Who treats spine problems?Open print version

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 many types of specialists are involved in the treatment of back and neck pain, spine centers have developed to provide integrated patient care. The specialists work together in multidisciplinary teams that focus on coordination of care, convenience for the patient, and quality of care standards.

Specialist

Overview

Types of Conditions

Scope of Treatment

Neurosurgeon
(spine surgeon)


MD


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.

Most spine surgeons are either orthopedic surgeons or neurosurgeons who are fellowship-trained in spine.

Patients with neurological problems such as spinal stenosis, spondylolisthesis, herniated disc, spinal deformity, spine infections, 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, and more. Some neurosurgeons specialize in a particular area (spine, vascular, tumors, epilepsy, trauma).

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.

Orthopedic surgeon (spine surgeon)
MD



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).

Most spine surgeons are either orthopedic surgeons or neurosurgeons who are fellowship-trained in spine.

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 orthopedic surgeons specialize in a particular area (feet, hands, spine, trauma). Spine surgeons treat disorders such as scoliosis, osteoporosis, herniated discs, spinal stenosis, spine injuries, fractured vertebrae, spinal deformity, tumors, infections, and congenital abnormalities.

Orthopedic surgeons are skilled in the diagnosis of the injury or disorder, surgical and nonsurgical treatment, and rehabilitation. Surgical treatments include discectomy, laminectomy, kyphoplasty, spinal fusion, endoscopy, laser, joint replacement, arthroscopy, and more.

Physiatrist
(physical medicine & rehabilitation [PM&R])
MD



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 electromyography (EMG) and nerve conduction studies to evaluate muscle and nerve function. PM&R uses physical and therapeutic agents, and may include massage, physical or occupational therapy, exercise, epidural steroid injections, and more.

Physical therapist
(PT or DPT)



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 practitioner
RN with MN



Nurse practitioner (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)



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



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


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


 

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, electromyogram (EMG), electroencephalogram (EEG), and evoked potential.

Primary care physician
MD or DO



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.

Oncologist MD



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 three 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


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


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 Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.


updated: 4.2016
reviewed by: Banita Bailey, RN, BSN, CCM

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. This information is not intended to replace the medical advice of your health care provider.