For persistent back pain treatment, call a specialist

Implications: If back pain persists, the patient should be referred to a specialist so further diagnosis and workup can be undertaken.  Patients with back pain are treated with a variety of interventions and medications in the hope that they will return to their normal activities.  Too often, the initial diagnosis is non-specific, and the treatments ineffective.  The appropriate timing of the referral to a specialist may avoid unnecessary delays and treatments. The key issue is to avoid unnecessary treatments and diagnostic studies by focusing on the correct diagnosis as early as possible in the process

Analysis: Back pain is extremely common.  It is one of the main causes of missed work and insurance claims.  Unfortunately, the treatment of back pain is frequently a haphazard process due to the lack of helpful standardized algorithms. 

The primary care physicians order imaging studies, physical therapy and spinal injections prior to making a definitive diagnosis.  While this approach works some of the time, it is expensive, and sometimes leads to delays in diagnosis, as well as wasted time and wasted resources.