When a friend with bad back pain asks me where to get help, I respond that personally I would start with getting a diagnosis from a physiatrist who specializes in back pain. Here is why:
I like the general orientation of physiatry, which is to provide enough pain management to enable patients to make progress with physical therapy and rehabilitation—which is often the best long-term solution. Practitioners in other specialties may also have this focus, but my impression is that physiatrists are most likely to have this focus.
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A physiatrist is usually well qualified to provide you with a combination of medical and therapeutic treatments for back pain. Some specialize more in injections and medications, and some more in rehabilitation, but most have received extensive training in both areas.
Typical treatments physiatrists offer include:
- Physical therapy and rehabilitation
- Prescription pain medications and anti-inflammatories
- Heat and cold therapy
- Spinal injections (for diagnostic and therapeutic purposes)
- Education on ergonomics, posture, and prevention
Most physiatrists have a strong surgical referral network. This means if you really do need surgery, they would be able to refer you to a surgeon who they know has done a good job for other patients.
Many physiatrists are part of an integrated clinic or network of clinicians to provide coordinated care, e.g. chiropractors, pain management specialists, physical therapists, surgeons, and psychologists who specialize in pain. For complex cases, this is often the best way to go.
Again, let me repeat: I realize that clinicians in many specialties have many of the above qualities, and I am not saying that every physiatrist is good at treating back pain. I am highlighting this specialty’s training and approach to treating back pain because, in general, this seems to be a medical specialty that many people don’t know about, and I would like those seeking back pain relief to know about this option.
Physiatry may also be referred to as physical therapy and rehabilitation.