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The Pediatrics Orthopaedic Team

Who treats pediatric orthopaedic conditions?

Picture of young boy, with canes, during a physical therapy session

Orthopaedic conditions may be treated by your child's physician and/or other medical specialists and health care providers. Several physicians from different medical specialties may be involved in the treatment of one child at the same time. This multidisciplinary team approach is particularly important in managing the symptoms of an orthopaedic condition, especially as many symptoms are chronic and change in severity over time. Some of the more common medical professionals involved in the treatment of pediatric orthopaedic conditions may include:

  • Pediatrician or primary care physician. While your pediatrician or primary care physician may treat and/or diagnose your child's disease, he or she may refer you to a specialist for more specialized treatment of certain aspects of the disease.
  • Orthopaedic surgeon. The physician who specializes in orthopaedic surgery is called an orthopaedic surgeon, or sometimes, simply, an orthopaedist. Orthopaedists are educated in the workings of the musculoskeletal system, which includes (but is not limited to) diagnosing a condition or disorder, identifying and treating an injury, providing rehabilitation to an affected area or function, or establishing prevention protocol to inhibit further damage to a diseased area or component of the musculoskeletal system.

    The orthopaedist may have completed up to 14 years of formal education. After becoming licensed to practice medicine, the orthopaedic surgeon may become board-certified by passing both oral and written examinations given by the American Board of Orthopaedic Surgery.

    Many orthopaedic surgeons choose to practice general orthopaedics, while others specialize in certain areas of the body (for example, foot, hand, shoulder, spine, hip, or knee), or in a specialized area of orthopaedic care (such as, sports medicine, trauma medicine). Some orthopaedists may specialize in several areas and may collaborate with other specialists, such as neurosurgeons or rheumatologists, in caring for patients.
  • Rheumatologist. A rheumatologist is a physician who specializes in the treatment of arthritis and other rheumatic diseases that may affect joints, muscles, bones, skin, and other tissues. Most rheumatologists have a background in internal medicine or pediatrics and have received additional training in the field of rheumatology. Rheumatologists are specially trained to identify many types of rheumatic diseases in their earliest stages, including arthritis, many types of autoimmune diseases, musculoskeletal pain, disorders of the musculoskeletal system, and osteoporosis. In addition to four years of medical school and three years of specialized training in internal medicine or pediatrics, a rheumatologist has had an additional two or three years of specialized training in the field of rheumatology. A rheumatologist may also be board-certified by the American Board of Internal Medicine.
  • Physical therapist. Physical therapy is the health profession that focuses on the neuromuscular, musculoskeletal, and cardiopulmonary systems of the human body, as these systems relate to human motion and function.

    Physical therapists, or PTs, are very important members of the health care team. They evaluate and provide treatment for children with health problems resulting from injury, disease, or overuse of muscles or tendons.

    Physical therapists have an undergraduate degree in physical therapy, and many have a master's degree. In order to practice, all graduates must be licensed by their state by passing a national certification examination.

    Physical therapists may practice in a variety of settings, including:
    • Hospitals
    • Rehabilitation centers
    • Home health agencies
    • Schools
    • Sports facilities
    • Community health centers
    • Private practice

    As related to orthopaedic conditions, physical therapists provide comprehensive training that includes, but is not limited to, the following:
    • Functional mobility
    • Balance and gait retraining
    • Soft-tissue mobilization
    • Body mechanics education
    • Wheelchair safety and management
    • Neuromuscular re-education
    • Exercise programming
    • Family education and training
    • Assistance with pain relief and management
    • Instruction in safe ambulation
  • Occupational therapist. Occupational therapy is a health care profession that uses "occupation," or purposeful activity, to help children with physical, developmental, or emotional disabilities lead independent, productive, and satisfying lives.

    An occupational therapist often coordinates the following in the care for the individual with a debilitating condition, such as an orthopaedic condition:
    • Evaluating children with developmental, neuromuscular problems in order to plan treatment activities that will help them grow mentally, socially, and physically
    • Assisting children in learning how to carry out daily tasks
    • Conducting group or individual treatment to help children in a mental health center learn to cope with daily activities
    • Recommending changes in layout and design of the home or school to allow children with injuries or disabilities greater access and mobility
    Occupational therapists work in a variety of different settings, including:
    • Hospitals
    • Rehabilitation centers
    • Schools
    • Home care agencies
    • Private practice
    • Government agencies
  • Physiatrist. Physical Medicine and Rehabilitation (PM&R), also known as physiatry, is a medical specialty that involves the process of restoring lost abilities for a person who has been disabled as a result of disease, disorder, or injury. Physiatry provides integrated, multidisciplinary care aimed at recovery for the whole person—by addressing the patient's physical, psychological, medical, vocational, and social needs. The physician who specializes in physical medicine and rehabilitation is called a physiatrist.
  • Podiatrist. A podiatrist specializes in foot care and is licensed to prescribe medication and perform surgery.
  • Nurses/nurse practioners. Nurse practioners specialized in the care of orthopaedic conditions may assist your child's physician in providing care. In addition, these nurses will help you to understand your child's treatment plan and can answer many of your questions.

Depending on the specific condition involved, other physicians and health care professionals may be involved in treating orthopaedic conditions. For example, a neurologist or neurosurgeon may assist in treating problems involving the spine because of involvement of the spinal cord. Occupational therapists may be involved in treating conditions which require rehabilitation. Occupational therapists often work in conjunction with physical therapists.

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