Your back hurts. It’s hurt for a long time, and over-the-counter pain relievers just aren’t cutting it anymore. You’re finally ready to see a doctor, but what kind should you see? An orthopedic surgeon? A pain management doctor? What about a chiropractor?
How about all three?
In Hampton Roads, it’s not uncommon for different specialists to work together and refer to one another in order to get the best care possible for their patients. Dr. Robert Pinto, a chiropractor with Pinto Chiropractic & Rehabilitation in Williamsburg, Va., says he often gets referrals from other doctors who recognize that sometimes chiropractic care is exactly what’s needed, rather than medication or surgery.
Sometimes, it’s a combination of different treatments that can best help a patient.
“We’re all in the same boat,” says Dr. Jeffrey Carlson, a spine specialist at Orthopaedic & Spine Center in Newport News. “We’re here to make the patient better. If I don’t think they need surgery, let’s get them to the chiropractor.” A chiropractor is a doctor who focuses on disorders of the musculoskeletal and nervous systems, and treats patients through manual adjustment and/or manipulation of the spine and extremities. Chiropractors are trained to provide therapeutic and rehabilitative exercise programs as well as nutritional, dietary and lifestyle counseling. Many chiropractors also utilize physical therapy treatments such as traction, electrical muscle stimulation, therapeutic ultrasound and laser therapy.
In Pinto’s eyes, too often people think surgery is the only option. Medical literature, he says, supports chiropractic as a first line of defense for neck and back pain. Results are often achieved faster and last longer.
In spite of that research, many patients suffering with back pain often choose chiropractic treatment as a last resort. Working together as a team, health professionals are doing their part to change people’s perceptions and get them the best option for their condition, Pinto says. A chiropractor can treat all sorts of maladies, from headaches and TMJ to disc problems in the back. There are many kinds of interventions that can be done; you just have to manage them carefully.
Sometimes all it takes is realignment or some manipulation, Carlson says, not being cut open.
I don’t want to operate on anyone who doesn’t need it,” he says. “Patients don’t want to be operated on if they don’t need it.”
Chiropractors are trained to recognize when patients need surgery. Other times, pain management might be needed. That’s where someone like Dr. Raj Sureja comes in.
Sureja, a pain management specialist at OSC, says his goal is to figure out a patient’s pain and treat it using the least amount of medication possible. A chiropractor can work with a patient to help improve mobility and flexibility. Or maybe a pain specialist can suggest medication to help get inflammation down so the alignment process can work better.
It’s another complementary treatment that potentially might help,” Sureja says. “If we can collaborate with our chiropractic colleagues to reduce pain, the patients can use less medication. I think our practices work well together.”
Many practices are trending toward integrating orthopedic, chiropractic, sports medicine and other specialties. A patient may work with a pain management doctor to help reduce symptoms with pain medications and/ or injections, meet with a chiropractor to help restore joint mechanics and function and work with a physical therapist to develop a home exercise program.
“When nothing’s really helping, and the patient finally calls uncle, then we go in surgically and relieve the pressure,” Carlson says.
Even if surgery is needed, patients can often resume chiropractic care afterward. Carlson had one patient who was six weeks out from lumbar surgery and wanted to know if she could go back to her chiropractor for hip issues and headaches. He said sure.
For all the specialists, “the mantra is do no harm,” Sureja says. “Everybody is focusing on improving the patient’s quality of life.”
