No two spines are alike. Spinal disorders, their causes, and presenting symptoms are therefore different. It takes time for a physician to diagnose a specific disorder because he or she needs to rule out other underlying health conditions. For example, if a person sees a doctor complaining of low back pain, it must first determine if it is indeed a back problem and not one resulting from a urinary tract infection, a herniated disc, referred kidney pain or something even more severe such as cancer.
Here’s why multiple specialists should be consulted in your treatment:
The complex nature of a spinal curvature is such that at least three types of spine disorders exist: Kyphosis, lordosis, and scoliosis. Kyphosis is a condition that occurs when the deviation of the spine points outward (otherwise known as a “rounded back”); lordosis occurs when the spine’s devitation is inward, and scoliosis is when the deviation points sideways.
With scoliosis, there are various classification systems if the cause can or cannot be determined. If the cause can be determined,such as trauma, the doctor will have to make a further determination:Some common ones are as follows:Congenital (failure of formation, can be pre-natal); Idiopathic (Infantile: age 0-3, Juvenile:age 3-10), Adolescent,ages 10+); Neuromuscular (Myopathic, Arthrogryposis,Muscular Dystrophy);Neuropathic (Upper motor neuron, Lower motor neuron) and Other types such as Neurofibromatosis, Marfan’s,Ehler’s Danlos, Traumatic, and various tumors that can cause the spinal column to shift.
If your primary visit to the doctor is your family doc or internist, he will most likely suggest you seek a second opinion from a doctor who is more familiar with scoliosis conditions. This might be an orthopedist, a chiropractor, a physical therapist, or a physiatrist.
Diagnosing spinal column disorders is not as straightforward as it appears, despite sophisticated medical devices that are commonly used. Your doctor will need the assistance of specialists who are knowledgeable about magnetic resonance imaging, CT scans as well as plain x-rays. Each of these diagnostic procedures has a specific purpose. The MRI is used when the specialist needs to obtain information about soft tissues, including tumors, or other space occupying lesions. A CT scan is used to get a 3D image or angles of a patient’s skeletal frame, while x-rays are used to show what the spine looks like bio-mechanically as well as structurally
Equipment specialists are trained on how to position a patient during a diagnostic procedure that involves any one or a combination of these machines. They would also know which images or angles have to be examined
Rarely do we recommend surgery unless it is absolutely necessary, as in severe unrelenting back and leg pain. For instance, a surgical procedure called a foraminotomy will require a specialist. When a person’s back pain is extreme because the spinal nerves are significantly affected, this procedure is intended to remove some of the pressure on the nerves. This is done by making the opening at the back larger at the point where the nerves leave the spinal cord.
A surgical specialist for a consultation in severe cases of either back pain or scoliosis can be a good idea so you understand the picture from that point of view. However surgery of any kind is an extreme trauma both physically, mentally and spiritually and therefore while obtaining the surgeon’s viewpoint, all the short, medium and long term ramifications should be considered along with the Chiropractic Specialist, the Family doctor and others consulted.
If the patient is in severe pain, then pain medication and a pain management team can guide the patient on how to cope and manage with his pain, and to prescribe acceptable doses of his medication.
Pain specialists will recommend one or a combination of anti-inflammatories, analgesics, relaxants, narcotics, or antidepressants. A patient’s history of allergies to drugs is of paramount importance so his care team can prescribe the most appropriate and safest .
Note that when patients are suffering from chronic pain caused by their spinal condition, their pain can rob them of quality of life. Their pain can be debilitating to the point that they are unable to do the simplest tasks. When this happens, it is only a question of time before their mental health is affected. If a spinal patient becomes depressed, he or she will need the supervision of a specialist who is experienced with the pain-depression equation.
Patients who are being treated for their spinal column will ask their doctors if they can have an exercise program to speed up their recovery. This is where a sports medicine chiropractic specialist or physiotherapist can help. For various scoliosis conditions, there are chiropractic specialists that only treat scoliosis.
In most post treatment cases, spinal patients are encouraged to follow an exercise program to continue their long term positive outcome for their condition. Exercise is one component of the whole “functional restoration” concept that is extremely important.