Back Pain Years After Spinal Fusion. What Doctor Should I See?

If you have scoliosis and have had spinal fusion, you may have some back pain in the future. If you don’t need another surgery, your orthopedic surgeon is not the right doc to see. 

But, what kind of doctor treats scoliosis in adults? Especially after spinal fusion?

 I had my last spinal fusion surgery at age 14, and did fine with minimal pain until I was in college. At age 22, I started getting pain in my low back, and having only seen an orthopedic surgeon for back pain, I decided to see one. 

 Since I was in a new city, it was a new doctor. He took x-rays, told me that the scoliosis rods looked fine, my back was okay, and he couldn’t do anything for me

He sent me on my way and passingly suggested I try physical therapy. I started seeing a PT who helped me somewhat. Fast forward 2 years to grad school, the Emory Doctor of Physical Therapy program. With all the sitting and increase in stress, my pain worsened.

I went to the student clinic, hoping for a PT referral, and the doctor told me I needed to see a back doctor first. I told him that the last orthopedist couldn’t help me, and that’s when I learned about physiatrists. He sent me to see a physiatrist who I still see every few years. 

 What is a Physiatrist?

Physiatrists are trained physical medicine and rehabilitation doctors. They often specialize in pain management, and work closely with surgeons after major surgeries for full rehabilitation of patients. 

 Their goal is to reduce pain and increase function, especially through exercise, injections, and medications. They work closely with physical and occupational therapists. 

I like to think of my physiatrist as a non-surgical orthopedist. She helps many with scoliosis pain relief, complications after spinal fusions, and helping people get back to normal life after spinal fusion. 

She is the only doctor I’ve seen who actually has tested the strength of my hip muscles thoroughly and correctly. She takes x-rays when I go to make sure my curve is not changing and my hardware is in the correct place.

 I have had an injection from her before, and she’s suggested specific physical therapists who are scoliosis trained. I have a lot of trust in her. The only trouble I have is she has a long waiting list for patients to see her. 

When Should I see an Orthopedic Surgeon?

In general, your orthopedist will want to follow up with you for a few years post op. They will want to make sure the hardware is in the correct place, your fusion is complete and solid, and that your spine has fully healed. 

 If you are having new onset, severe pain a few years after your fusion, it may be a good time to check in with your surgeon.  Additionally, if you feel like something, “just isn’t right” you should follow up with them. 

However, if you are consistent in following up with another provider who takes X-rays for you, then they will definitely be able to tell you when and if you need to see your surgeon again. 

How Can a Physical Therapist Help Me?

When you see your doctor, they may suggest seeing a physical therapist (PT). There are a lot of different types of PTs out there, and a lot of different training and skill sets. What would be best for you to see? And How can they help? 

If you didn’t know, PTs can go through residency programs and specialist certifications throughout their careers and also take many different continuing education courses.

If you are having pain that you feel is coming from your back muscles and joints, I would suggest looking for an orthopedic certified specialist PT. The ABPTS has a great tool for looking up providers near you.

If you have a scoliotic curve after fusion or not, you may want to look for a PT trained in the Schroth method

 If you are a new (or experienced) mom and feel some of your difficulty is from your core or pelvic floor, I would suggest seeing pelvic floor therapist. Some may have taken their specialty certifications, while others are trained but haven’t taken their certifications. 

 Whenever your pain is muscular, a physical therapist would be the best provider to see. 

I especially get relief from Dry Needling when I’m having muscle pain or cramps. If I have a headache that’s coming from my neck or a spasm that creates pain for a few days, dry needling really helps relieve this pain. 

 If you haven’t heard of dry needling, it is used to relieve trigger points or knots in muscles. It is non-medicated single filament needles that are inserted into your muscles. 

 Dry needling can especially be helpful in scoliosis pain relief and as your muscles are recovering after surgery.  It is available in most states, but there are a few states that PTs are still limited in this. 

 If you have any questions on PT for your pain after spinal fusion, please don’t hesitate to reach out. I’d love to share my knowledge as a patient with a similar problem and as a physical therapist. 

 

<3 Hannah

 

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