How about  Diagnose Yourself?

When is Appropriate time to Visit  Emergency Room?

Back specialist for Complex Symptoms?

Doctor’s Personality – how much it counts?

Government Guidelines on Treatment

What Activities Doctor Exam Consists?

What Test Needs To Be Perform For Back And Neck Pain?

Most back pain will subside within a month of its onset. But if the pain is bad enough, many people don’t want to wait around to see if it will stop. They may also worry that ignoring the pain may make a potential problem worse. So how do you decide if you need a doctor and even what type of doctor to see?

If you have health insurance coverage from an HMO or PPO, nurse call lines may be available. The nurses that work these call lines can listen to your symptoms and give you some information that may ease your mind about the back or neck pain you are experiencing. They can even provide you with some home remedies to try like those mentioned in the chapter called First Aid Remedies for Back Pain.

Larger hospitals often offer these medical advice lines as well. Nobody working one of these call lines can diagnose your problem over the phone, but they can offer you information regarding the symptoms of you back pain. They can also let you know if you can wait to make an appointment and see a doctor or if you should seek help immediately at a hospital emergency room.

How about  Diagnose Yourself?

While pain is a pretty obvious symptom that something is wrong with your back, you have no way of knowing what is causing the issue and how severe it is. Surprisingly, how badly it hurts doesn’t necessarily determine how serious the problem is. While a herniated disc is a much more serious injury than a muscle strain, a muscle strain can be considerably more painful.

There are some serious symptoms that can help you decide if it’s time to see a doctor, or more specifically a spine physician.

1. If your pain is radiating from the back downward into a leg, this can be an indicator of a disc problem.

2. Disc problems can also be characterized by what is known as “foot drop”. This means that the muscles are so weak that you cannot raise the front of your foot. The toe may also drag when you walk. Anyone with this symptom should see a doctor right away.

3. Perhaps the worst sign and the strongest indicator that a doctor is required is loss of bladder or bowel control. This is an indicator of neurological damage that may become permanent if not treated quickly.

When is Appropriate time to Visit  Emergency Room?

Emergency rooms aren’t always the best answer when you have an onset of back pain. The doctors that work in the average emergency room are not specialists in back pain. Their specialty is usually emergency medicine and it is likely that your treatment will consist of a prescription for muscle relaxants or pain pills and a referral to a spine doctor. If the pain is in your lower back only and there is no spread to a leg or arm, it is probably more expedient to call the office of a specialist directly rather than making a trip to the emergency room. The specialist may be able to see you that day after hearing what your symptoms are.

Most health insurance plans don’t consider back pain to be an emergency and won’t pay for the emergency room visit under these circumstances.

Along with symptoms described in the previous chapter like foot drop or loss of control of your bladder or bowels, there are two other good reasons to seek medical attention at an emergency room.

1. If it is an evening or weekend and you are in terrible pain, an emergency room may be your only recourse rather than waiting till the doctor’s office is open. Be prepared for a long wait since back pain is often not considered an emergency situation.

2. If you have any type of fall, accident, or event that has caused sudden injury and pain to your neck or back, you should go the ER right away if you can’t get in to see a spine physician. When trauma has brought about the pain, an X-ray may be required to ensure that nothing has been broken.

What Kind of Back Doctor Should You See for Attack of Acute Pain?
Acute pain is severe pain that comes on suddenly as your body’s way of telling you that something is wrong. If you have an attack of acute back or neck pain, there are a number of different options to consider when choosing a physician.

PRIMARY CARE DOCTOR
While there a number of different types of medical specialists that treat back and neck issues, often your family doctor, a primary care provider, can perform a physical check that can rule out potentially serious problems. A good percentage of health insurance plans require you to see your family doctor before you go to a specialist. The primary care doctor often must give you a referral.

But more and more health plans are allowing patients to go directly to the specialist. This cuts down on the time the patient may have to take off work when he or she is allowed to bypass the visit to the family doctor. In many cases a specialist can actually save the insurance companies money by not requesting unnecessary tests like MRIs.

In some cases it can be easier to get an appointment more quickly with a specialist than with a primary care doctor. In larger cities there is a shortage of this type of physician, making the waiting time longer to get an appointment. It is also true that primary care physicians lean towards treating the back pain with medication rather than recommending exercise and physical therapy.

CHIROPRACTORS
The manipulations of a chiropractor are often quick and effective relief for acute back pain. Add in the fact that wait times to be evaluated by a chiropractor are often much shorter than primary care doctors or other back specialists and you may find that chiropractic treatment is one of the better options. Chiropractors also seldom treat back pain with drugs that merely mask the symptoms.

OSTEOPATHIC PHYSICIANS
A D.O., or doctor of osteopathy, is part medical doctor and part chiropractor. Many people think of them is a happy medium between holistic care and traditional medicine. While they can prescribe medication, they can also provide chiropractic manipulations to treat the back pain.

ORTHOPEDIC SURGEONS AND NEUROSURGEONS
Doctors trained in these specialties can treat just about any type of back and neck pain, especially those that require complex surgery. The work they do in the operating room to treat back and neck injuries is talked about more in the section called “What Actually Happens in Back Surgery?”.

OTHER OPTIONS
Other specialists that can treat back pain include physiatrists, neurologists, and rheumatologists.

Back specialist for Complex Symptoms?

There are facilities that specialize in nothing but back pain. If you have had the symptoms of neck or back pain on-going for months and no one has been able to give you a diagnosis or treatment that works, a center like this may be the best option for you. They are equipped to handle the more complex cases.

Besides spine physicians, spine centers employ other specialists skilled in a variety of disciplines that include physical therapy, exercise physiology, injections, diagnostics, chiropractic, and biofeedback.

Neurology is another specialty found at a spine center. Neurologists are experts in the nervous system, including its function, structure, spine abnormalities, and brain and nerve tissue. Testing that they perform can be the key to evaluating the source of the pain.

Doctor’s Personality – how much it counts?

The personality of your doctor can be very important to your recovery. After all, if you are suffering from chronic pain, he or she may be in your life for a while. Your doctor must be sympathetic to your pain in order for you to trust their treatment philosophy. You want your doctor to spend at least 15 minutes with on the initial examination, listen to everything you know about your back pain, and not to perform a lot of costly tests that aren’t necessary. Your doctor should also thoroughly explain to you the cause of your pain and what the first step in your treatment should be.

To many people, the doctor’s manner is not important. In fact there are those who like it when the doctor is firm and speaks with authority, while others want the doctor to make them a part of the entire process from diagnosis and treatment till the pain is managed.

Government Guidelines on Treatment

Recently some of the country’s best experts in back pain got together to define and document the way a back patient should be processed through the medical system. This is included in a publication called “Clinical Practice Guidelines: Acute Low Back Problems in Adults: Assessment and Treatment”. This set of guidelines makes it necessary for all physicians to codify and provide justification for all back pain treatments.

This publication also defines the most dangerous back pain symptoms and “red flags” them as possibly requiring surgical solutions. It makes a distinction between these types of symptoms and those that require more conservative treatments.

What Activities Doctor Exam Consists?

At your first visit to the doctor you can expect to be asked a lot of questions about your pain. In order for the physician to determine the cause of your pain and the type of treatment it will require, these questions are necessary. This is just a small example of the types of question you will be asked:

· Is the pain on both sides or only on one side?
· Is the pain dull, sharp, burning or throbbing?
· Were you injured in an accident?
· Is there any numbness or tingling?
· Are there any things that make you feel better?

You will probably also be asked questions about any prior incidents of back pain.

The doctor will also try to find the exact location of the pain and ascertain how your movement is effected. He or she will likely ask you to bend forward and backward, stand on your toes and then on your heels, and to lift your legs straight up while lying on your back. The doctor may move your legs into different positions and possibly touch your legs with different objects to test the sensory nervous system.

This initial visit is what will determine if you need further tests before you are prescribed a treatment for your pain.

What Test Needs To Be Perform For Back And Neck Pain?

The initial exam, your medical history, and further tests that may be required are used to determine the source and cause of back pain as well as the treatment. Evidence that the initial exam turns up may determine that you need one or more of the following tests.

· CT scans and MRIs – These both can show the soft tissues such as a ruptured disc, narrowing of the spinal cord known as stenosis, nerve roots, and muscles. These tests are very valuable to a doctor in making a diagnosis.

· Myelograms – In this test the spinal canal is injected with a dye in order to make problems like herniated discs, spinal abscesses, or spinal cord tumors more visible in an X-ray.

· Discograms – Discograms are often performed before back surgery to remove a herniated disc. A dye is injected into the disc and an imaging device is used to see if the dye moves beyond the disc space to a spot near a nerve. The idea is to recreate the pain.

Other tests that may be required or bone scans or a nerve study called electromyography. X-rays are very rarely required unless an accident or fall is the likely cause of the injury.

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