What it is
Spine care is a clinical specialty focused on the bones, discs, joints, nerves and supporting muscles of the neck and back. Doctors who work in this area may include primary care clinicians, physiatrists, pain medicine physicians, orthopedic surgeons and neurosurgeons.
People often seek spine care for back or neck pain, a disc that may be pressing on a nerve, or sciatica, which is pain that travels from the lower back into the leg. Because many different things can cause similar symptoms, a careful evaluation is usually the first step.
Spine care is generally described in three parts: spine evaluation, non-surgical spine care and spine surgery. Which of these fits a person is a decision for a licensed clinician after an exam.
How it’s traditionally been approached
A spine evaluation has traditionally begun with a conversation about your symptoms, history and daily activities, followed by a physical exam that may look at movement, strength, reflexes and sensation. Imaging such as X-rays or MRI is sometimes used, but only when a clinician feels it is appropriate.
Non-surgical spine care has traditionally included approaches such as activity guidance, physical therapy, exercise, medications and, in some cases, injections performed by a trained clinician. Many people are first guided through these options before anything more involved is discussed.
Spine surgery has traditionally been reserved for situations where a clinician believes it may be appropriate, such as certain nerve compression problems or structural concerns. Surgery carries risks and benefits that vary by person, and the decision is made together with a qualified surgeon.
How the right doctor may help
The right spine doctor may help by listening carefully, examining you, and explaining what may be contributing to your symptoms in plain language. A visit generally includes questions about when pain started, what makes it better or worse, and how it affects sleep, work and activity.
A good provider may also walk you through the range of options, from non-surgical care to surgery, and explain the possible benefits, risks and alternatives of each. No outcome can be promised, and your care should be tailored to you.
Helpful questions to ask include: What do you think is causing my symptoms? What tests do I need and why? What are my options, including doing less? What are the risks? How much will care likely cost, and does my insurance cover it? If a product or injection is suggested, ask about its FDA status, its tissue source and the alternatives.
The whole-person view
Body, mind and stress affect each other, and this is often true with back pain. Ongoing pain can disrupt sleep and mood, while stress and tension can make the body feel more sore. Looking at the whole person, including movement, rest, work and emotional well-being, can be part of thoughtful spine care.
Some people explore supportive resources alongside medical care. Somatic Experiences offers body-based support that some find helpful for how they relate to tension and sensation, and Therapists.plus offers talk therapy for coping with the stress of persistent pain. Providers.plus lists licensed providers if you are looking for a clinician.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Licensed professionals should guide care for any spine condition, and this page is educational only, not medical advice or a diagnosis.
- Seek emergency care by calling 911 for sudden weakness, loss of bladder or bowel control, numbness in the groin area, or severe pain after an injury. If you are in crisis, call or text 988.
- Injectable amniotic, umbilical cord, Wharton's jelly and exosome products marketed for back pain, discs or joints are generally not FDA-approved for those uses, and the FDA has warned the public about unapproved regenerative products. Most contain no living stem cells after processing, and they should not be assumed to regrow disc or cartilage tissue.
- Before any treatment, ask the provider about risks, alternatives, total cost and insurance coverage, and consider a second opinion for major decisions.
Doctors
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Frequently asked questions
What is spine care?
Spine care is the evaluation and care of the neck and back, including the discs, bones, joints and nerves. It may involve non-surgical approaches, surgery, or both, depending on what a licensed clinician finds. The goal of a visit is generally to understand your symptoms and discuss options.
What kind of doctor should I see for back pain?
Many people start with a primary care clinician, who may refer them to a spine specialist such as a physiatrist, pain medicine physician, orthopedic surgeon or neurosurgeon. The right choice depends on your symptoms and needs. Providers.plus can help you find licensed providers.
What happens during a spine evaluation?
A spine evaluation generally includes a discussion of your history and symptoms and a physical exam of movement, strength and sensation. A clinician may recommend imaging or other tests if they think it is appropriate. You can then discuss possible next steps and ask questions.
Does everyone with a disc problem or sciatica need spine surgery?
No, surgery is not the path for everyone, and the decision belongs to you and a qualified clinician after an evaluation. Many people are first guided through non-surgical spine care. Ask your doctor about the risks, benefits and alternatives of any option.
Are amniotic injections approved for back pain or disc problems?
Generally no. Injectable amniotic, umbilical cord, Wharton's jelly and exosome products are not FDA-approved for back pain or disc problems, and the FDA has warned the public about unapproved regenerative products. Amniotic membrane's established uses are as a wound covering and on the eye surface. If a provider suggests one, ask about its FDA status, tissue source, risks, alternatives and total cost.
What should I ask a spine doctor at my first visit?
Ask what may be causing your symptoms, what tests are needed and why, and what your options are, including non-surgical care. Also ask about risks, expected recovery, total cost and insurance coverage. Bringing notes about your symptoms can make the visit more useful.
Educational resource. Amniotic Doctors shares general information and connects people with independent doctors. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.