Who Should Treat Your Back Pain?

You may be confused about which type of doctor to see for your back pain. The answer isn't simple; it depends on your specific situation and personal preferences. Many types of specialists treat back pain, and each has different training, skills, and interests.

Doctors Who Treat Back Pain A number of different types of doctors can treat back pain.
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Specialists Who Treat Back Pain

For many health conditions, there is one type of medical specialist who coordinates the patient's care, such as a rheumatologist who treats patients with inflammatory arthritis and refers them to a physical therapist, physiatrist, etc. as needed. In spine care, there is no one specialist.

This is especially true for any type of chronic or ongoing back problem. You may find that you need more than one type of specialist to diagnose, treat, and rehabilitate your condition.

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Find the right specialist

When a back problem occurs, it is typically a good idea to first visit a primary care physician, osteopathic physician, or chiropractor. That doctor will give you an initial exam, and depending on the situation may refer you to another spine specialist if needed.

While there are no absolute rules for when to get a referral, there are some general guidelines. For example, if a patient is not getting pain relief after the first 4 to 8 weeks of chiropractic care, typically the chiropractor should recommend a referral to another practitioner.

Surgery for Back Pain Treatment Sometimes surgery, such as a lumbar laminectomy to treat spinal stenosis, is the appropriate way to treat back pain. Watch: Lumbar Laminectomy Surgery Video

If you get a referral to a specialist, it will more likely be to one of the following types of health care specialists:

    Spine surgeons will usually have training and board certification in either orthopedic surgery or neurosurgery. While no one wants to have spine surgery, for some it may be the quickest and most reliable way to address the cause of the pain.

    Also called a Physical Medicine and Rehabilitation (PM and R) doctor, a physiatrist specializes in treating musculoskeletal disorders through nonsurgical treatments. Some physiatrists specialize in pain management and through the use of injections, some focus more on physical rehabilitation, and some will do a combination of both in their practice.

Injections for Back Pain Treatment Some anesthesiologists provide pain-relieving injections, such as facet joint injections.
Facet Joint Injections Procedure Video

    Anesthesiologists (Pain Management)
    Most people think of an anesthesiologist as the person who administers and monitors anesthesia during surgery. However, many anesthesiologists actually specialize in pain management and focus on injections for diagnosing and treating spinal disorders.

    Physical Therapists
    Therapists have expertise in either physical (PT) or occupational (OT) rehabilitation for people with back pain conditions. Some type of physical therapy and rehabilitation program is a core component of most back pain treatments. Other specialists may also provide physical therapy as a core part of their practice, such as chiropractors, osteopathic physicians, and/or physiatrists.

    Clinical Psychologists
    There is a strong correlation between chronic pain and depression and/or sleep disorders. When this is the case, a clinical psychologist can help treat the depression and/or sleep problems, which in turn will help reduce the pain. While many psychologists are qualified to help in this area, it is good to know that some psychologists specialize in treating patients who have chronic pain and this may be an option for you.

In addition to the above, other practitioners may treat specific types of back pain problems: for example, for someone with back pain from ankylosing spondylitis, a rheumatologist will be the primary specialist, and may refer the patient to a physiatrist or physical therapist for physical therapy.

If it seems appropriate for you to consult another spine specialist, we encourage you to research your options as much as possible.

Integrated spine clinics bring together skills

To handle the challenges involved with diagnosing and treating back conditions, health care experts from different specialties sometimes combine their skills by working together in one clinic called a multi-disciplinary or integrated spine care clinic.

By having access to a variety of specialists, a patient can benefit from having a coordinated treatment plan and the expertise of several types of health care specialists who focus on different areas of spine care. The idea is that by working in the same practice, the doctors are able to combine their resources and knowledge.

In many communities, this same concept is approached in a different way: Instead of having all of the specialists in one clinic, each specialist maintains their own clinic, but they work together by referring patients to each other as needed.

What does this mean for you?

If the treatments you've tried aren't working well, consider researching other types of spine specialists. There may be a different type of health professional better suited to treat your condition. Also, be sure to prepare for your consultation, especially in the initial consultation.

Writing a clear, succinct description of your symptoms and the treatments you've tried can help you communicate clearly with the spine doctor. Finally, please don't be shy about seeking a second (or third...) opinion if you think it will help.

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