Types of medical treatment for back pain, muscle strain or sports injuries

Whether it’s back pain, a strained muscle or a sports injury, it’s usually easy to tell if something’s not right. What’s not always easy, however, is knowing who to seek help from. Here’s a look at four different types of specialists who can help with bone and joint problems, and what to expect from each.

#1 Osteopath

A holistic, drug-free and non-invasive form of alternative medicine, osteopathy employs a range of hands-on manipulation techniques, and recognises the connection between the structure of the body and the way it functions, and how it works as a complete unit.

“A core principle behind osteopathy is the idea that the body is an integrated and indivisible whole, and contains self-healing mechanisms that can be utilised as part of the treatment,” says osteopath SEBASTIEN BODET of UFIT.

As a primary healthcare practitioner specifically trained to diagnose health issues, an osteopath uses hands-on assessment and treatment techniques, and rehabilitation programmes to meet each patient’s individual goals – whether that means treating or preventing illness or injury, explains Sebastien. “There are numerous manipulation techniques including Craniosacral Therapy (CST), Counterstrain, high-velocity lowamplitude (HVLA), the classic ‘thrust’ technique, Muscle Energy Technique (MET) and myofascial release.”

And osteopathy isn’t just for neck and back pain. “Our depth of treatment specialties is so much larger,” says Sebastien, whose patients – including office professionals, pregnant women, sports players, manual workers, children and elderly people – come to him for everything from headaches, vertigo and digestive issues to insomnia, postural problems due to pregnancy and arthritis pain.

What to expect

“When visiting an osteopath for the first time, it’s natural to feel a little unsure of what to expect,” says Sebastien. “At the start of your appointment, your osteopath will ask you questions about your medical history and lifestyle, and any symptoms you may be experiencing. It’s important to bring any scans, MRI or x-ray reports to assist with the diagnosis.”

Since the patient must remove clothing in the area of concern, Sebastien recommends wearing lightweight clothing and appropriate underwear or gym wear.

“After the examination, your osteopath will explain the diagnosis and proposed treatment plan,” he says. “Treatment will be performed at the initial consultation and home exercises, usually stretching, will be prescribed.”

#2 Chiropractor

Like osteopaths, chiropractors use manual manipulation (the term “chiropractic” is derived from the Greek words chiro meaning hand and praktikos meaning practice); however, chiropractic care is primarily focused on specific spinal manipulation. Called an adjustment, this specific manipulation is meant to correct vertebral misalignments that are responsible for causing various disorders throughout the body. While there are different methods, chiropractic takes a holistic and drug-free approach, and is aimed at preventing disease and promoting on-going wellness.

According to chiropractor DR TRAVIS FISHER of Genesis Chiropractic, the human body was built with an innate healing system, and chiropractic care eliminates interference of this system that’s caused by misalignments of the spine and joints, resulting from emotional, chemical and physical stresses on the body (including deficiencies, thoughts, traumas and toxins). These misalignments, called vertebral subluxation, put pressure on the nerve system, reducing the necessary communication between the brain and body that’s required for the body to function and heal properly; only when the proper neurological flow between body and brain is restored can true balance and health be maintained, notes Dr Fisher.

“Chiropractors are highly trained to locate and correct these misalignments. By correcting them, we help reduce spinal interference to our nervous system, which enhances human potential and the ability to adapt to stress,” he adds.

And, we’re not just talking back pain or slipped discs; while many patients do seek chiropractic care for back, neck and limb pain, chiropractic treatment can be sought for everything from high and low blood pressure, asthma and allergies, to infertility, acid reflux, bed-wetting and insomnia, as the entire body is affected by any interruptions to the nervous system, which runs through the spine.

“Misalignments of the spine can cause pressure on the disc that separates the vertebrae, causing it to swell and protrude,” explains Gonstead chiropractor DR WILLIAM CHOI of Academy of Chiropractic Clinic. “The pinching or compressing of the nerves results in a subluxation, creating an inflammatory response that may disturb natural hormones of the body. Improper transmission of impulses can result in nerve disturbance, and various ailments such as migraines and insomnia can be results of these disturbances. Chiropractic, therefore, is a specialty of the nervous system, removing nerve irritation and inflammation from the spine.”

Dr Fisher adds, “What some may not realise is how important chiropractic care can be for cultivating a healthy body, healing and optimising your entire system. Quite simply, when you get your nerves firing better, everything else can fall into place. The nervous system and immune system are totally intertwined. So, when the nervous system gets overwhelmed and stressed, the immune system starts tanking.”

Take ear infections, for example. A misalignment to the top bone of your neck can affect your ears’ ability to drain properly, which, in turn, can cause infection, says Dr Fisher. Chiropractic removes these irritations, which, in turn, improves one’s “plumbing” and immune system.

Not just for grown ups

Kids can benefit from chiropractic care, too. According to Dr Choi, stress and trauma to the spine begin at birth, when an infant’s soft and underdeveloped spine can suffer trauma during delivery. He says that as the child grows, repeated falls while learning to walk, physical activities like twisting and jumping, and athletic injuries can often cause subluxation.

“Children who have not yet developed awareness of their bodies frequently do not show signs or symptoms of being subluxated. A child may communicate his or her pain through grumpiness, acting out or incessant crying, for instance. Other signs of spinal distress may include colic, poor appetite, ear infections, bed-wetting and ADHD. A properly aligned spine promotes good posture, a stronger immune system and better health overall,” he says. “Regular chiropractic care can help keep a child’s ligaments and joints supple, which, in turn, can help prevent future injuries. It can also help to correct any underlying issues before they become hardwired.”

Dr Fisher agrees that everyone, including children, can benefit from chiropractic care. “Everyone should be checked for misalignments, which may be silently affecting their overall health, and should get adjusted by a licensed, qualified doctor of chiropractic when necessary from birth, to prevent dysfunction and enhance human potential as we grow and develop through the various stages of our lives,” he says.

What to expect

No matter which chiropractic method you choose, you can expect noninvasive spinal manipulation aimed at restoring joint function, relieving pain, and supporting the overall body and its nervous system.

Dr Fisher practices a range of methods, from highly sought-after Gonstead adjusting techniques to more low-force methods like Active Release Technique. His evaluations begin with a consultation, followed by a detailed examination and posture analysis. Recommendations are then made based on an individual’s unique needs, and certain rehab and posture correction therapies may be recommended, as well as tailored at-home exercise routines, thanks to Dr Fisher’s background in personal training and kinesiology.

And, not to worry – adjustments aren’t painful, he says. “Most patients report a sense of wellbeing or a feeling of calmness after an adjustment. If adjustments didn’t feel good, patients wouldn’t return for their repeat adjustments!”

As a Gonstead chiropractor, Dr Choi uses a specific set of criteria to detect the presence of a vertebral subluxation in both adults and children, including visualisation, feeling the patient’s spine in both static and dynamic positions, x-ray analysis, and the use of an instrument called a Nervoscope, which can uncover any signs of inflammation.

“Gonstead chiropractors look at the spine from an engineer’s point of view. By analysing and treating the structure and mobility of each disc in relation to the overall functioning of the spine and surrounding tissues, we aim to rebuild the spine from the bottom up,” says Dr Choi. Gentle adjustments are then made to the spine once the problem is detected.

“The focus of the Gonstead adjustment is to be as specific, precise and as accurate as possible, addressing only the problem areas – the areas of subluxation,” says Dr Choi. “If done correctly, the adjustment should be quick and painless with one segment corrected per adjustment. It is also common for most patients to feel relaxed, even sleepy, after an adjustment.”

#3 Physiotherapist

Like chiropractic, physiotherapy (known as physical therapy in some parts of the world) is aimed at eliminating pain and reinstating function; however, physiotherapists more commonly use a combination of manual therapy, massage, and rehabilitative exercises to do so.

In addition to examining the interaction between the muscular, skeletal and nervous systems to determine the root of the problem, a physiotherapist also takes into account a patient’s lifestyle, and the activities that could be contributing to the condition. Using a mix of manual therapy (Soft Tissue Release, for instance), education and strength training exercises, physiotherapists create tailored programmes to help patients with physical and/or functional impairments caused by injuries, as well as disease, environmental factors and natural ageing, with injury prevention playing a key role; and, restoring mobility, independence and quality of life are the major end goals.

“We are movement therapists, and our main job is to make movement in life’s daily activities better for our clients,” says physiotherapist KHONG BEE BEE, who co-founded Mobile Physio, a holistic rehabilitation service provider that offers physiotherapy services in the comfort of patients’ own homes and GP clinics. This can include anything from post-surgery rehabilitation, sports injuries and osteoarthritis management to neurological issues such as Parkinson’s or stroke, postnatal and antenatal care – strengthening the pelvic floor, for instance – and geriatric rehab, which helps prevent physical deconditioning, and promotes active ageing and mental function.

“Good mental and physical health are interconnected, and we now know that it’s impossible to find an effective solution if we look at, say, knee pain, only as knee pain. There’s a whole person attached to that knee – a person with feelings, emotions, fears and anxieties, a person with a certain routine, with likes and dislikes, and a person, who, perhaps, is affected by a lack of sleep, which, as evidence has shown, tends to increase knee pain. Thus, what we are treating is a person with knee pain, and what we are trying to do is to give that person solutions as to how they can do away with that pain and get on with life.”

So what does that involve? Not just assessing the knee, but all other relevant factors, too, including physical, psychological and social considerations. “In a session, we try our best to get to know the client and their family’s needs as best as we can, and try to provide rehab solutions according to those needs. Ultimately, the aim is to keep things SMART (Specific, Measurable, Achievable, Realistic and Timely), convenient, holistic and to meet the client’s goal of getting better.”

What to expect

At your first session, expect to spend some time answering questions, sharing information about your medical history (bring along any medical reports or scans if you can), and explaining your goals and concerns, says Bee Bee. She also suggests wearing comfortable clothes.

#4 Orthopaedic Surgeon

Devoted to the diagnosis, treatment, prevention and rehabilitation of injuries, disorders and diseases of the body’s musculoskeletal system (including bones, joints, ligaments, muscles, nerves and tendons), this type of physician uses both surgical and non-surgical treatment solutions depending on the patient’s individual situation, and often works in conjunction with physiotherapists or other specialists.

“The goal of an orthopaedic surgeon is to be your guide on your journey from injury to recovery. Your surgeon should educate you about your problem, and provide you with feasible treatment options to help you reach your goals, whether it be restoration of basic function or returning to full activities and sports,” says orthopaedic surgeon DR BERNARD LEE of SportsIn Orthopaedic Clinic. Specialising in sports surgery of the shoulder, elbow, hip and knee, Dr Lee treats patients with a variety of conditions, the most common being rotator cuff tendon problems, shoulder instability, knee instability from ligament tears and knee pain due to early cartilage damage or osteoarthritis.

What to expect

While pain killers are prescribed where necessary, Dr Lee says that treatment often involves properly managing the symptoms while the body heals itself, pointing to physiotherapy as a good option for his patients.“Physiotherapy can help with the recovery process by correcting underlying problems as well as relieving your symptoms,” he says. “I normally work closely with the physiotherapists and discuss the diagnosis and progress of the patients, and agree on future treatment plans.”

Sometimes, surgery is the necessary treatment route. “Should non-operative treatment fail, or should you have a major problem that is not amenable to nonoperative treatment, surgery may give you your best chance of a full recovery. The aim of surgery is to restore function, or to prevent a possible problem from occurring in the near future,” says Dr Lee, who has a special interest in arthroscopic surgery, ligament reconstructions and complex soft tissue injuries of the knee, shoulder and elbow. “Your orthopaedic surgeon’s goal would be to help you navigate through such an apprehensive and stressful life event to eventually emerge a winner.”