Back pain: where to start
Back pain is the second most common reason people see a healthcare provider, and most people never need a spine surgeon. Here's how to get to the right care faster.
Who treats what
| Back pain only, no leg symptoms | Primary care, physiatrist, physical therapy, pain medicine |
|---|---|
| Leg pain (sciatica) or arm pain | Physiatrist or spine surgeon, especially if it lasts beyond six weeks or there is weakness. See sciatica and pinched nerve in the neck. |
| Leg heaviness when walking | Possible spinal stenosis. Start with therapy and a physiatrist, and see a spine surgeon if walking keeps getting harder. |
| Hand clumsiness or balance trouble | See a spine surgeon promptly. See cervical myelopathy. |
| Emergency symptoms | Bladder or bowel changes, groin numbness, rapidly worsening weakness: go to the emergency department. |
Why surgery is rarely the answer for back pain alone
Most back pain comes from muscles, age-related disc and joint changes, or disc bulges that are also common in people without pain. These don't have a surgical fix, and operating on them often disappoints. Surgery works best when a specific structure is pressing on a nerve and the symptoms match the imaging.
A coordinated spine program
Luminis Health's spine program brings together physiatry, pain medicine, interventional spine and spine surgery, so you start with the right specialist and move to surgery only if you need it.
Frequently asked questions
Should I see a spine surgeon for back pain?
Usually not first. For back pain without leg symptoms, a primary care provider, physiatrist or pain specialist is the best starting point. See a spine surgeon when there is leg or arm pain from a pinched nerve, weakness, or a structural problem that hasn't improved.
What is a physiatrist?
A physician specializing in physical medicine and rehabilitation. Physiatrists diagnose and treat back pain without surgery using therapy, injections and medication.
When is back pain an emergency?
Go to the emergency department for new numbness in the groin or inner thighs, loss of bladder or bowel control, rapidly worsening leg weakness, or back pain with fever, a history of cancer, or major trauma.
Ready to talk about your options?
Call (410) 268-8862 or book online. Bring your most recent MRI — online scheduling requires one from the past 12 months.