Patients often ask if they can or should be seen by a chiropractor for the treatment of back pain. There have been some studies that show effective treatment of some types of back pain by chiropractors. However, not all causes of back pain should be treated by a chiropractor. There are some conditions that should be identified and treated by a spine surgeon rather than a chiropractor.
Why should I be seen by a medical doctor?
Some cases of back pain can be effectively treated by a chiropractor. However, there are some conditions, potentially serious problems, which must be considered before initiating any treatment. Most of these conditions can be screened with a thorough history and physical examination.
Symptoms that raise concern include:
Any problems controlling bowel or bladder function
Numbness around the genitals
Pain with associated fevers, chills, sweats
Pain that awakens you at night
Furthermore, there are some symptoms that are better treated by an spine surgeon than a chiropractor. These include:
Back pain with associated leg pain
Numbness or tingling in the legs
Weakness of the muscles of the legs
These above symptoms are found in patients who may have a problem other than a lumbar muscle strain or ligament sprain. When the underlying problem is a muscle strain or ligament sprain, then chiropractic treatments can be effective.
When NOT to see a chiropractor
Patients who have symptoms of nerve or spinal cord compression should not undergo chiropractic manipulations until cleared to do so by a medical doctor. Furthermore, there are rare problems such as infections and tumors of the spine that should not be treated by chiropractors. Unfortunately, there are stories of patients who undergo manipulations of the spine and sustain devastating complications because of nerve injury. These cases are incredibly rare, but it is important that there is a good understanding of the cause of back pain before initiating manipulations of the spine.
Because of inadequate exposure many less invasive procedures may also require an additional standard discectomy to adequately address the problem. This doubles the operative exposure, operating time and cost. Knowing when to appropriately utilize less invasive procedure is a matter of judgment based on the training and experience of the spine surgeon.