There is no shortage of health-care providers who treat back pain. Below is a partial rundown of who does what.
Doctors are divided into M.D.'s, who graduated from a traditional medical school, and
D.O.'s (doctor of osteopathic medicine), who have pretty similar educational backgrounds, except with training in "osteopathic
... manipulation," which can be a quick, easy and safe way to decrease your back pain. Problem is, most D.O.'s don't actually practice much osteopathy with manipulation. They are under the same rules and financial pressures as M.D.'s, so they're likely to do what most M.D.'s will do: write you a prescription and send you to see someone else.
Orthopedic surgeons end up seeing bad backs a lot and they will usually give you sound advice on what to do. Most of us don't really specialize in low back pain, however; our focus is on surgery of other joints.
There are both orthopedic and neurosurgeons who call themselves "spine surgeons," but curiously, few of these docs want to see patients with low back pain — at least not right off the bat. Many in my area will not even give an appointment to a patient unless he or she has already had an MRI, which means they have to have seen some other doctor first.
About 1 patient in 50 with a backache actually needs an operation, and you should not be thinking about spine surgery for your pain unless at least one, or better two, qualified doctors have recommended it. Unless you have already had a back operation in the past, you probably should call someone other than a spine surgeon when your back hurts.
Neurologists end up seeing a good bit of back pain. Of the docs who treat low backs, they are typically the most likely to use oral steroids, which can be effective — but there are some scary side effects. If the pain is greater in your legs than your back (a condition known as sciatica), or if you have numbness or weakness in your legs or feet, seeking a neurologist's care is a good bet.
A physiatrist is, overall, the most appropriate doc to see for back pain. Physiatrists do everything but operate, and their training is largely in what you need: the diagnosis and treatment of bad backs. They like to do spinal injections; they almost always order physical therapy; they often use oral medications. Physiatrists comprise a varied bunch however, so you would be wise to get a recommendation from a doctor who has previously referred patients with good results.
Generalists in medicine, like family practitioners, internists and emergency room doctors, see a lot of back pain patients. They can prescribe all the appropriate tests and medications as well as physical therapy — but they are not likely to direct your physical therapy like an orthopedist or physiatrist would (the good news is that physical therapists usually do a pretty good job of deciding your treatment on their own). General practitioners vary a lot in terms of how involved they get with a low back pain case, but the internist is my second pick (after physiatrist) for the doctor to see first with a backache.
Next: Chiropractors Versus Physical Therapists MORE
