Approximately 90% of all adults will experience some type of back pain in their lifetime. It is the second-most common reason for people to visit their primary care physicians. Fortunately, the natural history of back pain suggests a favorable outcome in most cases.
Many individuals are not familiar with the term “Physiatrist”. A Physiatrist is a medical doctor, who has completed residency training in Physical Medicine and Rehabilitation (PM&R) after completing medical school. A Physiatrist is able to provide expertise in musculoskeletal medicine and pain management. Physiatrists have specific training in the conservative, non-surgical management of back disorders, such as a herniated disc, in order to avoid surgery.
Rarely do lower back injuries require surgical intervention. A PM&R physician will organize and execute a comprehensive conservative program to avoid surgery, if possible. Typically, with conservative management, including medications, physical therapy and education on proper lifting mechanics, the body will heal on its own and lower back pain will resolve. This approach can take up to six months but with aggressive non-surgical management, the likelihood of surgery and long-term disability is significantly reduced. Patients are usually able to remain working, with appropriate restrictions, while undergoing their treatment regimen.
A Physiatrist can identify associated risk factors and work to eliminate these and minimize the risk of recurrence. These risk factors include:
While focusing on an organized, functional approach to the back pain patient, a Physiatrist is able to determine when electro-diagnostic (or EMG) studies are appropriate and also complete these tests.
A Physiatrist is also able to prescribe medications, physical therapy and educate patients on general health issues which will have an impact on their back pain. There is no single medication, modality or exercise that is solely effective in the management of low back pain, and it is the role of the Physiatrist to integrate and coordinate different therapies in order to maximize functional outcomes.
In a survey on back pain published in New York Magazine, patients reported greater long-term relief from low back pain when treated by PM&R physicians than any other medical specialist or health care professional, including orthopedists and chiropractors.
As the management of back pain and the majority of musculoskeletal disorders trends toward conservative management, the field of Physical Medicine and Rehabilitation will continue to grow as it has done over the past decade. Many health care networks are recognizing Physical Medicine and Rehabilitation as the primary care physicians for all musculoskeletal disorders and back pain is certainly included within this designation.
So if you are experiencing back pain, and wish to avoid surgery (if possible), then make an appointment to see a Dr. Reecer.
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