Because low back pain is one of the most common medical complaints, family doctors see a lot of patients with back pain. However, if four to six weeks of pain medication and exercise therapy do not help a patient, it may be time to see a specialist. Unfortunately, before they cover the cost of a specialist, many insurance companies require a referral from a family doctor or another primary care physician.
Knowing which doctor can best treat your pain is difficult among orthopedic surgeons, chiropractors, physiatrists, neurosurgeons, and osteopathic physicians.
Each takes a different approach to treatment. Because no treatment is guaranteed to provide relief, your decision will be influenced in part by your attitude toward the body and medicine and your doctor's philosophy.
1. Chiropractors
Chiropractors are frequently the first line of treatment for back pain. In 2002, approximately 15 million Americans sought chiropractic care, with approximately 40% seeking treatment for low back pain. Students must complete four years of education and training at an accredited chiropractic college, as well as a one-year internship, to become a Doctor of Chiropractic.
Make sure to select a chiropractor who is both board-certified and state licensed. Chiropractors, like osteopaths, prefer physical manipulation of the body, and chiropractic rehabilitation focuses on manipulation of the spine. Keep in mind that some practitioners make more claims about what they can cure than others. Choose a chiropractor who is forthright about your chances of success.
Osteopathic physicians hold a doctor of Osteopathic Medicine (DO) degrees, and their training is similar to that of MDs, though osteopathy places a greater emphasis on whole-body treatment and musculoskeletal manipulation. They can write prescriptions and perform the surgery just like MDs.
2. Physiatrists
MDs who specialize in physical medicine and rehabilitation are known as physiatrists. It is a relatively new specialty. The field began in the 1940s with returning World War II vets and many of the injuries they sustained. An entire field of medicine has evolved to evaluate and treat brain injury, spine injury, and amputees.
Physiatrists today often have broad practices, but some specialize in one area, such as pediatrics, sports medicine, geriatric medicine, or brain injury. With only 8,000 board-certified physiatrists in the United States, they tend to be concentrated in major cities, and many people are unaware of this specialty.
3. Surgeons
Surgeons, by definition, specialize in more invasive treatments. For example, both neurosurgeons and orthopedic surgeons perform spine surgery. Most people believe that neurosurgeons are "brain surgeons," but the majority of their operations are on the spine. Neurosurgeons must complete six to seven years of residency, as opposed to four to five years for orthopedists, and neurosurgeons tend to specialize in more delicate cases involving areas such as the lining of the spinal canal than orthopedic surgeons.
4. Osteopaths
An osteopath practices in a patient-centered, holistic manner. They take the same classes as an MD, plus up to 500 hours of musculoskeletal training.
They must pass the same exams and be licensed as an MD. Many osteopaths work as primary care physicians.
If you go to one for back pain, you can expect to hear about things like proper posture, stretching, massage, and spinal manipulation (popping your back). Their goal is to improve your mobility while also relieving pain and muscle tension.
Which Way Should You Go?
The variety of back pain treatment options available can be overwhelming. Unfortunately, there is no road map that instructs you to turn left here and right there.
A trusted family doctor's advice is a good place to start your journey. Once a serious problem, such as a tumor, has been ruled out, back pain treatment is frequently a collaborative effort. Make sure your primary care physician is aware of the various caregivers and approaches available, and then go shopping.
