Who We Are
At Palladian Health, we are dedicated to improving the management of low back pain. We provide high quality scientific information to people with low back pain. Solid information will help you to deal with low back pain on your own. It will also help you to navigate the health care system with confidence if you choose to see a doctor. Palladian Health can also provide you with a health coach to help you get the best care from your doctor. Palladian Health is also committed to helping doctors get the information they need to be more efficient. By connecting the different types of doctors in our network, we help them to give even better care.
You may prefer to manage your low back pain yourself. If you do, check the list of Red flags for low back pain first. Red flags are signs and symptoms that indicate low back pain might be related to a potentially serious condition. If you have a Red flags, see your doctor to help rule out rare but serious conditions before managing your own low back pain.
If you prefer to see a doctor, you will likely get your first care for low back pain from your family doctor, other primary care physician, chiropractor, or physical therapist. Your doctor will ask about your low back pain, review your medical history, and conduct a physical exam. Your doctor will make sure you have no Red flags and then check to see if your low back pain might come from a few other rare causes.
Rare causes can include inflammatory arthritis, spinal stenosis, or even causes outside the low back. Your doctor will most likely tell you that you have non-specific low back pain. More than 95% of low back pain cases are non-specific. Some doctors use slightly different terms. They may also say you have lumbago, simple backache, common back pain, lumbar sprain, or lumbar strain. All those terms mean the same thing.
Primary care. Research shows that the best treatment for more than 95% of people with low back pain is an approach that relies on what doctors often call “conservative” treatments. Conservative treatments often include education, self-care, return to normal activities, heat or ice, and over the counter medication. Those treatments should help you carry on with your life while your low back pain disappears. If not, you might try other forms of conservative treatments such as spinal manipulation therapy, supervised exercise therapy, or a combined approach. Those treatments are highly effective during the first 3 months of low back pain.
Secondary care. A minority of people won’t be able to get relief through primary care alone. When that happens, a primary care doctor may suggest a referral to a secondary care doctor. Depending on the situation, the secondary care doctor may be a neurologist, a physiatrist, an orthopedic surgeon, a neurosurgeon, or another medical specialist. A neurologist is a doctor who specializes in diagnosis and treatment of diseases of the nerves. A physiatrist is a doctor who specializes in rehabilitation and non-surgical treatments of spinal disorders. An orthopedic surgeon is a doctor who specializes in operating on bones and joints. A neurosurgeon is a doctor who specializes in operating on the brain and spinal cord.
Secondary care usually starts with a thorough exam to rule out specific physical causes of pain. Secondary care may continue if the exam detects one of the specific spinal problems that sometimes respond to surgery or other interventions such as injections. Otherwise, the secondary care doctor may suggest returning to a primary care doctor for more conservative treatments.
Tertiary care. Very few people with low back pain will not improve even after trying primary care and secondary care. Sometimes they may simply have rare conditions for which no treatments will work. Tertiary care is for those extremely rare cases. Tertiary care relies on a multidisciplinary approach. This approach typically includes physical rehabilitation, medication, and behavioral therapy to return patients to a normal and productive life.
