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Training and Treatment Differences Between Chiropractors and Spine Doctors

Should I see a Chiropractor or Doctor for my Back Pain?

Imagine this scenario: You’ve done everything you can think of to ease your back pain, including over-the-counter medications, ice and heat, and gentle stretches and exercises. But your back pain just won’t go away. From whom do you seek treatment – a chiropractor or a medical doctor?

Several fundamental differences in training, approach and treatment options should influence your choice, says Kaliq Chang MD, of Atlantic Spine Center. While the National Institutes of Health points out that back pain (especially the lower back) is extremely common, affecting about 80% of Americans at some point in their lives, deciding whom to seek help from isn’t necessarily easy, Dr. Chang says.

“The various health professionals who typically treat back pain, who include chiropractors and medical doctors specializing in interventional pain management of the spine, tend to have very different training and techniques at their disposal to treat these patients,” explains Dr. Chang, an interventional pain management specialist. “Choosing the provider who’s the best fit for your individual situation requires understanding these differences.”

Training and approach differ

What are the training and certification differences separating chiropractors and doctors practicing spine medicine? Dr. Chang explains:

Chiropractors diagnose and treat primarily back and neck pain. To do so, they:

  • Attend a graduate-level chiropractic program involving an average of 4 years of education
  • Complete a 1-year internship at a college clinic
  • Take board licensing tests

Spine doctors can include MDs (medical doctors) and DOs (doctors of osteopathic medicine) who specialize in surgery, neurology, orthopedics, spine medicine and/or anesthesiology and may focus on diagnosing and treating back pain and/or a variety of other medical problems. To do so, they:

  • Attend medical or osteopathic medical school for 4 years
  • Complete a 3- to 7-year residency within their specialty
  • Possibly complete a spine fellowship or other specialized fellowship lasting several more years
  • Take board certification and licensing tests
  • Treatment options vary

As with certification and licensing requirements, treatment options that chiropractors can offer compared to medical doctors also vary greatly, Dr. Chang notes.

Chiropractors are able to offer drug-free, non-invasive treatments. The bulk of chiropractic care centers around spinal manipulation, but they can also help address pain in areas such as the foot, elbow, shoulder and neck. They may also use techniques involving light, ultrasound, water, massage, electricity and heat therapy.

“Most chiropractors spend much of their time ‘adjusting’ the spine through manual movements to address patients’ lower back pain, neck pain or whiplash-related problems,” Dr. Chang says.

Medical doctors who specialize in spine care, by contrast, may also manipulate the spine but they’re also able to offer a broader and more intensive array of treatments. These doctors can prescribe medications or physical therapy, inject steroids into problematic joints, and perform spine surgery addressing a host of back pain-causing conditions in and around the spinal cord.

“Recent years have seen spine surgery becoming increasingly specialized within neurosurgery and orthopedics, and these days surgeons will often concentrate most of their practice on spine surgery,” Dr. Chang says. “Because of this, surgical techniques have become increasingly minimally invasive, improving outcomes and contributing to less pain and quicker recovery in patients.”

“There’s a place in back pain treatment for both chiropractors and medical doctors,” he adds. “Just know what each can offer so you can be the best advocate for your own care.”

3 min read

April 1st, 2020

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