It can be difficult to know what to do once you begin to experience back pain or are tired of having a history of back pain. If you are experiencing acute back pain following a traumatic event and are in pain immediately call emergency services to assist you.
If you are on the other side of the spectrum and have a sore back suddenly or have dealt with back pain for a while it can be difficult to know where and how to get an accurate back pain diagnosis.
There are many options out there including primary care physician, physical therapist, emergency room, chiropractor, athletic trainer, etc. All of these professionals are educated in spinal health and injury evaluation and rehabilitation. It often comes down to who is most accessible to you at the level of care you need.
Oftentimes at work, there is a massage therapist and/or athletic trainer that can give an initial medical opinion on what standard of care you need. Assuming the pain is not debilitation – start with the most accessible care that is available to you.
This can help save costs (as many times seeing a professional provided at your workplace, gym, etc. is free) and direct you to the next step more directly and quicker than without.
However, if cost and access are non-factors in your healthcare plan the best option would be to see a physical therapist or primary care doctor because they can specialize in this area and evaluate, diagnose, and treat as a whole system.
With all of this information on how to get a back pain diagnosis, it can be difficult to know what not to do throughout this process.
It is easy to assume that not moving and re-creating symptoms is the best option and I agree – to some extent. However, if you are experiencing back pain and commit to several days on the couch without seeing a medical professional things will only get worse.
Above all, seeking care right away is incredibly important, especially if your back pain is a new issue and you are unfamiliar with the next steps.
Waiting weeks or even just a few days may set you back in the process of getting effective care. This is often referred to treating injuries “upstream” which means getting your boat out of the water before the rapids, swift currents, and the eventual waterfall representing surgery and lifelong consequences.
To get into more detail of which professional provides an accurate diagnosis of your needs, the rest of the article will be broken down by service from lowest to the highest level of care.
Athletic Trainer/Massage Therapist/Personal Trainer
This level of care is accessible to most athletes and regular people at the gym, work, or in the sports arena.
These healthcare professionals are available to evaluate and treat acute, or sudden onset of symptoms or refer to the correct level of care as needed.
To be clear, just because these professions are under the same heading in this article does not mean they are exactly the same. I grouped them together because they often work under one roof and are easily accessible at work, the gym, or through an organization or sports team.
Athletic trainers are licensed healthcare professionals trained to evaluate and diagnose acute injuries. In certain settings, they are also valuable pieces in the rehabilitation process often working with physical and massage therapists, sometimes doctors and physician’s assistants too. They are the first line of defense in many industries from sports to airplane factories.
Often within the same settings, but not within the same scope of care (medical vs health and fitness) are massage therapists and personal trainers (or strength coaches). The athletic trainer is the medical professional in these settings but the massage therapist and strength coach are usually around and involved in getting an accurate back pain diagnosis.
As the patient in this setting, it can be confusing knowing who to go to first, but because these three positions are closely related any one of them should get you to the correct resource.
An athletic trainer can do a medical evaluation and diagnose, a personal trainer can give you stretches and strengthening exercises if appropriate, and the massage therapist can also reduce symptoms through massage techniques as needed and if appropriate.
Keep in mind that the athletic trainer is the medical authority and has the ability to refer across the healthcare spectrum to meet your needs.
To learn more about the role of each of these fields check them out here:
Massage Therapy: https://www.amtamassage.org/
Athletic Training: https://www.nata.org/
Strength and Conditioning: https://www.ncsa.com/
*NOTE: personal training and strength and condition are vastly different. The NSCA provides the gold standard of education and certification for strength coaches. Many certifications out there do not require bachelors degrees, any science courses, or medical education. The NSCA has a high standard of practice for their members which is uncommon in the fitness world.
According to the American Chiropractic Association website, chiropractors are healthcare professionals that focus on spinal health through the use of physical manipulations of the spine. They treat the area that is causing the pain and related body parts.
Chiropractors can provide an accurate diagnosis of direct spinal injuries and refer to other professionals as needed. Their services are great if you have already seen your primary care physician and have a history of back pain or an acute injury that is not going away.
It should be noted that many chiropractors suggest multiple visits a week which can add up to be costly in time and money.
This service is accessible to most but looking at your individual financial means and schedule may have an impact on your ability to participate and benefit from chiropractic services.
Physical therapists are all doctoral level educated healthcare providers through accredited physical therapy schools and are licensed in the areas they work.
According to the American Physical Therapy Association, physical therapists are healthcare professionals to help patients reduce pain and restore mobility.
This field integrates all of the bodily systems that affect physical function for a holistic and integrative approach to rehabilitation.
Like athletic trainers, physical therapists can perform special tests to determine an accurate diagnosis and have the knowledge to connect multiple systems in the body to treat dysfunction.
One of the best parts about physical therapists is that they are educated to work in nearly any environment while many other healthcare professionals are taught to work in one area (sports or a clinic) or within a more limited scope.
Physical therapists can help to restore walking, work with cancers, wound care, traumatic brain injury, cognitive diseases, and much more.
Additionally, a new program that will enhance patient’s abilities to get an accurate diagnosis is called GetPT1st.
This movement is the idea that patients should consider physical therapy for all musculosketal issues from the very beginning. This would be instead of seeking out a primary care doctor, waiting for a referral, and then scheduling an appointment pushing that accurate diagnosis down the road several more weeks.
The website supporting the movement, GetPT1st claims that seeing a physical therapist first can reduce rehabilitation time (avoidance of seeing primary care first, waiting for appointments, etc.), reduce costs (often times imaging scans are unnecessary and do not help the physical therapist give a more accurate diagnosis), and encourage better individual outcomes.
Above all, this level of care is most recommended because they are often the most accessible (as physical therapists are in almost every industry), educated, and cost reducing service for getting an accurate back pain diagnosis.
If you are unsure of the resources available to you and unaware of the differences – find a physical therapist near you and seek them out.
Primary Care Doctor
The highest level of care, and arguably the highest cost is your primary care doctor (or specialist).
Many people start here, which is great because you most likely have a relationship with this person, the medical history is readily available, and they can refer to whomever you may need down the road.
The problem with this is that you will most likely get an accurate diagnosis for back pain, but you are running the risk of missing out on the correct treatment plan.
Also, you are accepting that medications and imaging and seeing a specialist are a lot more likely that pursuing athletic training or physical therapy right out of the gates. Understanding the culture that comes with the care is important in not only getting an accurate diagnosis but a thorough evaluation and appropriate treatment for your individual needs.
What Should You Do?
To summarize all of this information you should understand what your values are and what is available to you. Start by answering these questions:
- What does my health insurance cover and what can I afford?
- What does my company, gym, etc. offer to me for complementary medical attention?
- Do I want to seek out a specific professional or am I ok with trying someone new?
- What are my health values and does that align with any particular kind of provider?
- What am I not willing to do to solve this problem?
Answering these questions should give you a more clear understanding of where to begin and even more importantly, where to stop.
I am personally more conservative in my health and prefer lifestyle changes over medications and treatments. This means that I am willing to exercise, stretch, and alter my diet to reduce symptoms of an injury and avoid surgery and medication if possible. On the other side of the spectrum there are people out there who want to see their primary care doctor and get imaging, see a specialist, and use medication – that is ok.
My main point is that getting an accurate back pain diagnosis may be a process depending on the route you choose and that will impact your treatment and outcome down the road. Work with what is in front of you and the resources that you are familiar with.
Make sure you seek care that educates you on your condition and aligns with your values. The best healthcare professionals provide the resources that you need.