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What is a Physiatrist? What Do They Do for Low Back Pain?

Blue Ridge Region / 21 Sep 2022

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EmergeOrtho
by EmergeOrtho
What is a Physiatrist? What Do They Do for Low Back Pain?

Physiatrists Use Non-surgical Methods to Alleviate Acute Low Back Pain

A physiatrist is a physician with specialty training in Physical Medicine and Rehabilitation. The goal of this specialty is to help people with various musculoskeletal conditions that cause acute and chronic pain. The focus is to decrease their pain and increase their functional status by using non-surgical methods.

When To See A Physiatrist for Low Back Pain

Low back pain is the second most common reason people see their primary care physician. Most people, about 60% to 90%, will experience at least one episode of low back pain in their lifetime. This often resolves on its own without medical treatment, but up to 90% will have a recurrence of their pain, and about half go on to develop chronic pain. Low back pain not only causes “pain,” but also frequently decreases the function of the person. A vicious cycle can develop where decreased function can lead to increased pain, and so on.

 Male doctor checking spine of a young man in a medical treatment room.

Many people ask when is it time to see a physiatrist. It’s important to seek treatment from a medical professional, such as a physiatrist, early in the course of low back pain. A physiatrist can develop a personalized program that focuses on functional restoration before it becomes chronic back pain.

Common Low Back Pain Causes

Common conditions known to cause low back pain include degenerative arthritis, spinal stenosis, and disc herniation.

Degenerative Arthritis

Degenerative arthritis is a common cause of low back pain and stiffness. Degenerative changes affecting the disc often cause low back pain that is worse with flexion of the lumbar spine, such as when sitting or standing. Arthritis affecting the facet joints, the joints in the back of the spine, often causes low back pain that is worse with extension or rotation.

Spinal Stenosis

Spinal stenosis occurs when pressure gets put on the cord and spinal nerves due to narrow space around the spinal cord. Spinal stenosis often causes leg pain that is worse with walking and better with sitting.

Sacroiliac Joint Disorders

Sacroiliitis occurs when one or both sacroiliac joints become inflamed. Disorders of the sacroiliac joint can also cause buttock and thigh pain.

Hip Arthritis

Hip osteoarthritis, a breakdown of cartilage in the hip joint, can often cause pain in the lower back.

Injections as a Diagnostic Tool

Injections can be useful diagnostically to determine which structure is causing the patient’s pain. Corticosteroids are often used to decrease inflammation and provide pain relief. Common spinal injections include lumbar epidural steroid injections, spinal nerve blocks, and facet joint blocks. These are performed under fluoroscopic guidance to allow specific placement of the medication at the intended target.

If a specific cause of low back pain can be found, with the disc, facet joint, or sacroiliac joint for instance, then a functional restoration program with a physiatrist could be the best method to achieve relief. A physiatrist can direct care at this specific structure to correct any imbalances that may be contributing to the pain and hopefully decrease the number of exacerbations of pain in the future.

The Goal of a Physiatrist

Of course, there are certain spinal conditions that may require surgery, but often people have surgery because nothing else has helped and they are tired of hurting. The goal of a physiatrist is to help the patient find ways to decrease their pain and increase their functional status using non-surgical means.

If you want to learn more about what a physiatrist can do for your back pain, schedule an appointment or contact your preferred location to speak with an EmergeOrtho-Blue Ridge Region team member.

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