From temporary aches to disabling chronic pain, lower back pain affects millions of people each year. According to the National Institute of Neurological Disorders and Stroke, (NNIDS) about 80% of people will experience lower back pain at some time in their lives. There are many kinds of back specialists, so if you're asking yourself, "Which type of doctor should I visit for lower back pain?," you'll want to read on.
What Causes Lower Back Pain and When Should I Get Help?
Orthopedic back and spine treatment usually starts with conservative approaches that include pain management, physical and occupational therapies, and rehabilitation. The American Academy of Orthopedic Surgeons (AAOS) reminds us that chronic back pain can get worse if left untreated, so it's important to visit a doctor early on who can start you with the right treatment.
Some of the most common causes of lower back pain include:
This condition is an abnormal curvature of the spine which is most common in teenagers, although older patients may develop it as well. The abnormal spinal curvature places pressure on the nerves, triggering lower back pain and symptoms in the legs such as neuropathy (pins and needles).
Injuries from Overexertion
People of any age risk lower back problems if they overstretch or injure ligament fibers and muscles. Lower back injuries occur when the person is not properly warmed up for sports or physical labor after long periods of inactivity. Stiffness and soreness in the lower back are common after overexertion, but these symptoms frequently disappear on their own after a few days.
- Worn Discs: As a person ages, the discs in the back deteriorate over time due to wear and tear. Sometimes disc tears are painless, while in other cases they trigger disabling pain that goes on for years.
- Slipped or Herniated Discs: Disc herniations can occur when a person performs twisting, pulling, bending, or lifting movements. When the center or nucleus of an injured or worn disk bulges out towards the spinal canal, it places pressure on the spinal nerves and causes pain.
A herniated disk in the lower back may place pressure on the nerve root that leads to the leg and the foot. This condition is called sciatica, frequently characterized by pain in the buttock which runs down the leg.
When the spinal discs experience enough wear and tear, they can collapse and cause osteoarthritis. The body may respond to these changes by growing extra bone in the form of bone spurs. Spurs can cause the spinal canal to narrow, which leads to spinal stenosis. This condition places pressure on the cord and the spinal nerves.
Spondylolisthesis also occurs as a result of aging and the general wear and tear on the disks. Your joints and ligaments have more difficulty keeping the spine in the proper position as they wear out, while the vertebrae at the base of the spine become more mobile and slide around. If the vertebrae slip too much, they can press on the spinal nerves.
Back pain can indicate the presence of serious conditions in special cases. The AAOS website instructs you to consult your primary care physician if you have lower back pain that doesn't go away, or if you an arterial or vascular disease.
Types of Doctors Who Treat Lower Back Pain
Primary Care Providers
A trip to your primary care physician is typically the first place to start when you have lower back pain. The primary care provider can take x-rays and perform other diagnostics, treat the problem, and if necessary, refer you to a spine specialist. You can choose among the following primary care providers to treat your lower back pain:
- Family practice doctors provide primary care for the whole family.
- Chiropractors do not hold medical degrees, but they may serve as primary care providers while they treat conditions through manual manipulation of the spine.
- Doctors of osteopathic medicine (DO) are trained in all areas of medicine and use a whole-body approach to primary care.
- Pediatricians specialize in treating children.
- Gynecologists specialize in women's health and focus on issues of the female reproductive system.
- Obstetricians (OB/GYN) also focus on the female reproductive system, specializing in pregnancy and childbirth.
- Internists or doctors of internal medicine specialize in the diagnosis and treatment of complex medical problems, and frequently treat patients that have more than one chronic medical condition.
If the pain in your lower back persists, or if your primary care provider sees a problem that needs specialized treatment, they are able to refer you to a specialist. Their are several types of spine specialists that are trained to treat different causes for back pain:
- Anesthesiologists: Treat and diagnose spinal pain through medical pain management.
- Neurologists: Evaluate and treat disorders that affect the nervous system.
- Rheumatologists: Specialize in the evaluation and non-surgical treatment of inflammatory conditions triggered by the immune system.
- Physiatrists: Specialize in physical medicine and rehabilitation, evaluating and treating a wide variety of disorders which interfere with normal physical functioning.
- Orthopedists: Specialize in evaluating and treating conditions of the musculoskeletal system. Not all perform surgery.
- Surgeons: When conservative treatments like pain management and physical therapy don't work, surgery may be performed to relieve pressure from nerves in the spinal cord and correct other problems which cause chronic, disabling pain.
Physical therapists and occupational therapists concentrate on restoring movement in everyday functioning. Clinical psychologists may also be part of the medical team in order to help the patient control anxiety, depression, and other mental health conditions known to aggravate chronic pain.
How Orthopedic Treatment Can Help
Orthopedic spine specialists who don't have a specialty in orthopedic surgery use non-surgical methods to treat patients who suffer from lower back pain. They specialize in musculoskeletal disorders that affect the lower back in people with sports injuries and other traumatic injuries, as well as disorders and diseases of the spine. They may work with other spine specialists mentioned above to manage the lower back pain and restore movement.
Non-surgical Orthopedic Treatment
Orthopedists who are non-surgeons are an invaluable part of a person's medical team when evaluating and treating sports injuries and other trauma to the musculoskeletal system. They may prescribe medications, order the appropriate therapies, and recognize when surgery is necessary.
When the patient's lower back pain does not respond to several weeks or months of treatment, or there is chronic, disabling pain involved, your orthopedic spine specialist will be able to recommend a top orthopedic surgeon who specializes in operating on the lower back. Surgery is used for extreme cases, and having an orthopedist on your medical team as a consultant from the early stages of your treatment can help insure that you receive the necessary treatment.
How to Find an Orthopedist for Lower Back Pain
Your primary care physician may recommend a leading orthopedist in your area. You can also ask your friends who they recommend, and search the website of the American Orthopedic Association (AOA) or the AAOS. Once you have found an orthopedist, you'll want to reach out to them to get more information on their specialty, experience, and background. If they are an orthopedic surgeon, it's important to inquire about their training and experience all of which can be done through a consultation.