Yes, orthopedic doctors treat arthritis, focusing on the mechanical and structural consequences of the disease rather than managing underlying systemic inflammation. Arthritis involves the inflammation of one or more joints, leading to pain, stiffness, and eventual loss of function. Orthopedic specialists manage the physical damage arthritis causes to the joint. Their intervention ranges from non-surgical methods to reconstructive procedures aimed at restoring mobility and reducing discomfort.
The Musculoskeletal Focus of Orthopedics
Orthopedic doctors specialize in the diagnosis, treatment, and rehabilitation of disorders, injuries, and diseases of the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves. Their expertise centers on the physical structure and mechanical function of the body. When dealing with arthritis, the orthopedist concentrates on the integrity of the joint itself, including the cartilage, bone, and surrounding soft tissues. They view arthritis primarily as a degenerative or structural problem that impairs movement and causes pain. Orthopedists commonly treat degenerative conditions like osteoarthritis, the most frequent form of arthritis involving “wear-and-tear” on the joint cartilage.
Conservative Management of Arthritis
The initial treatment involves non-surgical, or conservative, management strategies designed to alleviate pain, reduce inflammation, and maintain joint function. The goal is to maximize the life of the natural joint, especially in the early to moderate stages of arthritis.
One common treatment involves intra-articular injections. Corticosteroids deliver powerful anti-inflammatory medication directly into the joint space, providing temporary relief from swelling and pain. Viscosupplementation is another injection therapy where a gel-like substance containing hyaluronic acid is injected to improve the lubricating properties of the joint fluid, primarily for knee osteoarthritis.
Orthopedic physicians also prescribe physical therapy to strengthen surrounding muscles, which helps stabilize the joint and absorb shock. They may recommend assistive devices, such as braces, canes, or custom orthotics, to offload stress from damaged joint surfaces. Pain medication management, typically using nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, is coordinated to control daily discomfort. These measures aim to improve the patient’s quality of life and delay mechanical deterioration before considering surgery.
Surgical Interventions for Joint Damage
When conservative treatments no longer provide adequate pain relief or functional improvement, the orthopedic specialist transitions to surgical interventions. Surgery is reserved for end-stage arthritis, where extensive joint damage severely impacts a person’s ability to perform daily activities. These procedures correct structural damage and restore mechanical alignment and motion.
The most common intervention is Total Joint Arthroplasty, or joint replacement. This involves removing damaged cartilage and bone and replacing them with artificial components made of metal, plastic, or ceramic. Routinely performed on large joints like the hip and knee, this procedure offers a reliable long-term solution for pain relief and functional restoration. Partial joint replacement, such as unicondylar knee arthroplasty, is an option when arthritis is confined to one section of the joint.
Other surgical techniques include arthroscopy, a minimally invasive procedure using small incisions and a camera to clean out the joint space by removing loose fragments and inflamed tissue. An osteotomy may also be performed, involving cutting and reshaping the bone near the damaged joint to shift weight-bearing stress away from the arthritic area.
When to Consult a Rheumatologist
While an orthopedic doctor focuses on joint mechanics and structure, a rheumatologist specializes in the medical management of systemic diseases that cause arthritis. Rheumatologists are internal medicine physicians who treat inflammatory and autoimmune types of arthritis, such as Rheumatoid Arthritis, Psoriatic Arthritis, and Lupus-related arthritis.
These specialists use disease-modifying anti-rheumatic drugs (DMARDs) and biologic therapies to suppress the overactive immune system, which attacks the joint lining and causes widespread inflammation. A rheumatologist is the appropriate first contact when joint pain is accompanied by systemic symptoms like fever or fatigue, or when multiple joints are involved, suggesting an autoimmune cause.
An orthopedic consultation is more appropriate when the primary problem is mechanical, such as with Osteoarthritis, or when established joint damage requires physical repair or reconstruction. For patients with inflammatory arthritis, the rheumatologist and the orthopedic surgeon work collaboratively. The rheumatologist manages the systemic disease, and the orthopedist addresses resulting structural damage if it becomes severe and limiting.