A medical doctor (MD) is a physician who has graduated from medical school and is licensed to practice medicine and to diagnose the causes of diseases that are affecting patients. A medical doctor who treats patients with back pain may be at a patient's side at any step in a patient's treatment program that includes the physical examination, medical tests, back treatments, surgery, and prescriptions for patients. A medical doctor may be involved at any point in a patient's back pain cause: from the initial physical examination, the ordering of medical tests, diagnostic evaluations, and prescriptions for medications, physical therapy, and back surgery. A medical doctor may be the person who decides that the patient is a candidate for back surgery, or he or she may be the person who performs the surgical procedures.
Before we get into more specifics about specialty practices for MDs, we should make a mention about other physicians who are also qualified to practice medicine in the United States. Both medical doctors and osteopaths (doctors of osteopathy) are both qualified to practice any branch of medicine in the United States. Medical doctors graduate from medical school and doctors of osteopathy (DO or D.O.) graduate from osteopathic medical school. Both of these types of physicians may enter into any medical specialty, including surgery and neurosurgery. One of the differences among these two qualified professionals is the additional amount of training that osteopaths obtain in practicing manipulative medicine. Osteopathic manipulative medicine is in some ways similar to chiropractors in that osteopaths identify structural imbalances in the body and perform hands on manipulations of the soft tissues to remove these imbalances. Osteopaths also have a broader knowledge of alternative therapies than MDs do, and may be more likely to encourage their patients to pursue these therapies as complementary therapies of conventional treatments.
Types of Back Doctors
Primary Care physicians (M.D.): In some cases, a patient's back may suddenly seize up on them to the point where even small movements become excruciating. In other cases, patients have experienced a significant trauma and require emergency medical attention. In most cases, though, the first person that patient's see for their back pain is their primary care physician. Your primary care physician (PCP) may be able to diagnose and treat your condition on his/her own, or may be a relay station to direct you to an appropriate specialist, such as a physiatrist, spine surgeon, or neurologist. Your primary care physician may be able to directly prescribe physical therapy or medications to reduce the inflammation of the affected structures in your lower back. Types of primary care physicians include pediatricians, gynecologists, obstetricians, internists, and family practice doctors. Though your PCP may not be an orthopedic specialist, he or she will be qualified to order any medical test, and to read the medical images and other results of these tests. The PCP may be able to gain a lot of diagnostic information about your condition through their physical examinations and recording of your patient history. Your PCP will be able to differentiate whether or not your condition is the result of sprain and strain types of injuries or a more serious back problem.
Orthopedists: An orthopedist (orthopedic doctor) is a physician who diagnoses and treats problems of the musculoskeletal system. These physicians identify problems with the spine, joints, muscles, ligaments, and tendons. Back conditions that orthopedists may diagnose or prescribe treatments for include sciatica, spinal stenosis, and herniated discs.
Spine Surgeons: Back surgery is a rare option for patients with serious nerve compression issues related to their back condition. Back surgery may be performed by neurosurgeons, orthopedists, and spine surgeons. Physicians who are qualified to perform spine surgery are orthopedic surgeons and neurosurgeons who have completed 4-7 years of a surgical residency and have been accepted into a spine fellowship. There in the spine fellowship, they receive additional training in performing spine surgery.
Physiatrists: a physiatrist is a physician who specializes in Physical Medicine and Rehabilitation. For this reason, physiatrists are also called PM&R physicians. Fundamentally, these doctors come up with physical therapy treatment programs for patients as an alternative to surgery. Physiatrists may also be involved in physiotherapy treatment programs for patients recovering from back surgery. Physiatrists will not be involved in surgeries themselves. Physiatrists may be able to interpret a variety of diagnostic tests, such as myelograms and bone scans. They may also be able to perform specialized nerve tests (SSEP, NEV, EMG).
- Orthopedic surgeon: These physicians are M.D.s or D.O.s who have completed a five-year residency in the surgical treatment of musculoskeletal conditions. These doctors perform surgery to treat spinal disorders such as vertebral fractures, trauma, sports injuries, and arthritis. Orthopedic surgeons are more likely than neurosurgeons to perform spinal deformity surgeries to treat conditions such as scoliosis.
- Neurosurgeon: There are M.D. or D.O. physicians who finish a 5-6 year residency that specialize in the treatment of neurologic conditions with surgery. Neurosurgeons are skilled in diagnosing and treating disorders of the spinal cord, spine, brain, nerves, intraspinal and intracranial vasculature.