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Orthopaedic
Medicine
is a specialty of allopathic medicine founded by Dr. James Cyriax, M.D.
in London in 1929. He found that there was a void in the British health
care system when it came to the treatment of musculoskeletal disorders.
The general practitioners did not have the training, interest or time
to deal properly with these conditions. The Orthopaedic Surgeons were
mostly interested in surgical solutions to problems and the vast majority
of these problems did not have surgical solutions. The physiotherapists
and the chiropractors were the only ones interested in these problems,
but they were not trained in making a medical diagnosis.
Cyriax developed a way to make a medical diagnosis of musculoskeletal
disorders which included precise history taking and a systematic physical
examination of the patient which localized the soft tissue "lesion"
to a particular anatomical structure. He originated the concept of referred
pain which meant that the location of the pain was not always the exact
location of the lesion. His physical examination originated the concept
of selective tissue tension to localize the lesion precisely.
Cyriax also developed a system of treatment of the soft tissue lesions
that he diagnosed. His treatment methods consisted of manipulation,
massage, traction and injection. Although most present day Orthopaedic
Medicine physicians use osteopathic manipulative techniques because
they are more gentle and precise, Cyriax did introduce the allopathic
medical community to the concept of using manipulation as a medical
treatment. Cyriax's technique of cross friction massage continues to
be used today and is the treatment of choice for chronic tendonitis
at the musculo-tendinous junction. His injection techniques are also
widely used although modern Orthopaedic Medicine physicians augment
them with Prolotherapy and Neural Therapy injection techniques.
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