It can happen at any time. A simple twist to the left too suddenly, or you just slept “wrong”. Low back pain has so many different causes it can be impossible to predict when it is going to happen to you. And the data says that, statistically speaking, it will happen to you at some point in your life. 80% of us will experience this condition during the course of our existence.
Most cases of back pain resolve on their own, given a few weeks. Doctors now recommend against bed rest, instead prescribing gentle regular movement and exercise, along with an over-the-counter pain reliever like ibuprofen if you need it to manage the pain. It is important to keep moving and return to regular activities as soon as possible. But sometimes it doesn’t go away. And that can be a scary thing.
If your low back pain lasts more than a few weeks and it is severe, it is a good idea to pay a visit to your healthcare provider. If you have back pain as well as any of the following red flags (See our blog on Red Flags and Low Back Pain) you should seek medical care as soon as possible:
Loss of bladder or bowel function
Loss of strength
Numbness or tingling
Unexplained weight loss
History of cancer
Had a fall or trauma
Assuming you do not have any of these red flags, you now decide to go and see a doctor. But who should make an appointment with? Who treats low back pain? Often people might schedule a visit with their primary care doctor, which is an excellent place to start. Unfortunately low back pain is notoriously hard to diagnose and treat so your primary care provider may provide you with a recommendation to see a specialist.
In this article we take a look at the types of doctors or specialists who treat low back pain and break down what they do. Hopefully this will give you a basic understanding of how certain specialists treat low back pain and help you to decide which might be the best fit for you.
Physical therapists are health care professionals who help injured or ill people improve movement and manage pain. Physical therapists work with patients of all ages who have medical problems or health conditions that limit their ability to go about their daily activities. Physical therapists are key players in rehabilitation or preventive care for patients with injuries, illnesses, or other chronic conditions.
Physical therapists can help to develop fitness and wellness programs to restore function to injuries such as ACL tears, help with stroke patients to recover movements again and assist in remobilizing patients who have been bed ridden for a prolonged amount of time. The physical therapist designs recovery plans around patients’ specific needs to help reduce the need for surgery, reduce pain and improve function and mobility.
A physical therapist will take down your medical history and perform a thorough assessment and evaluation in order to determine a diagnosis and rehabilitation plan. During treatment a physical therapist may use exercise, hands on therapy such as massage or spinal manipulation, or use equipment to help with mobility and pain. They will also provide education around the injury or illness to help patients know what to expect from the recovery process.
Typically patients with low back pain will be advised to complete around four weeks of physical therapy before considering things like surgery. Non-surgical interventions are always preferable as many patients will find relief with these interventions. Physical therapy is recommended by all international guidelines for the first line treatment of low back pain.
Acupuncturists are healthcare professionals who practice a type of medicine based on an ancient traditional Chinese form of healing. They help patients evaluate and treat pain. Acupuncturists treat patients of all ages, from tiny babies, to the elderly. Acupuncturists must be licensed and they are regulated under the Acupunturist Regulations in The Health Professions Act 2010.
The traditional art of acupuncture is based on the idea of energy in the body. Super thin needles are inserted into the skin at various pressure points throughout the body that are believed to stimulate the central nervous system . These needles target the energy or “qi” in the body to enable healing and reduce pain. The needles do not cause pain, they are simply there to conduct energy. These biochemical changes in the body’s energy stimulates the body’s own natural healing.
Most acupuncturists work in private offices and clinics but as this way of medicine grows in popularity and acceptance, they are starting to be included more and more into traditional western medicine organizations like hospitals, cancer treatment centers, addiction centers and sports injury treatment facilities.
An orthopedic doctor is a board-certified surgeon that specializes in musculo-skeletal issues within the body. These can include issues with bones, tendons, joints, and ligaments. They work with dislocated joints and things like hip and knee replacement surgeries. They also work with issues related to the spine such as scoliosis, ruptured discs, and other types of back pain.
Chiropractors are highly trained healthcare professionals who specialize in treating conditions that affect the structure of your body. They often identify and treat neuromuscular disorders such as TMJ (temporo-mandibular jaw disorder) and back pain. Chiropractic treatment basically means treatment that is done by hand. Rather than using drugs or surgery to treat conditions they focus on manual adjustments of body parts to get them in the right position. They believe that when your body is in proper alignment, you will be able to experience healing along with improved function and reduced pain.
Chiropractors often take a holistic approach to healing, getting to know their patients thoroughly, seeing them as more than just their illness or symptom.
Chiropractic adjustments can help relieve pain from bones, muscles, joints, or connective tissue, and these can be done either by hand, or using a special device called an activator. Chiropractors believe that when patients’ bodies are properly aligned, symptoms are alleviated and quality of life is significantly improved. They can treat everything from back pain, to babies with colic, and everything in between.
Physiatrists specialize in nonsurgical options for back pain, using either interventional pain management or physical rehabilitation. They are also often known as physical medicine and rehabilitation physicians (PM and R). Physiatrists often specialize in certain aspects of physical medicine such as neuromuscular disorders, pain management, or sports medicine.
Like chiropractors, physiatrists are trained to see their patients in a holistic way, giving them a more comprehensive view of a patient’s condition. Physiatrists are qualified to perform diagnostic testing for many conditions and are often experts in things like EMG (electromyography), NCS (nerve conduction studies), and musculo-skeletal ultrasounds. These tests can often help the physiatrist accurately diagnose the root cause of back pain, and can help in forming a comprehensive treatment plan. Physiatrists often explore some of the latest non-surgical techniques for treating conditions, such as prolotherapy, stem cell treatments, or plasma injections.
Rheumatologists are internal medicine doctors that are trained in treating rheumatic and autoimmune diseases that affect the musculoskeletal system. Conditions such as ankylosing spondylitis, rheumatoid arthritis, osteoarthritis gout are often managed by a rheumatologist. The diseases they treat are similar to those managed by orthopedists but rheumatologists do not perform surgeries.
Your rheumatologist will gather a complete medical history and then possibly order additional laboratory tests as well as x-rays, ultrasounds or CT scans to help identify the underlying cause of the pain and inflammation that you are experiencing. Once they have all of the necessary information they will put together a comprehensive treatment plan that may include treatments such as medications, physical therapy or joint/tendon injections.
As you can see, there are many different types of doctors who may be able to assist with your low back pain condition. Each of these doctors takes a unique approach. With low back pain being so difficult to diagnose and treat, sometimes a collaborative approach is required and many of these doctors are trained to work together for the benefit of the patient. As we learn more about low back pain, and as new treatments and technologies emerge for its management, many of these healthcare professionals may offer even more unique and cutting edge treatment options.