Back pain is one of the most common ailments for adults in the United States, with 8% of the population suffering from chronic back pain.¹ Not only does it affect your quality of life, but it can also be concerning when you don’t know what’s causing it.
There are doctors and other healthcare professionals who specialize in treating lower back pain. Their expertise can help you deal with this condition so you can improve your quality of life.
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While acute (short-term/recent) lower back pain often resolves itself, sometimes there are red flags² you need to look out for.
If you have any of these symptoms alongside your back pain, it’s best to seek medical attention:
Recent severe trauma, including a car accident or falling from a height
Excruciating pain around your mid-back, rib cage, or between the shoulders
Previous cancer diagnosis or recent unintentional weight loss
Any swelling in your back
Difficulty moving your legs or walking
Tingling, numbness, or loss of sensation in your legs
Loss of bowel or bladder control or difficulty urinating
Abdominal pain, chest pain, fever, or chills
Pain that does not improve with rest and worsens at night or with exertion
If you don’t have any of these symptoms, you may wait a few weeks to see if your back pain resolves with rest. Note, however, that resting too much can exacerbate back pain, so keep up with your daily activities if you can.
Gentle exercise can improve your symptoms, such as walking, yoga, or stretching. Anti-inflammatory painkillers are another option for relieving pain and reducing any swelling. However, if your symptoms don’t improve, there are specialists you can see.
Physiatrists are also known as Physical Medicine and Rehabilitation physicians (PM&R). They are musculoskeletal specialists³ who can provide diagnoses, sometimes with the aid of ultrasound and electrodes (EMG and NCS) if needed.
Additionally, physiatrists can offer treatment options such as prescribing medications or formulating a non-surgical treatment plan. They take a holistic approach and ensure you are physically capable of progressing through the treatment options they prescribe.
While physiatry sounds similar to physical therapy, there are distinct differences. Unlike physiatrists, physical therapists do not diagnose or formulate a non-surgical treatment plan.
As they have a good understanding of common musculoskeletal ailments, physical therapists can create restorative exercises and treatment plans for patients. They can also apply TENS, heat and cold therapies, which can be great for an instant, short-term relief for lower back pain.
Rheumatologists specialize in diagnosing and treating arthritis and other diseases that affect joints, muscle, and bones.⁴
There might be concerns that your back pain stems from arthritis, e.g., ankylosing spondylitis. Rheumatologists can diagnose and initiate the appropriate treatment for your condition.
This specialist knocks you out before surgery, but that’s not their only job. They also specialize in pain management, so they can be a valuable addition to your back pain care team.
An example treatment from an anesthesiologist is an epidural steroid injection, which reduces discomfort associated with chronic back pain.
A self-explanatory job title, spine surgeons specialize in spinal operations, including neurosurgery and orthopedic surgery.
Surgery is typically the last choice for treating back pain, as specialists can manage many conditions without it. In rare cases, your care team will recommend surgery if your condition is only getting worse.
The best course of action for treating your back pain is to consult your primary care physician first. Your doctor will conduct a physical exam and ask questions about your symptoms. After this, they will refer you to the right specialist or a multi-disciplinary team if they think you need treatment.⁵
Unfortunately, some doctors are quick to dismiss pain as “all in your head,” with minorities⁶ and women⁷ often facing this issue. You may need to persevere to get the correct treatment, so don’t be afraid to ask for a second opinion if you believe your healthcare provider is being unfairly dismissive.
Hopefully, you won’t have this experience, but it’s something to bear in mind. Advocating for yourself can be hard, but you deserve fair and compassionate treatment.
Most acute lower back pain will resolve in a few weeks with rest and simple measures such as heat packs and simple analgesia (Panadol, Nurofen). However, if your back pain is severe or chronic, you might want to consider speaking to your primary care doctor about the next best step. If you notice any red flag symptoms, seek medical advice as soon as possible.
Don’t be afraid to seek a second opinion if you feel your doctor is not taking your concerns seriously.
Chronic back pain | Georgetown University Health Policy Institute
Overview: Back pain | NHS
What is the difference between physical therapy and physiatry | American Academy of Physical Medicine and Rehabilitation
Rheumatology | NHS
Is bias keeping female, minority patients from getting proper care for their pain? | The Washington Post
Women may experience more pain than men, but receive less treatment for it | Duke University Promis Lab
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