Non-Surgical Orthopedic Treatments in Northern Virginia

Non-Surgical Orthopedic Care at a Glance

• Goal: Reduce symptoms, improve movement and function, and help you remain active without surgery when appropriate

• Common Conditions: Arthritis, joint pain, sports injuries, tendon and ligament problems, overuse injuries, muscle pain, and selected neck and back conditions

• Treatment May Include: Activity modification, medication, physical therapy, bracing or splinting, orthotics, injections, and selected minimally invasive procedures

• First Step: Determine what is causing your symptoms before choosing a treatment

• Locations: Sterling and South Riding, Virginia

• Surgery: Considered when the diagnosis, severity of the condition, and response to nonsurgical treatment indicate that an operation may provide greater benefit

What Are Non-Surgical Orthopedic Treatments?

Non-surgical orthopedic treatments are approaches used to manage conditions affecting the bones, joints, muscles, tendons, ligaments, and related structures without performing an operation.

For many orthopedic problems, surgery is not the first—or only—treatment option.

Depending on the diagnosis, treatment may involve exercise and physical therapy, temporary activity changes, medication, bracing, custom orthotics or splints, injections, or selected minimally invasive procedures.

The right treatment depends on what is actually causing your symptoms.

A treatment that is helpful for knee arthritis may have little role in a torn tendon, compressed nerve, ankle injury, or painful shoulder.

At Arthritis & Sports Orthopaedics, we focus first on identifying the diagnosis and then matching treatment to your symptoms, health, activity goals, and individual needs.

Why Does the Diagnosis Matter?

Pain does not always identify the structure causing the problem.

For example, shoulder pain may come from a rotator cuff tendon, arthritis, bursitis, instability, or another condition. Numbness in the hand could originate from a compressed nerve at the wrist, elbow, or neck.

Even two patients with pain in the same joint may need completely different treatment plans.

Your evaluation may include a discussion of your symptoms and medical history, physical examination, and imaging or other diagnostic testing when appropriate.

Once the likely source of the problem is identified, your provider can explain which nonsurgical treatments have a reasonable role and which are unlikely to help.

What Conditions Can Be Treated Without Surgery?

Many orthopedic and musculoskeletal conditions can initially be managed nonsurgically.

Arthritis & Joint Pain

Many patients with osteoarthritis begin with nonsurgical care.

Depending on the joint and severity of symptoms, treatment may include exercise, physical therapy, activity modification, medication, braces or orthotics, and selected injections.

Not every arthritis treatment is appropriate for every joint.

Learn more about arthritis treatment.

Sports & Overuse Injuries

Many sports injuries and overuse conditions can improve without surgery.

Examples may include selected sprains, muscle strains, tendon irritation, bursitis, overuse injuries, and other conditions that do not require surgical repair or stabilization.

Treatment may focus on temporarily modifying aggravating activities, restoring mobility and strength, correcting movement limitations, and gradually returning to activity.

Learn more about sports medicine.

Tendon & Soft-Tissue Problems

Tendon problems can develop after an acute injury or gradually from repetitive loading.

Treatment depends on which tendon is involved and whether the problem represents irritation, degeneration, a partial injury, or a complete tear.

Options may include activity modification, physical therapy, progressive strengthening, bracing, selected injections, or other condition-specific procedures.

Some chronic tendon conditions may also be candidates for minimally invasive treatment when an appropriate course of conservative care has not provided enough improvement.

Hand, Wrist & Upper-Extremity Conditions

Conditions affecting the hand, wrist, elbow, and upper extremity often have nonsurgical treatment options.

Depending on the diagnosis, care may include activity modification, medication, corticosteroid injection, occupational hand therapy, custom splinting, or other supportive treatment.

Learn more about hand, wrist and elbow care.

Foot & Ankle Conditions

Many foot and ankle problems can also be treated without surgery.

Treatment may include footwear changes, physical therapy, bracing, custom orthotics, activity modification, and other condition-specific treatments.

Learn more about foot and ankle care.

Neck & Back Pain

Many episodes of neck and back pain can initially be treated without surgery.

Depending on the cause, treatment may include remaining appropriately active, physical therapy, medication, rehabilitation techniques, and selected interventional procedures.

Symptoms involving progressive weakness or other concerning neurologic findings require more urgent evaluation.

Learn more about nonsurgical neck and back pain care.

What Are the Main Non-Surgical Orthopedic Treatments?

Nonsurgical orthopedic care is rarely based on one treatment alone.

Your care plan may combine several approaches depending on the diagnosis and your response over time.

Activity Modification & Staying Active

Sometimes the first step is temporarily changing the activities that repeatedly aggravate an injured or painful area.

That does not necessarily mean complete rest.

For many musculoskeletal conditions, maintaining comfortable movement while adjusting aggravating activities can help preserve strength and mobility.

Your physician or therapist can help determine which activities are appropriate and how to gradually return to normal exercise, sports, work, or daily activities.

Medication

Over-the-counter or prescription medication may help manage pain or inflammation for selected conditions.

The appropriate medication depends on your diagnosis, health history, other medications, allergies, and individual risks.

Medication is often used to help manage symptoms while the underlying condition is addressed through rehabilitation, activity changes, or another treatment.

Do not begin or change prescription medication without discussing it with an appropriate healthcare professional.

Physical Therapy

Physical therapy is one of the most important nonsurgical treatment options for many orthopedic conditions.

A personalized rehabilitation program may address:

• strength;

• range of motion;

• flexibility;

• balance;

• walking or running mechanics;

• movement patterns;

• endurance;

• and return to normal activity.

Physical therapy may also include hands-on treatment and other techniques when appropriate.

The goal is not simply temporary symptom relief. Rehabilitation is designed to improve the physical limitations contributing to the problem and restore function.

Arthritis & Sports offers physical therapy at both our Sterling and South Riding locations.

Learn more about physical therapy at Arthritis & Sports.

Braces, Splints & Supportive Devices

Braces and other supportive devices may help selected patients protect an injured area, improve stability, reduce painful movement, or redistribute pressure.

Examples can include:

• knee or ankle braces;

• wrist braces;

• custom hand and finger orthoses;

• walking aids;

• and other condition-specific devices.

A brace is not automatically helpful for every orthopedic condition.

The type of device and how long it should be used depend on the diagnosis and treatment goals.

Custom Hand, Wrist & Finger Splinting

Custom orthoses may be fabricated for selected hand, wrist, and finger injuries or conditions when an off-the-shelf brace does not provide the necessary fit or positioning.

They can be used to protect healing structures, support painful joints, control motion, or help address stiffness as part of occupational hand therapy.

Learn more about custom hand, wrist and finger splinting.

Custom Foot Orthotics

Custom orthotics are shoe inserts designed around an individual's foot structure, symptoms, footwear, and activity needs.

They may help selected patients redistribute pressure, improve support, or address certain biomechanical problems affecting the foot and lower extremity.

Custom orthotics are not necessary for every person with foot pain.

Learn more about custom foot orthotics.

What Types of Orthopedic Injections Are Available?

Injections can play a role in nonsurgical orthopedic care, but there is no single injection that is appropriate for every condition or every joint.

The expected benefit depends on the diagnosis, location being treated, severity of symptoms, previous treatment, and individual patient.

Corticosteroid Injections

Corticosteroid injections are used for selected inflammatory and orthopedic conditions.

Depending on the diagnosis and joint involved, they may provide temporary relief of pain and inflammation.

The duration and degree of improvement vary.

Corticosteroid injections do not repair torn tissue or reverse arthritis, and repeated injections are not appropriate in every situation.

Your physician can explain whether a corticosteroid injection is reasonable for your condition.

Platelet-Rich Plasma (PRP)

Platelet-rich plasma, or PRP, is prepared from a sample of the patient's own blood.

After the blood is processed to concentrate platelets within the plasma, the PRP is injected into the selected treatment area.

PRP may be considered for certain tendon problems, sports-medicine conditions, and selected patients with knee osteoarthritis.

Evidence varies considerably by diagnosis, and PRP should not be presented as a treatment that regrows cartilage or reliably heals every orthopedic injury.

Your physician can discuss whether current evidence supports PRP for your particular condition.

Learn more about platelet-rich plasma injections.

Viscosupplementation for Selected Knee Arthritis Patients

Viscosupplementation involves injecting hyaluronic acid into the knee joint.

It has primarily been used for symptoms associated with knee osteoarthritis.

Research on its effectiveness is mixed, and it is not routinely recommended for every patient with knee arthritis.

It also should not be treated as a generic injection option for arthritis in every joint.

Your knee specialist can help determine whether viscosupplementation is reasonable based on your symptoms, prior treatment, insurance coverage, and individual circumstances.

Learn more about viscosupplementation.

What Other Minimally Invasive Treatments May Be Available?

Some patients may be candidates for procedures that are more involved than medication or physical therapy but do not require traditional orthopedic surgery.

These treatments are highly diagnosis-specific.

iovera° for Selected Knee Pain

iovera° uses controlled cold to temporarily interrupt pain signals from selected peripheral sensory nerves.

It may be considered for selected patients with symptomatic knee osteoarthritis and in certain patients around knee replacement.

iovera° does not repair knee cartilage or reverse arthritis.

Learn more about iovera° treatment for knee pain.

Tenex for Selected Chronic Tendon Problems

Tenex is a minimally invasive, ultrasound-guided procedure that may be considered for selected chronic tendon or plantar fascia problems that have not improved adequately with conservative treatment.

Potential treatment areas may include the elbow, shoulder, Achilles tendon, and plantar fascia depending on the diagnosis.

Tenex is not appropriate for every painful tendon and does not replace the need for an accurate diagnosis and rehabilitation plan.

Learn more about the Tenex procedure.

Dry Needling Within Physical Therapy

Dry needling is a physical therapy technique that may be used for selected musculoskeletal pain, muscle tightness, and movement impairments.

It is best viewed as an adjunct to an active rehabilitation program rather than a standalone treatment.

Learn more about dry needling physical therapy.

MLS Laser Therapy

MLS Laser Therapy is another supportive treatment available at Arthritis & Sports for selected musculoskeletal conditions.

It may be incorporated into a broader care plan when your healthcare provider believes it is appropriate.

Laser therapy should not replace established treatments such as appropriate rehabilitation or other condition-specific care.

Learn more about MLS Laser Therapy.

How Do I Know Which Treatment Is Right for Me?

There is no single “best” nonsurgical orthopedic treatment.

The right option depends on questions such as:

• What is causing the symptoms?

• Which structure is involved?

• How severe is the injury or joint damage?

• How long have symptoms been present?

• Which treatments have already been tried?

• Are strength or mobility limited?

• What activities are you trying to return to?

• Are there health conditions that affect treatment choices?

Sometimes the best plan is physical therapy alone.

Another patient may benefit from medication plus rehabilitation, a brace, or a carefully selected injection.

The purpose of an orthopedic evaluation is to determine which treatments fit your diagnosis rather than simply trying every available option.

How Long Should I Try Non-Surgical Treatment?

There is no universal amount of time that every orthopedic condition should be treated without surgery.

Some acute injuries need prompt surgical evaluation.

Other conditions can reasonably be managed nonsurgically for weeks, months, or longer.

Your provider will consider the diagnosis, severity of structural damage, stability of the joint, neurologic findings, symptoms, function, health, and response to treatment.

The goal is not to delay surgery at all costs.

It is to avoid an unnecessary operation when an effective nonsurgical option is available while also recognizing when surgery may provide greater benefit.

When Is Orthopedic Surgery Considered?

Surgery may be discussed when the underlying condition is unlikely to heal or function adequately without an operation or when appropriate nonsurgical treatment no longer provides enough relief.

Examples may include:

• certain fractures;

• complete tendon or ligament injuries;

• significant joint instability;

• advanced arthritis;

• severe structural damage;

• progressive nerve problems;

• or persistent pain and loss of function despite appropriate treatment.

Meeting with an orthopedic surgeon does not mean that surgery has already been decided.

An evaluation allows you to understand both surgical and nonsurgical options, expected benefits, limitations, risks, and alternatives.

Learn more about our orthopedic services.

Find Care for Your Area of Pain

The best treatment often starts with seeing the provider who specializes in the area causing your symptoms.

Hip

Our hip specialists treat arthritis, sports injuries, labral problems, tendon conditions, and other causes of hip pain using nonsurgical and surgical options when appropriate.

Explore hip pain and orthopedic hip care.

Knee

Our knee specialists treat arthritis, meniscus and ligament injuries, cartilage problems, sports injuries, and other causes of knee pain.

Explore knee pain and orthopedic knee care.

Shoulder

Shoulder treatment may include physical therapy, injections, activity modification, and other nonsurgical options depending on whether symptoms originate from the rotator cuff, arthritis, instability, tendons, or another structure.

Explore shoulder pain and orthopedic shoulder care.

Hand, Wrist & Elbow

Upper-extremity conditions may be treated with medication, injections, occupational hand therapy, custom splinting, and other nonsurgical options depending on the diagnosis.

Explore hand, wrist and elbow care.

Foot & Ankle

Foot and ankle care may include footwear modification, orthotics, bracing, physical therapy, injections, or other treatments based on the condition.

Explore foot and ankle care.

Neck & Back

Many neck and back conditions can initially be treated through nonsurgical care including physical therapy, activity modification, medication, and selected procedures.

Explore nonsurgical neck and back pain care.

Non-Surgical Orthopedic Care in Sterling & South Riding, Virginia

Arthritis & Sports provides comprehensive orthopedic evaluation and nonsurgical treatment at our Sterling and South Riding, Virginia locations.

Our practice serves patients throughout Loudoun County and Northern Virginia, including Sterling, South Riding, Ashburn, Leesburg, Reston, Herndon, Chantilly, Aldie, and surrounding communities.

Patients have access to orthopedic physicians, advanced practice providers, physical therapy, occupational hand therapy, diagnostic services, injections, and selected nonsurgical procedures through one coordinated practice.

Visit our Sterling location.

Visit our South Riding location.

Frequently Asked Questions About Non-Surgical Orthopedic Treatment

Can an orthopedic doctor treat me without surgery?

Yes. Orthopedic physicians provide many treatments that do not involve surgery. Depending on your diagnosis, care may include activity modification, medication, physical therapy, bracing, splinting, orthotics, injections, or other procedures. Seeing an orthopedic surgeon does not mean you will automatically be advised to have surgery.

What is usually tried before orthopedic surgery?

That depends on the diagnosis. For many conditions, treatment may begin with activity modification, appropriate exercise or physical therapy, medication, and other conservative options. Injections or additional procedures may be considered for selected conditions. Some injuries, however, require earlier surgical evaluation, so there is no mandatory list of treatments that every patient must complete first.

What is the best non-surgical treatment for joint pain?

There is no single best treatment for all joint pain. The right option depends on whether symptoms are caused by arthritis, a tendon or ligament injury, inflammation, instability, nerve irritation, or another condition. An accurate diagnosis is more important than choosing a treatment based on pain location alone.

Can injections help me avoid surgery?

An injection may reduce symptoms for certain conditions, but it cannot correct every structural problem. Some patients can manage their condition nonsurgically for a long time, while others eventually need surgery. The goal should be appropriate symptom and function management rather than promising that an injection will permanently prevent an operation.

Does physical therapy work for orthopedic pain?

Physical therapy is useful for many orthopedic conditions and can help improve strength, mobility, movement, balance, and function. Whether it is appropriate—and what the program should include—depends on the diagnosis.

Do I have to exhaust every non-surgical treatment before surgery?

No. Treatment decisions are individualized. If an injury requires surgical repair, a nerve problem is progressing, a fracture is unstable, or another condition is unlikely to improve adequately without surgery, waiting through every available nonsurgical treatment may not be appropriate. Your orthopedic provider can explain the reasonable options for your condition.

Schedule a Non-Surgical Orthopedic Evaluation

If joint pain, an injury, tendon symptoms, or another orthopedic problem is making it difficult to work, exercise, sleep, or perform everyday activities, an evaluation can help determine what is causing the problem and which treatment options make sense.

You do not need to decide whether you want physical therapy, an injection, or another procedure before your appointment.

Our team can evaluate your condition first and help build a treatment plan around your diagnosis, health, activity level, and goals.

Request an appointment with Arthritis & Sports Orthopaedics in Sterling or South Riding, Virginia.