Back Doctor: Where to start if you have back or neck pain

If your lower back pain is not improving with conservative treatment and home remedies after 6 weeks, you should consider scheduling an appointment with a Denver back doctor. You should seek care sooner if you are exhibiting any of these red flag symptoms of back or neck pain. Most spine pain goes away with self care in a few weeks, but if your pain is interfering with your daily activities and you’re not finding relief with home treatment options, schedule an appointment with your primary care provider or the Neurosurgery One Spine Center.

Stiff neck and neck pain affect roughly 1 in 5 adults every year. Stiff neck that is temporary is not typically not a cause for concern. Posture and sleeping are the most common causes of stiff neck. Whiplash caused by trauma is the top reason for neck pain resulting from auto accidents. Longer lasting stiff neck that persists for more than two weeks, interferes with your daily life, or is getting worse may be signs that your neck pain is more serious. These symptoms of neck problems could also signal that your stiff neck is serious and you should seek medical attention. 

Lower back and hip pain can be tricky to diagnose and treat. For pain that persists for weeks or months even after trying home care, you should schedule an appointment with a back doctor. While a primary care physician could be your first point of contact, a back doctor can streamline your care and get you on a faster track to diagnosing and treating your back pain. Our team at the Neurosurgery One Spine Center will work closely with your primary care physician in the process.

If your back or neck pain has persisted for 6 weeks or more and home care is not alleviating your pain, you should schedule an appointment with a back doctor. Based on your insurance, you may need to first schedule an appointment with your primary care provider and obtain a referral. Some insurance providers will allow you to go see a back doctor without a referral or your primary care provider often can make a referral for you over the phone. Seeking treatment from a back doctor sooner doesn’t mean you will end up having spine surgery. In fact, the majority of patients who get care from a back doctor don’t wind up having spine surgery. But by starting early in the process with a spine specialist, you will ensure that you are starting on the fastest journey to the right care for your condition. 

By most estimates, 8 out of 10 people with back pain or neck pain will get better with some self care or conservative treatment such as physical therapy in the first six weeks. If you have experienced pain in your back, legs, neck or arms longer than that and it’s impacting your daily living, it’s important to seek care with a back doctor so that you can get help to diagnose and treat the root cause of your symptoms. By finding the cause, we can help minimize or eliminate your pain and make recommendations on how to limit it in the future. 

When seeing the Neurosurgery One Spine Center for an initial appointment for back or neck pain, you will most likely be seen by one of our experienced physician assistants or certified nurse practitioners. During this visit, you can expect:

Physical exam: One of our skilled spine specialists will perform provocative tests (such as moving your body and putting pressure on certain spots) to help reproduce or rule out where the pain is coming from.

Imaging: For most patients, we use a combination of imaging including X-rays, that can identify structural issues, and CT and MRI scans, which highlight issues with nerves, tendons, and ligaments.

Goals: Starting on day one, we work closely with you to determine your goals for pain relief and your comfort level with various treatment options. Maybe you want 100% relief and will stop at nothing to get to that goal. Or, maybe you will never try chiropractic care so it’s not helpful for us to recommend that. We get to know you so that we can recommend what’s best for you.

Diagnosis: Based on your exam, images, and symptoms, your back doctor will begin the process of making a diagnosis. Sometimes we can pinpoint the issue and offer a diagnosis immediately. Other times we may need more time and to see how your pain reacts to certain initial treatments. We sometimes use electromyography (EMG), a minimally invasive, office-based diagnostic test, to help pinpoint issues between nerves and muscles causing back pain. While we don’t always find a definitive diagnosis, we will always keep working to uncover the root cause of your pain and offer appropriate treatment. At Neurosurgery One, we pride ourselves on being honest and forthcoming using the latest evidence-based medicine. We also pride ourselves on listening to you to make sure what we’re seeing is what you are experiencing. What we see on an MRI, for example, may not correlate to the level of pain you are experiencing, so we will continue to look deeper for additional causes. 

Initial Treatments: The good news is that more often than not, back and neck pain often can be treated with conservative treatments such as self-care, physical therapy, acupuncture, and massage. According to the Annals of Internal Medicine, “Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatment with superficial heat (moderate-quality evidence), massage, acupuncture, or spinal manipulation (low-quality evidence).” At Neurosurgery One, we always start with non-invasive treatments, if appropriate for your condition. These treatments often will work to relieve your pain – and your insurance will more than likely require conservative treatment before approving additional therapies, even for things like spinal injections. This is because this is sound medicine – no back doctor should ever recommend any type of invasive treatment if not warranted by medical evidence. 

Every back and neck pain patient is different. Yet, there are some non-invasive conservative treatments that we have seen provide relief for the majority of patients:

• Anti-inflammatory medications
• Physical therapy
• Massage
• Acupuncture
• Spinal injections 
• Lifestyle changes