Getting Better Spine Care
June 6, 2011
By: Stephanie Burke
If you have had back pain for a while, you probably already know that navigating the healthcare system to find the right doctor or treatment can be quite a challenge. While the process will probably always be frustrating at times, playing an active role - asking pertinent questions and sharing the decision-making with your care provider - can help make it easier.
Ask the Referring Doctor Questions
Please note that there are market forces and personal forces (such as friendships and familiarity) that can influence which physician you are referred to. When you have been referred to a particular specialist or spine surgeon, it’s a good opportunity to ask questions about why he or she has been recommended. For example, a good bottom-line question to ask your physician is “would you have this spine surgeon operate on one of your own family members?” See Getting a Referral to a Spine Surgeon.
Explore the Wide Variety of Spine Specialists
There is a wide range of spine specialists who treat back pain. One specialty that is not that well known is physiatry - physical medicine and rehabilitation. Physiatrists are often a good choice for providing conservative care (e.g. physical therapy, injections and medications) and for managing a patient’s overall spine care program. Regardless of the specialty, it’s a good idea to select an individual who specializes in spine medicine, as not all doctors or therapists in a specialty have that focus. See What is a Physiatrist? and Specialists Who Treat Back Pain.
Research the Treatment that is Recommended
Knowing certain pieces of information about a treatment can be very valuable. For example, did you know that epidural steroid injections done without fluoroscopy have the medication misplaced in 13-34% of cases? If you knew that, you’d probably ask for fluoroscopy before having an epidural. We encourage you to do your own research so that you can ask your doctor important questions.
Focus on the Clinical Diagnosis of Your Back Condition
It bears repeating that an accurate clinical diagnosis is essential to the success of any treatment you choose. This is not the same as the findings on an MRI scan or other radiographic test, which are only a part of the diagnostic process. For example, if you have a degenerated disc and a lot of pain, you may be considering spine fusion surgery. However, disc degeneration is a natural part of aging and the finding of a degenerated disc may be incidental. If this is the case and there is another cause of the back pain, a spine fusion surgery would not eliminate the pain and you could have had a very large surgical procedure for little or no benefit. See Getting an Accurate Back Pain Diagnosis.