Primary care providers

Primary care physicians (M.D.)
Doctor of Chiropractic (D.C.)
Doctor of Osteopathy (D.O.)

A medical doctor, doctor of chiropractic, or doctor of osteopathy is a practitioner of the healing arts who examines patients, analyzes the results of laboratory tests, diagnoses and treats the patient's medical condition, and advises the patient about methods of preventive health care. Doctors differ from pure scientists in that medicine is a marriage of the biological sciences and the humanities and must apply his or her scientific knowledge in the context of patient care.

1. Primary care physicians (M.D.)—types of primary care physicians typically include family practice doctors, internists, obstetricians, gynecologists, and pediatricians (as well as chiropractors and doctors of osteopathy, reviewed below). As back pain is extremely common, these doctors often have extensive experience in treating acute lower back pain and muscle strains.
   
   Primary care physicians have a non-invasive (non-surgical) approach and often utilize prescription medications to help reduce pain and inflammation, as well as the services of physical therapists to assist in maintaining range of motion and muscle tone. Often, they may order a variety of spinal diagnostic procedures to more fully investigate the potential causes of persistent back pain and neck pain and refer patients to a specialist for further diagnosis and treatment.
   
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2. Doctor of Chiropractic (D.C.)—Chiropractors diagnose and treat back and neck pain and are considered by definition primary care physicians as they are often the first doctor a patient will visit when experiencing back pain. Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body's muscular, nervous, and skeletal systems, especially the spine.
   
   Chiropractic education consists of four academic years of chiropractic training, as well as a one-year internship at a college clinic. Successful completion of 2 levels of National Boards is required for chiropractors and a third level for those who use physiologic therapeutics in their practice. Part IV is often used for state licensing and tests knowledge of diagnostic imaging, chiropractic technique, and case management.
   
   The chiropractic profession holds that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system, and that skeletal imbalance through joint or articular dysfunction - especially in the spine - can cause pain and/or dysfunction.
   
   As with all healthcare practitioners, chiropractors follow a standard routine to secure the information needed for diagnosis and treatment. When the source of pain involves musculoskeletal structures, chiropractors manually manipulate or adjust the spinal column. Many chiropractors also use water, light, massage, ultrasound, electric, and heat therapy and may apply supports such as straps, taping and braces. They may also counsel patients about wellness concepts such as nutrition, exercise, lifestyle changes, and stress management, but do not prescribe drugs or perform surgery. When appropriate, chiropractors consult with and refer patients to other health practitioners.
   
   Some chiropractors specialize in orthopedics, sports injuries, neurology, nutrition, internal disorders, and/or diagnostic imaging. Chiropractic is considered an integral part of the back care team as noted in many guidelines published in this and other countries and many chiropractors have joined multidisciplinary spine care practices.
   
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3. Doctor of Osteopathy (D.O.)—Osteopathic medicine is one of the two health fields nationally recognized as complete schools of medicine. Osteopathic Physicians, also known as Doctors of Osteopathic Medicine or Doctors of Osteopathy ( D.O.) diagnose and treat all illnesses and injuries and emphasize preventive care, with special emphasis on:

• The need for the body's systems to be in correct relationship with one another
• The importance of the neuro-musculoskeletal system (nerves, muscles, bones, and joints)

Treatments commonly include manipulative therapy, medication, and all other therapies when needed. Osteopathic physicians can be licensed in all 50 states for the full practice of medicine. Most states require licensed D.O.’s be graduates of an approved school of osteopathic medicine and have completed a 12-month internship with an approved hospital program.

In addition to primary care-focused doctors of osteopathy, some D.O.’s are specialized in an area of medicine (as are some Medical Doctors) and may become Board Certified by completing a 3 to 4 year residency within the specialty area, such as orthopedic surgery, neurosurgery, physiatry, or anesthesiology. (See Specialty care physicians.)

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