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Navigating Back Pain – Part 2: Who Treats Back Pain?

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Dr. Alexis Tingan of Penn Sports MedicineRead part two, written by Dr. Alexis S. Tingan, from the Penn Spine Center, who shares with us what types of doctors can help treat and cure back pain. 

Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back pain.

Navigating Back Pain

As a spine specialist, we know as many as 85% of all adults experience some form of back pain. With a familiarity of the most common causes of back pain and the importance of treatment, let’s consider the specialty providers who treat back pain and choose which is best suited for your unique circumstances.

Can a primary care physician cure my back pain?

Primary care physicians can and very often do treat general back pain. Primary care physicians can prescribe medications to help with back pain as well as prescribe physical therapy which improves overall function. Primary care physicians will refer to a spine specialist when "red flag" symptoms are encountered or if there is a patient that is not initially improving in pain and function after an initial round of medications and appropriate physical therapy.

Primary care physicians can:man holding lower back

  • Recommend a spine specialist such as a surgeon, physiatrist, or pain medicine specialist
  • In rare or more severe cases, refer you to the nearest emergency room
  • Prescribe medication

We recommend you visit a primary care physician first so they can navigate you to the most appropriate specialist. Primary care physicians will determine if a consultation with a spine surgeon is needed or if your ailments can be treated through non-surgical interventions, such as medication or physical therapy.

Non-Surgical Spine Specialists

Not all spine specialists are surgeons. After visiting your primary care physician, you may learn surgery is not the best option for you. In this case, you’ll need to visit a non-surgical spine specialist: a physiatrist, also called a physical medicine and rehabilitation (PM&R) specialist, or a pain medicine physician.

Physiatrists

Physiatrists treat both acute and chronic back pain. Primarily, physiatrists are physicians who focus on how a patient’s back affects his or her overall lifestyle. Treatment is aimed at improving pain to restore function, not just treating pain merely to have the pain go away. While physiatrists do not perform surgery, they train with spine surgeons and physical therapists during residency, allowing them to understand the many different treatment options for back pain.

A physiatrist can help you by:

  • Formulating detailed diagnoses
  • Prescribing physical therapy
  • Referring you to the appropriate physical therapist or physical therapy office
  • Performing X-ray guided back injections including epidurals, facet joint injections, and radiofrequency nerve ablations

Pain Medicine Physicians

Most pain medicine physicians are trained in either anesthesiology or physiatry and complete an additional year of fellowship training in pain medicine. As the name suggests, the focus of pain medicine is to alleviate pain from a variety of causes.

A pain medicine physician can:

  • Prescribe and manage medications used to treat back pain
  • Offer traditional back injections
  • Perform more advanced procedures such as implanting pain pumps
  • Prescribe physical therapy 

While addressing your back pain, you may be referred to a radiologist as well. Some radiologists are trained to perform many of the interventional spine procedures, but they typically focus on performing procedures and not evaluating and treating patients in an office setting.

Treating Back Pain

To best treat back pain, a comprehensive, team-based approach is most successful. With the help of your provider, be sure to find most appropriate treatment for your lifestyle and health needs. Options may include:

  • Surgery
  • Medications
  • Injections
  • Physical Therapy
  • Lifestyle changes including weight loss and smoking cessation
  • Chiropractic care
  • Osteopathic Manipulative Treatment (OMT)
  • Yoga
  • Acupuncture
  • Massage

Stay tuned for our upcoming blogs exploring the variety of back pain treatment options.

About this Blog

Get pain management and fitness tips from our orthopaedic doctors, stay up-to-date on the latest advancements in the orthopaedics field, and hear from patients like you, who achieved what once seemed impossible. 

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