This is a tricky question.
There are numerous types of allied health professionals, doctors, and specialists who are trained to assist in the diagnosis, treatment and management of low back pain.
There are many more alternate methods such as acupuncturists and naturopaths who feel their treatment and expertise can assist also. With so many options, it can be confusing to know who to see and when.
If you have had back pain yourself, you may have already consulted Dr Google and/or sought opinions from friends and family as to what treatment has worked for them.
I work in a multi-disciplinary team of Rheumatologists, Physiotherapists, Exercise Physiologists and Massage Therapists. Each of these services are trained with different skills to assist all clients work towards healthier, happier versions of themselves.
If you or a loved one have struggled with low back pain, read on to better understand how each service approaches the management of low back pain.
Rheumatologists: Rheumatologists are “arthritis” doctors, who deal with both degenerative joint diseases and inflammatory joint diseases. In addition, they deal with complex problems affecting muscles, tendons and ligaments, as well as a variety of autoimmune diseases. Their tools are typically a thorough history, a good examination and an investigative mind. In terms of how they work with those with low back pain, they are often involved in cases which are more complex or chronic (lasting >3 months). A big part of a rheumatologist’s role is differentiating between mechanical or inflammatory back pain. We have written about this challenge HERE if you are interested in reading on. Once an appropriate diagnosis has been decided upon, they are then able to establish an appropriate action plan for clients which may involve further investigations, prescription of appropriate medications or referral to another specialist or health professional. As they are specialised medical practitioners, anyone wishing to see a rheumatologist needs a referral from their GP.
Physiotherapists: Using advanced manual therapy techniques and evidence-based care, physio's assess, diagnose and treat a wide range of health conditions and movement disorders. They aim to repair damage, reduce stiffness and pain, increase mobility and improve quality of life. A physio will take a thorough history, perform an assessment and then embark to create a treatment plan which addresses the cause of any lower back dysfunction and/or pain. Physiotherapists may use techniques such as soft tissue massage, joint mobilisation and exercise prescription to relieve lower back discomfort and restore optimal movement. They are also able to guide the appropriate use of tape, joint braces, foam rollers and. No referral is needed to seek treatment from a physiotherapist.
Exercise Physiologists: EP’s are the new kids on the Allied Health block. Their speciality is exercise prescription and working with clients to achieve great quality movement patterns and any health related aspirations. They typically do not perform any hands on treatment, instead they use pacing strategies, exercise prescription and health coaching principles to help their clients move in the best way possible and achieve their goals. An Exercise Physiologist will also perform a history and an assessment, likely more focused on movement and posture. At BJC, the Physiotherapy and EP teams work e closely together to ensure we restore movement patterns and then put in place an appropriate plan to help prevent future episodes of low back pain.
Remedial Massage Therapists: Massage therapists are skilled in their delivery of manual therapy to soft tissue (muscles and fascia). Tissue that is restricted, tight or uncomfortable can be improved under the hands of a skilled massage therapist. They don’t tend to prescribe exercise (which can be nice!) but instead focus on restoring the flexibility and health of soft tissue.
Rheumatologists, Physio’s, EP’s and Remedial Massage Therapist’s are each regulated by national governing bodies and they need to meet strict criteria in order to achieve and maintain their ability to practise. I appreciate these specialities are just four of the options available out there. However, hopefully the explanations above may clarify how each of them may approach low back pain.
Getting an appropriate diagnosis as to what is driving your low back pain is a crucial step in any great management plan. I appreciate that this may not always be easy.
At the moment we are offering free back checks for this very purpose. These sessions have no strings attached. Should you wish to receive treatment with us after the session, the check does not affect the pricing of future visits.
If you are uncertain if your past or current treatment regime is appropriate for you, then don’t hesitate in booking this complimentary session with one of our physio's.