Back pain relief: Who to call and when

Back pain relief can be hard to come by, with the pain ranging from annoying to debilitating. Factors such as the duration and severity of your pain, the degree to which your function at work and home is impacted and your pain threshold determine when you need to see a health care provider. These factors also determine who you see first in your spine care journey.

Provider pointing to spine image, discussing back pain relief options

There are many different types of spine care providers available to help you treat back pain.

“Standard back pain and neck pain is very common, especially acute flare-ups, so the first question becomes is it acute pain or chronic?” said Tyler Laber, orthopedic surgery physician assistant at Marshfield Clinic Health System. “People with chronic pain have a higher degree of comfort level in that they know what to expect with regard to their pain. They know the triggers, how to treat acute flare-ups and they know when it changes and something’s not right.”

In general, if you’re feeling pain that doesn’t seem to lessen, or it continues to worsen over two to four weeks, it’s time to see a health care provider.

Who to see

If you have a relationship established with a primary care provider, that’s the best place to start. If you’re dealing with something more, your primary care provider will likely refer you to a spine care specialist or physical therapist. The majority of back pain can be managed without surgery.

“Most back pain responds well to conservative treatments including oral medication that may be anti-inflammatories or muscle relaxers, activity modification and therapy,” Laber said.

If you’re feeling shooting pains, numbness, tingling or weakness in your arm or leg, in conjunction with your back or neck pain, you may be referred to a spine surgeon for back pain relief.

“When you’re feeling numbness in your legs, you’re typically compressing nerves in your lumbar spine,” Laber said. “If it’s one or both arms, you’re typically compressing nerves within your cervical spine or neck.”

Your provider will work with you to determine a treatment plan or next steps in your care.

Types of spine care providers

You could be referred to a number of different spine care providers depending on your type of pain and what is causing it.

Physiatrist –
- Physical medicine and rehabilitation focuses on restoring a person’s original functional level after an injury or illness. This type of provider will use treatments like medication, injections, acupuncture, rehabilitation exercises and other treatments.
Pain management –
- A pain management team may include physicians, psychologists, nurse practitioners or advanced practice clinicians, working together to develop a treatment plan that manages the underlying cause of chronic pain. Treatment can often include medication management, spinal cord stimulator trials and implants, injections, radio-frequency ablation and educational coping skills.
Physical Therapist –
- Physical therapists offer a variety of services to reduce pain and improve bodily function. Those include aquatic therapy, dry needling, neurological rehabilitation and strength and endurance programs.
Chiropractor –
- Chiropractors use hands-on methods to adjust a patient’s spine, reducing pain, improving function and restoring range of motion. They also develop plans for patients to improve ergonomics and lifestyle changes to avoid future pain.
Orthopedic spine surgeon –
- Spine surgeons surgically correct issues including scoliosis, adult degenerative deformity, spinal stenosis and radiculopathy which involves symptoms like pain, numbness, tingling or weakness affecting a patient’s arms and legs. Surgery can be minimally invasive.

Many times a patient may see one spine specialist and then be referred to another. This comprehensive network between health care providers is essential to providing the best back pain relief, treatment and outcome for the patient.

If you have questions about back pain, talk with your primary care provider.