In addition to epidural injections of cortisone, an injectionist might inject medication into the facet joint [located on each side of the vertebrae] to relieve irritation and inject local anesthetics and steroid medications into specific “trigger points.”
These injections don’t actually heal anything, Fish says. “It’s like putting a Band-Aid over a blister when your shoe doesn’t fit well. That doesn’t change the fact that the shoe (foot interface) doesn’t seem to fit but it blocks the pain so that over time a callous can develop on the foot and the shoe will stretch.”
A chiropractor receives a doctor of chiropractic degree from a 2 to 4 year accredited institution. Chiropractic training focuses on the musculoskeletal system, and chiropractors primarily use spinal manipulation and adjustment to relieve back pain. They also use soft tissue therapies, and frequently also offer massage therapy and exercise training.
“Although we don’t have chiropractors on staff here, I frequently refer patients to outside chiropractors,” says Johnson. “They can be very effective. Both chiropractic and physical therapy can be good first-line treatments for back pain.”
Integrative Care and Other Practitioners
Depending on your personal situation, your physiatrist or other back pain specialist may suggest that you see other types of caregivers, including:
- Acupuncturist. Many spine clinics have trained acupuncturists on staff, and some physicians have also trained in acupuncture. This Eastern tradition, which uses fine needles inserted at specific points on the body, has been found in some studies to alleviate back pain.
- Biofeedback or relaxation specialist. Biofeedback and guided relaxation have been found to be helpful for people coping with back pain.
- Nutritionist. If you are overweight or obese, that may be aggravating your back pain. A nutritionist can help improve your diet and reduce the burden of your weight on your back.
- Psychiatrist or psychologist. Many studies have found links between chronic back pain and depression. Whether back pain causes depression, depression causes back pain, or both, it’s a good idea to have access to a mental health specialist to help you cope with the emotional challenges of living with back pain.