Back Pain: Which doctor should you see?

In the majority of cases, patients are able to experience back pain relief over time, with or without treatment. In some cases, simply taking it easy, and letting the muscular sprains and strains heal themselves will be sufficient for the symptoms to resolve themselves. In other cases, simple do it yourself treatments may help in the healing process, or to speed it along. However, you should consult with your doctor just to make sure that your back pain is not a symptom of a more serious medical problem before you decide to rest just rest your back or embark on your own self-help treatments.

Not often, but sometimes, back pain may be a symptom of a more serious spinal problem or disease, such as cauda equina syndrome, arachnoiditis, or endometriosis. There are some symptoms that go along with back pain that are improbable, but warrant an examination and possible medical imaging from a physician. It's appropriate to see a doctor immediately if you have pain that occurs after an injury or severe fall, doesn't improve when you're lying on your back or is accompanied by one or more of the following:
  • Difficult of painful urinating
  • Fever with unintentional weight loss
  • Numbness, weakness, or pain in one or both of your legs.
In those situations, you seek the care and evaluation of a doctor or appropriate medical specialist to rule out a serious spinal injury or condition.

Which doctor should you see?
Less than 1% of the causes of back pain are due to trauma to the spinal cord itself or fracture to one or more of the spinal vertebrae. Unless you have been in a major accident, or are suspected of having a spinal cord injury or fracture of the spine, your foray into back pain therapy will usually begin with your primary care physician. Your primary care physician, though probably not a spine specialist, will be able to quickly determine if you are suspected of having a major injury, he can prescribe anti-inflammatory medications, and he can order X-Ray images as well as more sophisticated tests, such as MRI, CT, and even laparoscopy to get a more direct look at some of the structures in the abdominal and thoracic cavities. Usually, MRI and CT images will be read by a radiologist and orthopedic surgeon or MD spine specialist. Then your primary care doctor will have the medical images to look at himself, as well as the review of the other doctors who have read the tests. Once the primary care physician has all available information, his typical options will be.
  • If the results of the tests and examination show negative results for a serious spinal condition, he may prescribe no therapy, low level pain relief drugs (analgesics) , or narcotic medications meant to be a short term treatment for the problem.
  • The doctor may find results indicative of a more serious medical problem, or a less serious back condition that can be resolved or treated with physical therapy. If he suspects either of the latter, he may write a referral for the appropriate doctor.
The following doctors specialize in arthritic or degenerative back conditions, or other back problems related to the structures of the spine and muscles and tissues that support the spine.
  • Rheumatologist
  • Physiatrist (rehabilitation doctor)
  • Osteopathic physician
  • Neurologist
  • Orthopedic surgeon
  • Neurosurgeon