Overview
Of the many types of specialists
who treat spine problems, each has specific
skills and plays an important role in patient
care. Some spine specialists are physicians
and some are non-physicians. The right specialist(s)
to treat your condition depends on the type
and severity of the problem. Spine problems
can arise from soft tissues (muscles, tendons,
ligaments), nerves, or bone. If a spine problem
is complex or does not improve, you may be referred
to one or more of the specialists described
below for further consultation, diagnosis, and
treatment.
Because of the many types of spine
problems, spine centers have become a recent
trend toward providing an integrated approach.
At Mayfield Clinic and Spine Institute, specialists
work together in multidisciplinary teams that
focus on coordination of care, convenience for
the patient, and quality care for the treatment
of spine problems.
| Specialist |
Overview |
Types
of Conditions |
Scope
of Treatment |
Neurosurgeon
MD
www.neurosurgery.org |
Neurosurgery is a medical
specialty that focuses on diagnosis and
both surgical and nonsurgical treatment
of disorders of the brain, spinal cord,
and nervous system.
Neurosurgeons provide surgical or nonsurgical
care for neurological disease or injury. |
Patients with neurological
problems such as spinal stenosis, spondylolisthesis,
vascular disease (e.g., carotid artery disease,
aneurysm), carpel tunnel syndrome, pain,
head/spinal cord injury, epilepsy, brain/spine
tumors, trigeminal neuralgia, movement disorders,
chronic back and/or neck pain, herniated
disc, and more. |
Neurosurgeons use many
of the same tools for diagnosis and treatment
as neurologists as well as surgery. Surgical
technologies can include kyphoplasty,
laminectomy, spinal fusion, endoscopy,
laser, stents, shunts, radiosurgery, and
other operative techniques for the head,
spine, or peripheral nerve locations. |
Physiatrist (physical
medicine & rehabilitation [PM&R])
Medical doctor (MD)
www.apmr.org |
Physiatry is a medical specialty
that focuses on the diagnosis, nonsurgical
treatment, and rehabilitation for chronic
illness/ injury and musculoskeletal disorders.
PM&R treats the whole person to improve
quality of life, addressing physical, mental,
and emotional issues during rehabilitation.
Helps patients achieve maximal functional
capacity. |
Patients with stroke or other
chronic illness, spinal cord or brain injury,
acute and chronic pain (e.g., back pain),
and musculoskeletal injuries (e.g., sports-
or work-related injuries). Physiatrists
can help patients with acute or chronic
pain and musculoskeletal problems, and can
coordinate the rehabilitation for those
needing long-term care (e.g., after stroke
or spinal cord injury). |
Physiatrists direct the rehabilitation
team. They use EMG nerve conduction to evaluate
muscle and nerve function. P&MR uses
physical and therapeutic agents, and may
also include massage, physical or occupational
therapy, exercise, epidural steroid injections,
and more. |
Physical
therapist
(PT or DPT)
www.apta.org |
Physical therapy
focuses on therapeutic exercise and functional
training to restore, promote, and maintain
overall health. Studies movement and function,
and how musculoskeletal and neuromuscular
problems affect health. |
Patients see
physical therapist (PTs) with neurological
or musculoskeletal problems such as chronic
pain, stroke, neck/back pain, injury, arthritis,
degenerative disc disease, and more. People
with sprains, strains, and fractures, and
injuries related to work or sports. |
PTs have specific
training in functional training and therapeutic
exercise. They may mobilize (manipulate)
a joint or massage a muscle to promote proper
movement and function. PTs also use ultrasound
and hot/cold therapy, and educate patients
on how to take care of themselves. They
also provide fitness and wellness education. |
Nurse
practioner
RN with MN
www.nurse.org
www.allnursingschools.com |
Nurse practioner
(NP) is a type of advanced practice nursing,
with a focus on a specialty area (e.g.,
family, adult, acute care, pediatric). Collaborating
with physicians, NPs ensure many aspects
of patient care, including education and
physical exams. |
Patients may
see NPs for diagnosis and management of
most common and some chronic illness. Working
with physicians, NPs monitor the patient’s
progress with therapies or medications prescribed
for the treatment of spine problems. |
In collaboration
with physicians and other healthcare providers
as needed, NPs can diagnose and treat illness,
order and interpret diagnostic tests (e.g.,
blood tests, X-rays), and prescribe medications.
NPs counsel patients, and, in some cases,
coordinate surgical care from preoperative
to discharge to follow-up. |
Doctor
of chiropractic (DC)
www.amerchiro.org www.chiropractic.org |
Chiropractic
is a natural, conservative care that aims
to improve health by restoring structure
and function to the spine and other joints.
Goals are to restore joint motion, reduce
pain and muscle tightness, and maintain
healthy spinal discs. |
Patients with
muscle pain and overuse syndromes. Patients
with neuromuscular (e.g., headaches, back
and neck pain, joint pain, carpel tunnel)
and non-neuromuscular symptoms (e.g., allergies,
asthma). |
Chiropractors
evaluate the structure and function of the
spine, joints, and affected muscles. Treatment
includes various types of manipulation (adjustment).
Also massage, ultrasound, electrical muscle
stimulation, hot/cold therapies, trigger
point therapy, and exercise, acupuncture,
and nutritional advice. |
Massage
therapist
www.amtamassage.org |
Massage is a
healing art that focuses on the soft tissues
(muscles, tendons, ligaments) to positively
affect health. Improves the circulation
of blood and lymph. Eliminates metabolic
wastes from muscles. |
Patients with
muscle pain, back/neck pain, stress, and
overuse syndromes. Athletes before or after
sports. Others want to relax, increase a
feeling of well being, and improve energy
flow. |
Massage therapists
use hands-on manipulations of soft tissues.
Massage techniques vary from gentle to firm.
Types include deep tissue, shiatsu, Swedish,
trigger point, sports, Reiki, Rolfing, craniosacral,
and more. |
Occupational
therapist (OT) or OT assistant
www.aota.org |
Occupational
therapy is a skilled treatment, helping
patients toward greater independence when
a health condition affects daily living.
Occupational therapists (OTs) study human
growth and development, and how illness
and injury affect these. |
Patients see
OTs when health conditions interfere with
daily life. Some conditions include acute
or chronic injuries (e.g., back pain); limitations
caused by stroke, brain or spinal cord injuries,
chronic conditions (e.g., arthritis, Alzheimer’s,
multiple sclerosis), and developmental /
learning problems. |
OTs assess performance
skills, customize treatment plans, conduct
home and job-site evaluations, instruct
on how to use adaptive equipment (e.g.,
wheelchairs, splints), and guide caregivers.
OTs may guide patients to regain basic skills,
and address learning problems. |
Neurologist
MD or DO
www.thebrainmatters.org |
Neurology is
a medical specialty that focuses on diagnosis
and nonsurgical treatment of brain and nervous
system disorders. Neurologists care for
patients with chronic neurological disorders. |
Patients with
neurological problems such as stroke, epilepsy,
headache, Parkinson’s disease, tremor,
brain tumors, pain, amyotrophic lateral
sclerosis (ALS), and sleep disorders. |
Neurologists
evaluate medical history, and conduct neurological
and diagnostic tests for vision, strength,
coordination, and sensation. Some tests
include CT scan, MRI, transcranial Doppler,
electomyogram (EMG), electocephalogram (ECG),
and evoked potential. |
Primary
care physician
MD or DO
www.aafp.org |
Primary care
covers a wide range of general medical knowledge.
Provides the first step of care for patients
with undiagnosed health concerns, and also
continuing care and referrals to a specialist.
Specialties include family medicine, geriatrics,
pediatrics, and general internal medicine. |
Patients with
undiagnosed signs, symptoms, or concerns.
Those with routine healthcare needs such
as check-ups, health promotion, and diagnosis
and treatment of acute and chronic illness. |
Primary care
physicians have specific training and skills
in giving first-contact, continuing care.
They are generalists, caring for most medical
and health needs. They are advocates for
patients coordinating their care through
the health system. Thus, they consult specialists
when referrals are needed. |
Orthopedic
surgeon (orthopaedist) MD
www.orthoinfo.aaos.org |
Orthopaedics
is a medical specialty that focuses on diagnosis,
surgical and nonsurgical treatment, rehabilitation,
and prevention of disorders of the musculoskeletal
system (bones, joints, muscles, tendons,
ligaments, nerves, and skin). |
Patients with
problems in any region of the musculoskeletal
system. For example, those with broken bones,
dislocations, back pain, spine and limb
deformities, torn ligaments, and arthritis.
Some orthopaedists specialize in a particular
area (feet, hands, spine, trauma). |
Orthopedists
are skilled in the diagnosis of the injury
or disorder, surgical and nonsurgical treatment,
and rehabilitation. Orthopedists can perform
CT or MRI imaging, endoscopy, laser, joint
replacement, arthroscopy, laminectomy, and
more. |
Oncologist
MD
www.oncologychannel.com
www.oncology.com
www.abta.org |
Oncology is
a medical specialty that focuses on diagnosis
and treatment of cancer. Three specialties
are medical, radiation, and surgical oncologists.
They often work together to manage patient
care. Pediatric oncology is another specialty
area. |
Patients with
a diagnosis of cancer (e.g., brain metastases,
spinal cord tumor) consult an oncologist.
Cancer is typically managed by a team of
specialists from the 3 disciplines. Patients
may consult with oncologist with expertise
in a subspecialty (e.g., neurosurgical,
gynecological). |
Oncologists
diagnose, assess the disease stage, and
plan and deliver treatment or palliative
care. Medical oncologists treat cancer with
medicine or chemotherapy. Surgical oncologists
perform biopsy, staging, and resection of
tumors. Radiation oncologists use therapeutic
radiation. |
Radiologist
MD
www.acr.org
www.radiologyinfo.org |
Radiology is
a medical specialty that uses and electromagnetic
radiation and ultrasonics to diagnose and
treat disease/injury. Radiologists “see”
inside the patient’s body with imaging
studies, like CT, MRI, and ultrasound. Specialty
areas can include diagnostic and interventional
radiology, and radiation therapy. |
Patients who
require additional diagnostic imaging studies
and radiological procedures. For example,
those with brain or spinal cord disease/injury,
fractured bones, vascular disease (e.g.,
aneurysms, arteriovenous malformations,
carotid artery disease), stroke, or epilepsy. |
Radiologists
use x-ray, high-energy radiation sources
(CT, MRI), ultrasound, angiography, and
more. They read films and perform minimally
invasive image-guided surgery (interventional
radiology). They play important roles during
angioplasty, kyphoplasty, vascular stenting,
gamma knife surgery, radiological thrombolysis,
and LINAC. |
Rheumatologist
MD
www.rheumatology.org |
Rheumatology
is a medical specialty that focuses on the
diagnosis and treatment of arthritis and
more than 100 other diseases of the joints,
muscles, and bones. |
Patients with
arthritis, autoimmune diseases, musculoskeletal
pin, and osteo- and rheumatoid arthritis.
Those with gout, back pain, fibromyalgia,
tendonitis, lupus, osteoporosis, and more. |
Rheumatologists
are internists or pediatricians with specialty
training in rheumatology. They are trained
to identify and treat these complex, painful
conditions. They consult with other physicians,
nurses, psychologist, and OTs to establish
treatment. |
Sources
If you have more questions, please contact the Mayfield Spine Institute at 800-325-7787 or 513-221-1100.
updated: 10.2004
reviewed by: Theresa Greenwald,
RN, CCM, CRRN |
