The musculoskeletal system includes the bones, joints, muscles, ligaments, and tendons. When seeking care for these structures, patients often look for a specialist broadly referred to as a “bone doctor.” The most common specialist is the orthopedic surgeon, a physician dedicated to treating physical and mechanical issues of the body’s structure. Different medical problems require different specialists; some focus on structural repair, while others concentrate on systemic disease. The appropriate doctor depends on whether the condition results from trauma, wear-and-tear, or a complex inflammatory disorder.
The Surgical Specialist: Orthopedic Surgeon
The orthopedic surgeon (MD or DO) is trained to address mechanical damage and structural issues within the musculoskeletal system. Their focus involves diagnosing and correcting conditions that require surgical intervention to restore form and function. Orthopedic surgeons manage a vast range of problems, from acute injuries like complex fractures and sports-related ligament tears to chronic degenerative conditions such as severe osteoarthritis.
A core component of orthopedic practice is performing reconstructive surgeries, most notably total joint replacements for the hip, knee, or shoulder. They also specialize in orthopedic trauma care, which involves the surgical fixation of broken bones using plates, screws, and rods. Not all patients require surgery, as these surgeons also utilize non-surgical treatments like injections, medication, and physical therapy to manage pain and improve mobility.
Many orthopedic surgeons pursue additional fellowship training to specialize in a specific body area or procedure. Subspecialties include hand and upper extremity surgery (e.g., carpal tunnel syndrome), spine surgery (e.g., herniated discs), pediatric orthopedics, sports medicine for athletic injuries, and orthopedic oncology for bone tumors. This provides highly targeted expertise for various patient needs.
The Non-Surgical Specialist: Rheumatologist
In contrast to the orthopedic surgeon, the rheumatologist specializes in diagnosing and treating systemic conditions that affect the joints, muscles, and bones. Their training focuses on inflammatory, autoimmune, and metabolic disorders, which often manifest as widespread or chronic joint pain. Rheumatologists do not perform surgery; they manage complex diseases through medication, targeted injections, and lifestyle modifications.
A significant portion of a rheumatologist’s practice centers on autoimmune disorders, where the immune system mistakenly attacks healthy tissues. These conditions, such as rheumatoid arthritis, lupus, psoriatic arthritis, and gout, cause inflammation and damage to the joints and connective tissues. Treatment plans aim to control systemic inflammation and suppress the immune response to slow disease progression and preserve joint function.
Rheumatologists also manage metabolic bone diseases, particularly complex cases of osteoporosis, characterized by low bone mineral density and increased fracture risk. They use specialized medications to strengthen bone structure and monitor the patient’s condition. If joint damage requires structural replacement, the rheumatologist refers the patient to an orthopedic surgeon for evaluation.
Related Medical Professionals and Diagnosis
Treating bone and joint issues often involves collaboration with several other specialized medical professionals. Radiologists play a foundational role in diagnosing musculoskeletal conditions using various imaging modalities. They interpret standard X-rays, computed tomography (CT) scans for complex bone structures, and magnetic resonance imaging (MRI) for soft tissue damage.
Radiologists also perform dual-energy X-ray absorptiometry (DXA) scans to measure bone mineral density and diagnose osteopenia or osteoporosis. Their accurate interpretation of these images is fundamental to guiding treatment decisions made by surgeons and rheumatologists.
Another important non-surgical specialist is the Physical Medicine and Rehabilitation (PM&R) physician, also known as a physiatrist. These doctors focus on restoring function and reducing pain for patients with musculoskeletal and nervous system impairments. PM&R specialists oversee comprehensive rehabilitation plans, utilizing non-operative techniques like therapeutic injections and prescribing physical or occupational therapy to enhance mobility and independence.
For problems concerning the lower extremities, a Doctor of Podiatric Medicine (DPM), or podiatrist, provides specialized care for the foot and ankle. Podiatrists treat bone conditions in this area, including fractures, deformities like bunions and hammertoes, and arthritis affecting foot function. They offer a range of treatments, from custom orthotics and non-surgical care to surgical reconstruction for severe deformities.