Orthopedic pain management is a guessing game. Knowing where and how to get treated is challenging.
Say you’ve sprained your ankle ice skating. On the drive home, it’s swelling and painful. Now you’re concerned about the next steps. Should you check in with your primary care physician or skip that step and go to a specialist, assuming your physician will send you there anyway?
But if you’re a patient of a direct primary care (DPC) practice, you don’t need to guess about orthopedic pain management. Contact your DPC physician immediately.
At Priority Physicians, we guide you on optimum treatment for your injury and, depending on its complexity or severity, often treat you immediately in our DPC offices.
Orthopedic Pain Management: Treating Musculoskeletal Issues
The musculoskeletal system is complex and often leaves students confused. Consequently, many primary care physicians in traditional care systems don’t feel well-trained in orthopedic pain management. Yet orthopedic injuries — damage to muscles, bones, joints, and soft tissues — tend to represent the bulk of the injuries doctors see.
Unfortunately, traditional care doctors often resort to the two easiest options for patients with joint or back pain: They send the patient for imaging or refer them to a specialist. When people think these are the only two possible options, injured patients often skip the doctor’s office and head directly to a subspecialist.
Priority Physicians Provides Care for Musculoskeletal Injuries
But before you rush that sprained ankle to urgent care, consider this: At Priority Physicians, we have fellowship-trained sports medicine doctors with the proper credentials to handle musculoskeletal injuries knowledgeably.
Typically, a patient wants an X-ray, pain relief, and the quickest path back to normal living. Imaging isn’t always required to get them there.
In our direct primary care setting, we take the time to deep-dive and explain options to our patients so they’re comfortable with a diagnosis and treatment plan that might not require an X-ray. By conducting a thorough exam at our offices, we provide peace of mind and save patients money (and radiation exposure).
Consider a patient with painful arthritic knees who has tried several oral medications without experiencing relief. Maybe they think it’s time to consult an orthopedic surgeon for immediate joint replacement.
A DPC physician might suggest an interim step — perhaps a beneficial steroid injection so the patient can take that trip to Europe or host a daughter’s wedding pain-free, without the stress of surgery.
When a Specialist Is a Good Idea
We see many “common” injuries, such as sprains, strains, and fractures. An injury that’s “uncommon” to you may be an issue we’ve treated several times this month.
Our physicians are alert and aware of serious situations that warrant deeper examination by a specialist. For instance, if you’ve lost flexion or function in a limb, have an obvious bone break, or have exposed bone or muscle, we’ll get you in swiftly to examine you and evaluate the type of specialist you may need.
Of course, if your injury’s initial treatment isn’t effective, we quickly determine when to engage a subspecialist.
Is an MRI Always Needed?
Magnetic resonance imaging (MRI) delivers incredible detail in cases of musculoskeletal injury (soft tissue, muscles, tendons). An MRI augments and adds confidence to our clinical diagnosis.
But MRIs — and imaging in general — are not a “be-all-end-all.” Scans are expensive and require scheduling. They’re time-consuming compared to a two-second X-ray, and you must remain still and deal with claustrophobia.
MRI Risks
MRIs have downsides as well. Consider the following outcomes:
- An unintentional discovery. If we randomly choose 100 adults and MRI their spines, half of them will have some sort of pathology there — often asymptomatic and unrelated to the reason for the MRI.
- No clues. A patient may feel pain in a certain area yet have no pathology evident on an MRI.
Imaging may also temporarily point to the wrong path. More often than not, an MRI reveals multiple potential pain sources, and it’s up to us to figure out which to pursue first.
Because everyone’s anatomy is unique, this type of scenario is commonplace, and certain imaging uses aren’t guaranteed to solve the problem.
We try not to get lost in unnecessary procedures or follow-ups of other pathologies we may come across (e.g., a minor cyst causing no problem). In the long run, trying to address every anomaly we find can be more harmful to the patient. It’s better to stay focused on the cause of the patient’s discomfort.
Orthopedic Pain Management: What to Do at Home
When a specialist isn’t required, we examine and treat patients at our office and offer simple steps to manage musculoskeletal aches or pains at home:
Follow the acronym RICE — rest, ice and heat, compression, elevation:
- Take a few days off from your daily activities or exercise regimen to let your body replenish energy and work to repair itself.
- Get good sleep to encourage the body’s natural healing.
- In the first 24–48 hours after injury, apply ice to reduce swelling and prevent further inflammation.
- Switch to a heating pad after 24–48 hours to stimulate and expedite recovery.
- Elevate the injured area as much as possible to minimize blood flow and promote lymphatic drainage.
Use NSAIDs (non-steroidal anti-inflammatory drugs) as indicated by your direct primary care physician:
- For patients with normal kidney and stomach function, NSAIDs like Advil (ibuprofen) or Aleve (naproxen) are effective medications for orthopedic pain management. Using them briefly reduces inflammation and pain and helps the body heal.
- Don’t use anti-inflammatories to push through a workout while injured. You may hurt the compromised body part further if you try to work through temporarily masked pain.
As you heal, check in with your direct primary care physician. Even if your pain is minor and easily treatable through RICE, we want to see you through complete recovery of the injured area.
See Your Direct Primary Care Doctor for Orthopedic Pain Management
Are you concerned about swelling or recurring pain from a fall or sports injury? Good orthopedic pain management doesn’t always automatically call for imaging or a subspecialist.
Make your Priority Physicians your first stop.
We’ll evaluate your situation, determine what you need, and get you on the path to quick healing. Reach out today.
