What Every Back Pain Patient Needs to Know

The old adage "if all you have is a hammer, everything looks like a nail" applies in spades to treatment of back pain. Doctors tend to have a way of looking at a patient's problem in terms of what their skills can do - a surgeon evaluates patients in terms of whether or not they should have surgery, a pain medicine anesthesiologist will consider an injection, and a chiropractor will evaluate patients for manual manipulation therapy. So when a back pain patient goes to three different doctors, he or she will typically get three very different treatment recommendations.

So what's a patient to do?

Well, on Spine-health.com we first and foremost advocate getting educated - simply go to some patient information sites, make sure the information is reliable, and research your symptoms, diagnosis, treatment options - so that when you talk to your doctor you're informed and able to ask to the right questions and have some context in which to evaluate the responses. That is definitely the first thing you should know. But there's one other thing you should know too: with all the complexity involved with back pain diagnosis and treatment, it's sometimes not feasible for one doctor to know enough to be able to make the right recommendations. You could consult with three or four doctors for their opinions, but this is quite a hassle, and if you're in a great deal of pain then you might not want to wait that long. Here's where integrated back care comes in: you can go to a spine clinic that has all of the specialists working together under one roof.

What does integrated spine care mean for you?

• No more losing your MRI scans while they're being transferred from one clinic to another - your MRI's, other tests and medical file all stays in one place
• No more having to listen to a surgeon tell you why a chiropractor can't be trusted, or vice-versa - they've already agreed to work together, so you know they trust each other and value each others skills
• No more having to find physicians who specialize in back pain on all your own and go for several opinions - you know that the different specialists (physiatrists, physical therapists, chiropractors, surgeons, etc.) all specialize in spine care, and with integrated care they should all be working on your case.

Traditionally, the practice of medicine has been an individual effort, with one or two person clinics, but as the field of medicine has progressed there are lot more treatment choices available for many disease entities and collaboration among physicians as become more important. This is particularly true with back pain, where each specialty brings a certain skill set to the treatment of patients with complicated problems such as chronic low back pain. Integrating the different specialities gives patients options for treatment that are not be as readily available in single specialty practices.

If these same specialists are collaborating with one another in an integrated clinic (and not competing against each other), they will be much more inclined to offer a patient more treatment options in a more fair and balanced fashion. Also, they are more likely to learn from the other specialists what does and does not work for any particular diagnosis.

In my practice, we believe the patient also benefits from focusing on non-surgical care first. Patients are usually first diagnosed and treated by a chiropractor, physiatrist or physical therapist, or by a combination of these specialists. If they do not find enough pain relief with these treatments, or if their pain is so bad that they are unable to function, then they are referred to a spine surgeon in our practice for evaluation and possibly surgery.

I'm interested to read your thoughts.