10 Types of Back Pain Specialists
Back doctors are not all created equal. Numerous medical specialties exist for a person with spine pain, and unless you understand the various types, picking out the one (or ones) who can treat you effectively can quickly become overwhelming. Who do you turn to, and when? Here’s the short list.
Family and General Practitioners
When your neck or back pain first starts, your family doctor or GP is probably your best bet. She may prescribe some painkillers, give you a few exercises to do and possibly send you to a physical therapist. If she deems your problem a serious one, she’ll likely order diagnostic tests and/or refer you on to a specialist such as a rheumatologist or a neurologist.
But family doctors can be slow to include new back treatments as they come out, according to a 2006 study published in Spine Journal. Other than taking your medical history and giving you a physical exam, which are two staples of spine diagnosis, the study found that even as new recommendations were published by leading medical organizations, physicians did not adopt them into their practices.
Because of this, taking a pro-active approach when shopping for spine care may be helpful to you. One way to do this is to research possible diagnostic and treatment options before seeking the doctor. Asking pointed questions while you’re at your appointment is another way.
Pediatricians provide diagnosis and treatment for a range of childhood health problems including back pain and injuries. A pediatrician is the family doctor for a child from birth until the early adult years. If your child’s spine condition requires a specialist, your pediatrician will likely refer you.
Emergency Room Doctors
The emergency room is often the go-to destination for people with neck or back pain who need immediate medical attention. Such injuries may be due to trauma from car accidents, falls or gunshot wounds. They also include symptoms of cauda equina syndrome, for example, loss of bowel or bladder function, or if your legs grow progressively weaker.
If you don’t actually need to see a doctor immediately, though, it’s best to schedule an appointment with your provider’s office.
An orthopedic doctor is a board-certified surgeon who specializes in problems—from head to toe—of the musculoskeletal system. This includes, of course, the spine. An orthopedist might address conditions such as ruptured discs, scoliosis or other types of neck or low back pain. Some of the surgeries performed by orthopedic surgeons can also be done by neurosurgeons (see below.) Examples of such procedures include spinal fusion, discectomies and more.
A rheumatologist is a board-certified physician who treats many forms of arthritis.
A sizeable percentage of rheumatologists specialize in inflammatory arthritis; in the spine, this type of disease manifests as ankylosing spondylitis and related conditions.
Seeing a rheumatologist for spinal stenosis (which is a progressed form of osteoarthritis) is not out of the question. But in general, a rheumatologist sees patients who have symptoms of sacroiliitis, axial spondylosis, ankylosing spondylitis, and related issues.
A neurologist is a specialist who diagnoses and treats problems with the nervous system. For example, Parkinson’s disease, other disorders of the brain, spinal cord, and peripheral nerves.
A neurologist might be the doctor of choice if your back or neck pain is chronic and longstanding, as she or he is an expert in the origins of pain. A neurologist does not perform spine surgery; instead, she will examine how well your nerves function, prescribe medication and refer you to on to another specialist, as appropriate. A neurologist can be an M.D. or another licensed practitioner.
A neurosurgeon specializes in diseases and conditions of the central nervous system, and the nerves that branch out from the spine (called the peripheral nervous system.) A neurosurgeon might perform surgery on the brain, the spinal cord or on the spine itself. While neurosurgeons do provide non-surgical management of back pain, in most cases, you’ll be referred to one only after you’ve exhausted all your conservative care options.
An osteopath is board certified physician who, by oath, is bound to work in a patient-centric, holistic way. Becoming a board certified osteopath (referred to as a D. O., or Doctor of Osteopathy) requires graduation from an accredited medical school, where they receive the same curriculum as an M.D. plus 300 to 500 hours of study focusing on the musculoskeletal system. About 20 percent of medical students are training to be osteopaths. After medical school, a D.O. then completes an internship and residency program (usually alongside M.D.s), passes state licensing exams, and usually obtains certification in a specialty. Many osteopaths practice as primary care physicians.
While osteopaths are licensed to prescribe drugs and perform minor surgeries, they often look to the environment and lifestyle and perform hands-on manipulation when caring for patients.
Another type of holistically minded provider, the physiatrist is a board-certified physician specializing in physical functioning. This growing sub-specialty provides rehabilitation for all kinds of conditions and injuries from stroke to low back pain, athletic injuries and more. Quite often, the physiatrist will coordinate a patient’s team of specialists, ensuring a treatment plan that effectively addresses your specific medical needs. You might understand a physiatrist as a physical therapist M.D.
Chiropractic is a hands-on alternative medicine discipline that restores the body’s physiological functioning by aligning the spine. To do this, chiropractors treat subluxations (a term that means something different to the chiropractor than it does to a conventional medical doctor.)
Chiropractors consider their work to be a combination of art and a science. The goal of an adjustment (of a subluxation) is to improve overall health by removing interruptions to the normal flow of nerve transmission.
It’s important to recognize that the strategy of most chiropractic adjustments is to loosen; in other words, to increase flexibility. Toning and tightening are not really what your chiropractor is going for when they adjust you. If you’re loose-jointed, you have a connective tissue compromise or you have osteoporosis, chiropractic may possibly do more harm than good.
- Bishop, P.B., Wing, P.C. Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. Spine Journal. May-June 2006.