Common orthopedic concerns: when to see the doctor

At some point in your life, you might be injured or have a condition that affects your musculoskeletal system … which includes:

• Muscles (600)
• Bones (206, including 26 in each foot and 27 in each hand)
• Joints (360)
• Tendons, which connect muscle to bone
• Ligaments, which connect two bones
• Fasciae, which connect muscle to muscle
• Bursae, about 150 fluid-filled sacs by joints

Your bones and muscles protect your internal organs. And they’re involved in every move you make … walking, dancing, running, bending, lifting, sitting, lying down … literally every move.

Because there are so many of these interconnected parts and because you use them every day, the odds are good that one or more could wear down, break or have other problems. In fact, orthopedic conditions are among the most common across all ages and stages of life.  

Orthopedics is the branch of medicine that diagnoses and treats musculoskeletal concerns. PeaceHealth orthopedic doctors, Alec Fedorov, MD, and Carter Kiesau, MD, share some of the most common conditions that affect bones, muscles and joints.

Treating muscles, bones, joints

Orthopedics focuses on helping people with conditions that affect bones, muscles and joints. Other specialties may also play a role in diagnosing and treating musculoskeletal concerns. These include endocrinologists, neurologists, rheumatologists and podiatrists.

A few of the most common musculoskeletal conditions are:

• Arthritis. Several types of arthritis affect nearly 60 million Americans. Rheumatologists help people with systemic autoimmune conditions. When arthritis is advanced, an orthopedic surgeon might be needed to repair the damage or replace the joint. Read more about arthritis.
• Bursitis. Thousands of people are affected by this condition that causes swelling of the bursa, a sac of fluid, near the joint. It’s most common in shoulders, elbows, hips and knees.
• Osteoporosis and osteopenia. These conditions make your bones weak so they may break more easily. More than 10 million Americans have osteoporosis. And 43 million have low bone-density.
• Tendinopathy. Tendon-related conditions affect thousands of people, especially athletes. In fact, about 30% of musculoskeletal visits are related to tendons. This could be due to inflammation or a breakdown of the tendon, which connects muscle to bone. A few examples are tennis elbow, pitcher’s shoulder and runner’s knee.

Common major orthopedic conditions

Dr. Fedorov sees patients with a wide variety of common orthopedic conditions such as:

• Shoulder pain. About 4 million Americans have shoulder pain — especially as they get older. It may be caused by arthritis, bursitis, frozen shoulder or separation, among other things.
• Hip pain. Nearly 10% of people have chronic hip pain. That number goes higher as people age. It may be caused by arthritis, bursitis or other conditions.
• Knee pain. More than 25% of adults in the United States have knee pain. It can be due to arthritis, bursitis and sports injuries, among other causes.
• Fractures and broken bones. Every year, millions of people have broken bones. Breaks can be clean and simple or complex. 

Common conditions of the ankle, feet and toes

Your ankles, feet and toes are vital to the rest of your body. Some orthopedists, like Dr. Kiesau, specialize in helping people with conditions such as:

• Fallen arches or flatfoot. Adults and children over age 5 can have problems with the arch in one or both feet.
• Bunions. One out of 3 people over the age of 65 have bunions. A bunion is the painful enlargement of tissue or bone by the big toe.
• Fractures or breaks. Each foot has 27 bones. While the bones are small, they’re crucial to your ability to move well. You’ll want to have an x-ray as soon as possible if you suspect a break in your mid foot or arch.
• Hammertoes. About 7 million people have this condition that causes bent and painful toes. Surgery can be required for severe cases.
• Morton’s Neuroma. This condition makes if feel like you’re walking on a marble. It affects women more than men and usually is more common in people between the ages of 30 and 60.
• Sprains. A sprain happens when you overextend or break a ligament (the tissue that connects two bones). More than 2 million people a year experience a sprain — often in their ankles. Learn more about treating ankle sprains.
• Tendon ruptures. This is a full or partial tear of the tendon in the back of the ankle. This kind of injury is most frequent among athletes in their teens and 20s. When it happens, you might hear or feel a “pop.” Or you might feel like you were kicked in the back of the ankle.  Seek care within a couple of days. The longer you wait, the less opportunity there is for surgical repair.

You can expect to see a podiatrist for treatment of plantar fasciitis (heel pain), tarsal tunnel syndrome (ankle pain), ingrown toenails, nail deformities, calluses or foot ulcers.  If you have neuropathy (pain and/or lack of feeling in the feet), you may get care from a neurologist.

Learn more about foot and ankle conditions.

When to see a doctor

Sometimes it’s obvious when you need to get care for an orthopedic condition. For example, if you’ve been in a car accident, were injured during a game or if you’ve fallen. In those cases, seek care right away. It’s safer to get checked out rather than to wait.

At other times, you might experience symptoms without knowing what caused them.

If you have any of the following symptoms that don’t get better with home care, talk to your primary care provider about next steps:

• Significant trauma — especially to an ankle, foot or other lower weight-bearing parts.
• Swelling — especially if it's excessive and there is bruising. An X-ray might be needed.  
• Difficulty moving or stretching.
• Tenderness or pain.
• Weakening muscles.
• Misshaped joint.
• Midfoot or arch injury. Seek care as soon as possible as it could be a fracture, sprain or dislocation.
• Ankle injury with a “pop” in the back of the ankle. If it’s an Achilles rupture, it should need be seen within a couple of days.

Because there are many types of providers who treat the most common musculoskeletal conditions, your PCP can point you in the right direction for advice or treatment.