Back pain is one of the most common reasons for patient visits to a doctors office and patients often wonder who they should see for back pain treatment. Below is a list of some of the most common types of doctors seen for back pain and what one might expect on a visit:
Family Physicians, General Practitioners, Internists
These are the most frequently visited physicians for low back pain. The medical doctor may be called upon to make an initial diagnosis. After taking the history, the medical doctor can review the systems of the body to determine the cause of pain and determine any risk factors. This group is experienced in the treatment of acute low back pain, they are able to rule out the serious problems such as organic disease, cancer and infection. In the absence of high risk factors listed above, this group of physicians may elect to treat low back pain with medications, ergonomic recommendations and chiropractic or physical therapy referral. If the patient’s symptoms fail to respond, they will often perform additional testing or imaging and/or refer the patient to a specialist.
Chiropractors, Chiropractic Physicians
Chiropractic is the largest non-surgical and drugless healing profession and is the third largest healthcare profession in the United States after medicine and dentistry. Many patients with low back pain obtain relief using chiropractic care. The Agency For Health Care Policy Reform says that chiropractic treatment and exercise is often the most beneficial form of treatment for acute low back pain. Chiropractors perform manipulative treatments or spinal adjustments and treatments which may also include passive modalities like cold laser therapy, electrical stimulation, ultrasound, stretching, exercise, rehabilitation and nutritional counseling. Chiropractors do not prescribe medications and do order special diagnostic testing when needed.
This group of medical doctors specializes in the treatment of musculoskeletel injuries as low back pain. They are medical doctors who practice physical therapy, physical medicine and rehabilitation. The therapy they prescribe often includes exercise, therapeutic modalities and hot and cold packs. They prescribe medications and order other laboratory or diagnostic testing as indicated. They may also include physical therapists and occupational therapists as part of the treatment plan and sometimes have them as part of their staff. Some physiatrists work in pain management clinics (see below).
These physicians specialize in the treatment of disorders of the nervous system. They perform detailed neurological exams, and order tests to diagnosis causes of pain and weakness.
Pain Management Specialists
Pain Specialists and Anesthesiologists see patients who fail to improve under the more conservative approaches but for whom surgery is not an option. Their treatments may include medications and injections, nerve blocks, implantable pain devices or stimulators. Pain Psychologists are also included in this group for the evaluation and treatment of the psychological component of low back pain.
Neurosurgeons and Orthopedic Surgeons
These physicians concentrate in the surgical treatment of low back and lower extremity pain. Spinal attempts to maintain or enhance stability to the lumbar spine, while taking pressure off of the nerves to relieve pain and increase function.