Back Pain Specialist

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Back Pain Treatment

Published: 04 December 2015

The term “back pain specialist” covers such a wide spectrum of potential professional people around the world and when you research the topic online you will find many different varieties and disciplines offering guidance and advice. So this article provides an introduction into the type of disciplines out there and where they can help you in the management of your back pain.

Choosing the right back pain specialist

How do you choose the right pain support specialist for your condition?

Let’s start with an overview of the therapies containing back pain specialists. What should you look out for when picking the correct professional person for you!! However - just before we go on, I’d like to point out two things:

1. Depending where you are in the world, you will find different “labels” used for different specialists e.g. General Practitioner in the UK is generally the same as Family doctor or Family Physician in the US. Or - Physical Therapist in the US is generally the same as Physiotherapist in other parts of the world.

2. Some of the areas below may be either lightly regulated or unregulated. So, please only use a practitioner who can demonstrate their qualifications AND comes highly recommended for your particular condition.

• General practitioner/Family Doctor: A general practitioner is in my opinion the “gatekeeper” to your overall health. Most of us start our treatment by going to our Doctor when we first encounter back pain. I encourage this. However, some GPs are experts in back pain management and others are not! Some refer you correctly to the professional to help you, whereas others will not.

  Ultimately, the term general practitioner says it all! They are doctors who have a general knowledge in all areas of health, but are only experts if they further their studies and interests in certain fields of health over their practising years. So, keep this in mind when you attend your GP, and keep your mind open to other possibilities of treatment (see below)in the overall management of your back pain.

• Physiotherapist/Physical Therapist: In the UK, Ireland, Cananda and Australia a Physiotherapist must be “chartered” to warrant the value of their title. Don’t be afraid to ask your Physio if they are chartered and, if they are not, go elsewhere if you have a pain in your back. Also, remember that to become a Chartered Physiotherapist they need to study hard for full time for four years. However, after that it is up to each individual Physio to acquire further knowledge in back pain by doing regular recognised courses.

Ongoing training is required for a physic to remain their chartership. I have averaged at least 12 days a year further training in back pain since I qualified in 1996. I am now confident in the management of back pain that I provide to my patients, but it took a lot of work to get here. So do not presume all chartered Physiotherapists are specialists in back care - ensure that they have done some post qualifications in the subject!

• Osteopath: An osteopath is another health care professional frequently involved in the management of back pain. I have done some very good osteopathic courses but, as with my own profession, have noticed that some Osteopaths are better and more qualified than others. Seek an Osteopath that has a lot of experience in back pain and has studied it in depth.

• Chiropractor: Chiropractors generally manipulate your spine. Although not all do! This is where you here a click or a clunk as they move your bones around. Although this can work well, their treatment does not suit all back pain patients. If you have osteoporosis or other joint conditions it is not advisable to let chiropractor or other health care professional to manipulate your joint!

• Acupuncturist: An acupuncturist trained well is a great person to know! Acupuncture is gentle and non-invasive, safe and effective. However, I consider Acupuncture to be an adjunct to the overall management of your back pain and not a sole treatment. Accupuncture combined with Physiotherapy is often my treatment of choice! However, your choice of acupuncturist is the key!

• Pilate’s instructor: Although I am a Pilate’s instructor, I do not consider a Pilates instructor to be a back pain specialist. The training is not medical. If you have back pain you are better off to attend a Physiotherapist or Physical Therapist who uses Pilates as they will be able to understand your back pain and advise you on which Pilates exercises are suitable for your condition.

  Pilates carried out both well and appropriately is a fantastic support in the management of back pain. Alternatively, allow your physiotherapist to refer you for specific Pilates program taught by a Pilate’s instructor.

• Craniosacral Therapist: While Craniosacral Therapy can be a wonderful treatment to assist in the management of back pain, particularly in stress and tension relief, the field is largely unregulated. This means you need to exercise great caution when choosing a therapist - check their qualifications and experience. I practice craniosacral therapy myself as an adjunct to physiotherapy and when used in conjunction with medical and physiotherapy care it is a great tool and can have some magic results!

• Massage therapist. I have a wonderful massage therapist working at my clinic. However I assess my back pain clients fully prior to their massage. I then advise my massage therapist on what muscles I want them to massage. If you have back pain and have a general massage it may make you worse! This is due to the muscles in your back tightening to protect your back from further damage and if they are massaged the result can be PAINFUL!

• Neurologist: Is a well-qualified specialist doctor who is an expert in serious back pain management. If you have nerve-associated back pain then a neurologist will be your next appointment if your physiotherapist cannot release the nerve that is trapped or damaged. The neurologist will assess the degree of nerve involvement and advise you on the appropriate treatment - be it surgery or further physiotherapy.

• Orthopaedic surgeon: In the past, the orthopaedic surgeon was very involved in back pain management and surgery. They are less frequently used now as Physiotherapy and neurology are recognised as an easier expertise combination. However, if you see an orthopaedic doctor they will hopefully send you on the right road!

• Anaesthetist: An anaesthetist is a doctor who puts us to sleep for operations! However, they are also experts in nerve blocks which are a valuable treatment for chronic back pain that has failed all conservative treatments. Your General Practitioner will refer and guide you.