabilitation) of neurological disorders. Because neurosurgeons have extensive training in the diagnosis of all neurological disease, emergency room doctors, neurologists, internists, family practitioners, and osteopaths often call upon them for consultations.

What is a Neurologist?

Introduction to Neurology

Neurology is the branch of medicine concerned with the study and treatment of disorders of the nervous system. The nervous system is a complex, sophisticated system that regulates and coordinates body activities. It has two major divisions:

  • Central nervous system: the brain and spinal cord
  • Peripheral nervous system: all other neural elements, such as eyes, ears, skin, and other “sensory receptors”

A doctor who specializes in neurology is called a neurologist. The neurologist treats disorders that affect the brain, spinal cord, and nerves, such as:

  • Cerebrovascular disease, such as stroke
  • Demyelinating diseases of the central nervous system, such as multiple sclerosis
  • Headache disorders
  • Infections of the brain and peripheral nervous system
  • Movement disorders, such as Parkinson’s disease
  • Neurodegenerative disorders, such as Alzheimer’s disease, Parkinson’s disease, and Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease)
  • Seizure disorders, such as epilepsy
  • Spinal cord disorders
  • Speech and language disorders

Neurologists do not perform surgery. If one of their patients requires surgery, they refer them to a neurosurgeon.

Education to Become a Neurologist in the United States

  • Four years of pre-medical education in a college or university
  • Four years of medical school resulting in an M.D. or D.O. degree (doctor of medicine or doctor of osteopathy degree)
  • One year internship in either internal medicine or medicine/surgery
  • At least 3 years of specialty training in an accredited neurology residency program

Many neurologists also have additional training or interest in one area of neurology, such as stroke, epilepsy, neuromuscular, sleep medicine, pain management, or movement disorders.

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