People with back pain can seek support from several different health professionals
Your GP is the first person to talk to about your back pain. They can help you with medication, imaging and if necessary, referrals to other practitioners who can help you with managing your condition.
The first thing your GP will want to do is diagnose the cause of your pain by examining you and asking about your symptoms. They will be interested in how bad the pain is, what provokes it, what relieves it, how long you’ve had it, what you think might have caused it, how it affects your daily life and your mental state.
Your GP can recommend or prescribe medication to help with your pain and give you advice about dos and don’ts in managing the pain. They can also refer you to an interventional radiologist for back imaging. If appropriate, the radiologist can inject steroid next to your spine, which may provide both acute and long-term relief from the pain. Referrals to other specialist doctors and pain management programs can also be made by your GP.
A physiotherapist can assess your problem and give you help and encouragement with managing back pain. They’ll assist you with improving mobility, give you personalised exercises, show you how to improve your posture and suggest ways of setting up your workstation to keep your back comfortable. At each visit they’ll monitor your progress and tailor your exercise program depending on how well your back is responding.
Some physiotherapists use supportive strapping and other techniques to help with back pain. Some physiotherapists also use ultrasound, however the evidence for its effectiveness is weak.
You don’t need a GP referral to see a physiotherapist, but your GP may recommend one.
Find a physio who participates in our 100% back More for You program.
An occupational therapist
An occupational therapist can help you make changes in your home or work place to reduce the strain of everyday activities on your back.
A chiropractor or osteopath
Chiropractors and osteopaths are alternative health practitioners who treat back pain by manually adjusting or manipulating the joints in the spine. Chiropractors focus more specifically on manipulating the spine while osteopaths are likely to focus on your muscles as well. There’s quite a bit of overlap between the way chiropractors, osteopaths and physiotherapists work. Some people who don’t have success with one of these, go on to find relief from another one. The evidence for the effectiveness of chiropractic and osteopathic treatments is inconclusive.
Some, but not all, medical doctors believe the potential dangers of chiropractic and osteopathic treatments outweigh the benefits. Complications are rare but can include a herniated disc, a worsening of an existing disc herniation, compression of a spinal nerve and a certain type of stroke which follows chiropractic neck manipulation.
You should avoid chiropractors and osteopaths if you have severe osteoporosis, numbness, tingling or weakness in an arm or leg, instability or cancer in your spine, or an increased risk of stroke. Instead you should get advice from a rheumatologist or surgeon.
An acupuncturist works to relieve pain by inserting fine needles into your skin. The needles are thought to stimulate your body’s natural painkilling chemicals. Because the needles are so thin, it’s not usually painful. The use of acupuncture isn’t part of traditional western medicine and its benefits are unproven, but some Eastern medicine practitioners, as well as some doctors, chiropractors and osteopaths believe it’s an effective way to treat pain. Although clinical evidence of its effectiveness is limited, many back pain sufferers find that acupuncture provides temporary relief from their pain.
Make sure your acupuncture practitioner is qualified and registered with the Australian Acupuncture and Chinese Medicine Association.
A massage therapist
A program of massage can ease back pain, increase your range of motion, reduce anxiety and help you sleep better. To be effective, you need to have regular massages by a skilled practitioner. Many physiotherapy, chiropractic and osteopathic practices offer massage therapy as well.
Remember, if something hurts then tell the therapist. Don’t suffer in silence. You can ask the therapist to be gentler. Also, if the massage has been particularly intense you can expect your muscles to feel sore for a day or two afterwards.
Note: HCF will pay rebates to members with eligible cover who consult qualified physiotherapists, chiropractors, osteopaths, acupuncturists, and massage therapists.
A psychological counsellor
You probably think of pain as a physical thing but your mind plays an important role in how you feel pain. Chronic pain can evoke a range of negative feelings such as anger, fear, hopelessness, sadness and anxiety. These feelings can make the pain worse and more difficult to cope with.
A psychologist or counsellor can help you to develop ways of coping with the feelings that pain is bringing up. They can also work with you to help you to make the changes to improve your quality of life.
These professionals can also teach you useful meditation and relaxation techniques to help you control pain.
Your GP can refer you to a psychologist after developing a Mental Health Treatment Plan. Then you can claim up to 10 psychological consultations on Medicare with the option of another 6 sessions if your GP and psychologist believe it’s necessary. Depending on your level of cover, your health insurance may cover you for further visits.
If your GP wants to confirm an opinion about your diagnosis and treatment they may refer you for further assessment by a rheumatologist. Rheumatologists are specialists in a wide range of diseases that affect joints and muscles and are particularly skilled at treating arthritis. A rheumatologist can help you to get an accurate diagnosis for your back pain and can work with you to design a treatment program aimed at managing pain, reducing inflammation and improving your quality of life. Sometimes they may need to refer you to a spine surgeon if surgery is required.
A pain specialist
If your back pain is chronic, disabling or severe and hasn’t responded to exercise, medication, physiotherapy and other measures, it may be time to visit a pain specialist. Pain specialists can offer a range of options for treating chronic pain, from specialised medications to injections that stop nerves from transmitting pain signals.
Some pain specialists offer procedures such as neurotomy (also known as rhizotomy), radio-frequency ablation, spinal cord stimulation, implantable analgesic devices such as morphine pumps, and IV infusions of pain-relieving medications. These alternatives to surgery are useful for treating certain types of back pain that haven’t responded to other measures. Pain specialists can also teach you advanced ways of self-managing your pain. Some pain specialists can enrol you into a pain management program. These programs may be individual or group based. They use multifaceted and multidisciplinary approaches to pain management.
Some treatments that are started by a pain specialist can then be continued by your GP.
An interventional radiologist
In addition to providing diagnostic imaging, certain interventional radiologists can inject corticosteroid with local anaesthetic close to your spine. This may provide temporary and sometimes permanent relief of back pain, especially if your pain is caused by direct pressure on a nerve. The procedure is guided by CT imaging to pinpoint the spot that needs to be injected. Examples include epidural blocks, facet blocks, perineural blocks or discal blocks. Read more about medications for back pain.
If your pain hasn’t responded to more conservative measures, if there are worrying symptoms or signs, and/or the pain has persisted for 6 months or more, it may be time to consider surgery. Spine surgery is normally performed by an orthopaedic spine surgeon or a neurosurgeon. The surgeon will discuss the history of your condition, your options for non-surgical vs. surgical procedures and the pros and cons of each. Your surgeon will explain the possible complications of surgery, the recovery process and the likely outcome. Read more about back pain surgeries