Where to Turn for Low Back Pain Relief

Man suffering from back pain. Photo credit: Wavebreakmedia
Man suffering from back pain. Photo credit: Wavebreakmedia
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Where to Turn for Low Back Pain Relief

Man suffering from back pain. Photo credit: Wavebreakmedia
Man suffering from back pain. Photo credit: Wavebreakmedia

Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.

When pain strikes
There are many causes of low back pain. Some of the most common include an injury to a muscle or tendon (a strain), an injury to a back ligament (a sprain), and a herniated or "slipped" disc (when the soft material inside of a disc between spinal bones leaks and irritates nerves). Many of these issues will eventually resolve on their own.

But some causes of low back pain, such as a narrowing of the spinal canal (spinal stenosis), may require a specialist. "A referral makes sense when conservative measures have failed to address your back pain, symptoms aren't improving or are getting worse, or there's a suspicion that surgery might be needed," says Dr. Shmerling.

Where to turn
Since you shouldn't try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. "Both can serve as the entry point for back pain," says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women's Hospital. "And 35% to 42% of people with their first episode of back pain will consult a chiropractor."

Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.

The next step
If you do need a specialist on your team, there are many experts who can help, depending on your needs. You may be referred to any of these:

- A neurologist, a doctor specializing in treatment of the nervous system. "Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions," says Dr. Kowalski.

- A physiatrist, a doctor with expertise in physical medicine and rehabilitation. "This may be helpful for back pain related to a sports injury, if surgery is not needed, and when medications are not working," says Dr. Shmerling.

- A rheumatologist, a doctor who treats diseases of the joints, muscles, and bones. "Referral is most appropriate when there is inflammation of the joints in the back, or if the back pain might be related to an inflammatory disease, such as psoriatic arthritis," explains Dr. Shmerling.

- A physical therapist, a licensed therapist who can help you strengthen back and core muscles to absorb pressure on the spine.

- A pain management physician, a doctor who can prescribe medications, provide injections, and consider other approaches. "People with symptoms that aren't responding to treatment are great candidates for pain management, such as injections or procedures to smaller joints in lower back," says Dr. Kowalski.

- An orthopedic spinal surgeon or a neurosurgeon who primarily does spine surgery, if surgery is likely needed for severe, unrelenting pain that may be due to a disc or spinal column problem.

Keep in mind
It may take several types of tests, such as x-rays, MRIs, and blood tests, to determine the exact cause of your back pain.

And you may need more than one expert managing your back pain. It just depends on the situation. "Most people who see more than one expert have more than one problem or have not improved with prior treatments," says Dr. Shmerling.

But for back sprains, strains, and herniated discs, a visit to your primary care physician or chiropractor may be all it takes to feel better. Make that initial call if back pain is interfering with your day.



Heatwaves in Spain Caused 1,180 Deaths in Past Two Months, Ministry Says

The most affected regions were Galicia, La Rioja, Asturias and Cantabria. (Getty Images/AFP)
The most affected regions were Galicia, La Rioja, Asturias and Cantabria. (Getty Images/AFP)
TT
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Heatwaves in Spain Caused 1,180 Deaths in Past Two Months, Ministry Says

The most affected regions were Galicia, La Rioja, Asturias and Cantabria. (Getty Images/AFP)
The most affected regions were Galicia, La Rioja, Asturias and Cantabria. (Getty Images/AFP)

High temperatures caused 1,180 deaths in Spain in the past two months, a sharp increase from the same period last year, the Environment Ministry said on Monday.

The vast majority of people who died were over 65 and more than half were women, the data it cited showed.

The most affected regions were Galicia, La Rioja, Asturias and Cantabria - all located in the northern half of the country, where traditionally cooler summer temperatures have seen a significant rise in recent years.

Like other countries in Western Europe, Spain has been hit by extreme heat in recent weeks, with temperatures often topping 40 degrees Celsius (104 degrees Fahrenheit).

The 1,180 people who died of heat-related causes between May 16 and July 13 compared with 114 in the same period in 2024, the ministry said in a statement citing data from the Carlos III Health Institute. The number of deaths increased significantly in the first week of July.

The data shows an event "of exceptional intensity, characterized by an unprecedented increase in average temperatures and a significant increase in mortality attributable to heatwaves", the ministry said.

In the period the data covers, there were 76 red alerts for extreme heat, compared with none a year earlier.

Last summer, 2,191 deaths were attributed to heat-related causes in Spain, according to data from the Carlos III Health Institute.

The data from Spain follows a rapid scientific analysis published on July 9 that said around 2,300 people died of heat-related causes across 12 European cities during a severe heatwave in the 10 days to July 2.

It was not immediately clear whether the study conducted by scientists at Imperial College London and the London School of Hygiene and Tropical Medicine was using the same methodology as the Spanish data.