Why see a physiatrist for low back pain?

Low back pain is an extremely common ailment and one of the top reasons individuals visit their physicians. While sometimes back pain is temporary, resulting from minor injury and healing within a few days or weeks, all too often, back pain becomes a chronic issue. Many types of doctors and other professionals are consulted about this condition — including orthopedists, chiropractors, neurosurgeons and massage therapists — but physiatrists, who are medical doctors trained in physical medicine and rehabilitation, are often the practitioners most capable of treating low back pain.

What does a physiatrist specialize in?

In addition to being trained in physical medicine and rehabilitation, physiatrists focus primarily on conditions of the spine, brain, and musculoskeletal system, the system comprised of bones, joints, muscles, ligaments, tendons, and nerves.

Advantages of Seeing a Physiatrist for Low Back Pain

Physiatrists are medical doctors who may further specialize in one aspect of Physical Medicine and Rehabilitation, such as neuromuscular disorders, sports medicine, or pain management.

Advantages to consulting with a physiatrist include that:

  1. Physiatrists are not surgeons and will work to exhaust all noninvasive therapies before recommending a surgical solution.
  2. Physiatrists treat patients of all ages.
  3. Physiatrists are focused on improving function whether pain results from injury, illness, or congenital disability.
  4. Physiatrists are highly trained in diagnosis and treatment planning that involves other professionals, such as physical or occupational therapists and doctors in other specialties.¬†This gives them the advantage of performing collaboratively to the patient’s benefit.
  5. Physiatrists are trained in a holistic manner to treat the whole patient, not just some particular part of the anatomy.

What types of treatments and procedures do physiatrists perform?

Physiatrists have expertise in a great many areas and are fully qualified to perform the following diagnostic and treatment procedures:

  • EMG (electromyography): in which fine needle electrodes are inserted in muscles to assess muscle or nerve dysfunction
  • NCS (nerve conduction studies): in which electrodes are used to record motor and sensory responses to electrical stimuli to locate a nervous system lesion
  • Peripheral joint injections: which are administered to help diagnose and treat bone and soft tissue disorders, such as knee osteoarthritis, rotator cuff tendinopathy, and epicondylitis
  • Trigger point injections: lidocaine injections are administered to treat trigger points believed to be sources of chronic myofascial (soft-tissue) pain
  • Musculoskeletal ultrasound: used for decades as a modality to deliver deep heat in therapies, ultrasound is now being used increasingly in an outpatient setting to supplement musculoskeletal evaluation of soft tissue abnormalities in commonly examined joints and structures and to guide injections
  • Spasticity management: spasticity is a common complication related to CNS injury (e.g., SCI, stroke, cerebral palsy). Physiatrists treat spasticity by using oral antispasticity agents, botulinum toxin injections, phenol injections, and intrathecal baclofen pump management to improve function and decrease pain.
  • Interventional spinal therapeutics: image-guided spinal diagnostics and injections, including discograms, interlaminar and transforaminal epidurals, and radiofrequency ablations, spinal cord stimulation, vertebroplasty/kyphoplasty, and intrathecal pump placements. These techniques are being used as a nonsurgical pain-relieving intervention for back pain and radiculopathy (pain or numbness down the limbs)
  • Other procedures performed by some physiatrists include acupuncture, prolotherapy, platelet rich plasma injections, and autologous stem cell treatments

More and more patients are turning to physiatrists for treatment of their low back pain, finding that these specialists are well-equipped to evaluate the sources of discomfort and to relieve low back pain in a variety of innovative, noninvasive ways.

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