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The multidisciplinary approach to back and neck pain

You're back hurts. You're not sure what started it or where it came from, but it is here now and you don't know what to do about it. Do you call your primary care doctor or go to the emergency room. Should you see a Chiropractor or an Osteopath? Should you take medication and if so which one? Medications, procedures, manipulation, braces, physical therapy, surgery, the list goes on and on.

With all of the options for evaluating and treating back pain, a new concept has evolved called the "Multi-discipline" approach to back pain. The concept for this new model is based on the premise that back pain is an elusive and complicated problem that can be difficult to diagnose and even more difficult to treat. The multi-discipline approach to back pain brings all of the specialties to the patient rather than the other way around. This was the concept that led to creation of the New Hampshire NeuroSpine Institute. We have combined leading specialties and treatments and put them under one roof. Whether the problem is acute or chronic, surgical on non-surgical, our team of doctors and therapists will diagnose the problem and find the right treatment without the patient having to leave the facility. The evaluation may begin with one of our team of physiatrists (doctors of physical medicine and rehabilitation).These doctors are extensively trained in the diagnosis and non-surgical treatment of back pain as well as a host of other physical ailments. They utilize state of the art equipment such as electro diagnostics for identifying which nerves may be involved. This may lead to slightly more interventional procedures such as epidural steroid injections (ESI), nerve root blocks, or facet injections. Our physiatrists are trained in these and other procedures, allowing for a continuity of care that links the diagnostic process to the treatment process.

A vital component of the multidiscipline approach is the involvement of physical therapy. Patients are often referred to a physical therapy facility by the treating doctor without the doctor's input as to what type of therapy will be used. The therapist may have limited information on what diagnosis they are treating and therefore what specific therapy modalities will be most effective. In a multidiscipline environment there is a direct communication link between the doctor and the therapist. This communication link of course works in both directions so that changes can be made in the working diagnosis or specific treatment modality based on the therapists observations. It is not unusual for a doctor to also observe the patient at therapy, saving valuable time and resources to optimize the treatment.

The last link in the multidiscipline chain is the surgeon. Instead of surgery being a separate evaluation disconnected from the rest of the treatment plan, our surgeons are an integral part of the total care of the patients. A patient or referring physician may be confused as to when a surgeon should be involved, and which type of surgeon (Neurosurgery or Orthopaedics) should be consulted. In a multi-discipline environment the patient may see one or the other but ultimately receives the benefit of both. Our neurosurgeons, orthopedic surgeons, and physiatrists work side by side, often consulting each other and sharing perspectives without additional expense to the patient or insurance company. This pooling of expertise assures that our patients receive the very best evaluation and treatment all at one facility. This multi-discipline approach is unique to the New Hampshire NeuroSpine Institute allowing us to remain the acknowledged leader in the evaluation and treatment of neck and low back pain.