The question was raised as I treating a patient the other day, “What do you mean, Conservative Care.” What a good question! The definition of “Conservative” can be used in many ways, but for me and most of my professional colleagues, the definition concerning “Conservative treatment” or “Conservative care” is a non surgical, basic to progressively advanced care. As a podiatrist this includes many aspects of care that are pieces of a puzzle to make my patients happy and healthy.
What is the purpose or goals of conservative care?
The first goal is to treat and hopefully eliminate pain, or the symptoms that are causing discomfort and aggravation. The second goal is to eliminate the problem, sometimes referred to as the pathology, or the disease. These references to the problem may be distasteful to some, but in the medical field are commonly used.
What are some of the conservative care treatments that most all podiatrists (including me) endorse?
Good shoes, stretching, periodic anti-inflammatories, strapping and taping, and a little tincture of time. This is the beginning of treatment that I start with, with most of my patients. After the initial visit, and hopefully establishing a relationship of trust and addressing the two goals of eliminating pain and problem, the treatments become more focused. This may include additional modalities or staying a course with the initial treatment. Additional treatments may involve the use of other medications, injections if the patient is willing, support devices such as orthotics, braces and boots, physical therapy, tens units, and many other options that I provide for the selection of the individual.
When is surgery necessary?
This depends on the type of problem that the patient needs help with. My feelings towards this topic are that some injuries or problems require immediate surgical intervention. These problems include fractures that are displaced or irregular, infections that are advanced and limb threatening, and suspicious bone and soft tissue tumors.
A detailed and logical reason should be given before anything surgical is performed and informed consent is vital. In conclusion, conservative care usually is exhausted before surgery is performed. Understanding of what the treatments is, and why it is performed, should be communicated between the patient and their medical care provider to insure optimal results.
Conservative care usually begins at a basic level and graduates to a more advanced level depending on the course of the problem and the desires of the patient for treatment options.