This blog is part two of a two-part series about navigating back pain. Here the Penn Spine Center outlines the specialty providers involved in back pain treatment.
The Penn Spine Center also offers an online assessment test to help you learn when it is time to see a doctor for your back or neck pain.
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:
- 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