In most cases, a primary care doctor or chiropractor can help you resolve the problem.

 

Published: November, 2017 by Harvard Health Letter a publication of Harvard Medical School

Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. “In most cases, you won’t need a specialist,” says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

When pain strikes

There are many causes of low back pain. Some of the most common include an injury to a muscle or tendon (a strain), an injury to a back ligament (a sprain), and a herniated or “slipped” disc (when the soft material inside of a disc between spinal bones leaks and irritates nerves). Many of these issues will eventually resolve on their own.

But some causes of low back pain, such as a narrowing of the spinal canal (spinal stenosis), may require a specialist. “A referral makes sense when conservative measures have failed to address your back pain, symptoms aren’t improving or are getting worse, or there’s a suspicion that surgery might be needed,” says Dr. Shmerling.

Where to turn

Since you shouldn’t try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. “Both can serve as the entry point for back pain,” says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women’s Hospital. “And 35% to 42% of people with their first episode of back pain will consult a chiropractor.”

Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. “A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor,” Dr. Kowalski explains.

The next step

If you do need a specialist on your team, there are many experts who can help, depending on your needs. You may be referred to any of these:

A neurologist, a doctor specializing in treatment of the nervous system. “Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions,” says Dr. Kowalski.

A physiatrist, a doctor with expertise in physical medicine and rehabilitation. “This may be helpful for back pain related to a sports injury, if surgery is not needed, and when medications are not working,” says Dr. Shmerling.

A rheumatologist, a doctor who treats diseases of the joints, muscles, and bones. “Referral is most appropriate when there is inflammation of the joints in the back, or if the back pain might be related to an inflammatory disease, such as psoriatic arthritis,” explains Dr. Shmerling.

A physical therapist, a licensed therapist who can help you strengthen back and core muscles to absorb pressure on the spine.

A pain management physician, a doctor who can prescribe medications, provide injections, and consider other approaches. “People with symptoms that aren’t responding to treatment are great candidates for pain management, such as injections or procedures to smaller joints in lower back,” says Dr. Kowalski.

An orthopedic spinal surgeon or a neurosurgeon who primarily does spine surgery, if surgery is likely needed for severe, unrelenting pain that may be due to a disc or spinal column problem.

Keep in mind

It may take several types of tests, such as x-rays, MRIs, and blood tests, to determine the exact cause of your back pain.

And you may need more than one expert managing your back pain. It just depends on the situation. “Most people who see more than one expert have more than one problem or have not improved with prior treatments,” says Dr. Shmerling.

But for back sprains, strains, and herniated discs, a visit to your primary care physician or chiropractor may be all it takes to feel better. Make that initial call if back pain is interfering with your day.

Image: © Creative_Outlet/Thinkstock

Chiropractic is vastly misunderstood among the general public. It is inevitable that we can’t fully understand the depth of a certain area of study unless we immerse ourselves in it. This is precisely the reason we hire an accountant, a lawyer, and a realtor to take care of our respective needs in their field of expertise. Clearing the nervous system of interference by using a specific and safe adjustment is the domain of a chiropractor. The chiropractic profession was built upon principles and a philosophy that was founded over 100 years ago and is now the 2nd largest health care profession in the world.  Somewhere during the professions’ history, a chiropractor has been portrayed as someone you see “to get your back cracked to cure your pain.”  This is as far from the truth as imaginable.

Your children are an excellent example of the amazing intelligence of the nervous system and the body.  Two cells meet, divide and continued to divide. The nervous system (brain, spinal cord, and nerves) were the first system to develop upon conception and continued to develop a heart, lungs, eyes, ears, little fingers and toes in perfect harmony. Your child was born exhibiting one of the greatest miracles of life.

It is the nervous system that controls all other systems. It regulates the heart rate and rhythm, it allows the lungs to coordinate breathing, giving essential oxygen to the brain and body. It controls the gut and digestion, senses, and regulates all hormones and chemicals that are integral to your bodies homeostasis. A chiropractors job is to locate, analyze, and remove any interference in your nervous system — the master system of your body — to facilitate your body’s innate wisdom to heal itself. We were never programmed to be sick. Symptoms such as pain, sneezing, coughing, runny nose, etc., are our body’s perfect adaptation to warn us that something is out of balance and needs to be changed. Chiropractic is a physiological approach to health care while medicine is a pathological approach to sick care.

Any interference in your nervous system is termed “subluxation” in the chiropractic world, which is literally broken down as sub-meaning less, lux-meaning light. Subluxations arise from stress, whether emotional, physical or chemical. Do you have any stress in your life? Many of the foods that we eat today are pumped full of hormones, antibiotics, sprayed with herbicides and pesticides, and pose a significant stress to our bodies. A physical stress is described as any type of trauma, such as falling down, sports injuries, car accidents and often times birth traumas. Emotionally, our home life, workplace and other relationships can produce stress in our lives. All of these stresses are processed by our nervous system and handled the best way our body knows how, but often times manifest in a physical form, resulting in displacement of the spinal column. The chiropractic adjustment is a specific force put into the body to clear your nervous system from any subluxations (interference), allowing your body to function to its optimal potential, becoming a greater expression of life and allowing our inborn intelligence to heal itself.

Chiropractic is a way of treating the body as a whole to aid your body in functioning to its maximum potential, embracing a unique approach to create balance in your nervous system without the use of drugs or surgery—therefore optimizing your inborn intelligence to move closer to health, rather than away from disease.  There are a wide spectrum of chiropractic specialties and techniques, but the fundamental philosophy is the keystone from which the profession was built.  Find a chiropractor with whom you feel a connection and comfortable while keeping in mind that your body is its own greatest doctor.