If you experience frequent or debilitating back pain, you should consult your primary care doctor. Starting a conversation with your doctor about your back pain is the first step in identifying the cause and finding a treatment that can improve your quality of life.

Diagnosing the cause of your back pain may take time. Many conditions can cause debilitating back pain, including spondyloarthritis. Spondyloarthritis is a family of inflammatory rheumatic diseases that cause arthritis, like nonradiographic axial spondyloarthritis and ankylosing spondylitis. Read more about spondyloarthritis.

The diagnostic process starts with a frank discussion with your medical provider, a medical history, and a physical exam. Your doctor may order blood tests or an X-ray to help determine the cause of your pain.¹ If your doctor suspects you have inflammatory back pain or other symptoms of inflammatory arthritis, they may refer you to a rheumatologist to help diagnose your condition.²

At every step of the process, you are your own best advocate. You can feel empowered to ask questions about your doctor’s approach to your health and be an active participant in your care. In the medical world, working as a partner with your doctor is known as shared decision-making.³

Shared decision-making requires that you ask questions and express opinions about your treatment options, and that your doctor provides you with information and respects your preferences. For example, you may ask about what side effects to expect from a medication, or you may ask why your doctor is or isn’t considering a certain class of medications.

It may feel intimidating to speak up with your doctor — you may worry that you’re bothering them or being disrespectful. It may help to know that shared decision-making can lead to better health outcomes, in part because shared decision-making is associated with better adherence to treatment plans.³

In some cases, you may not be able to form a good working relationship with your current doctor. Or you may need to find a specialist who can better meet your needs. Many members of MySpondylitisTeam have switched doctors or sought second opinions from a physician specializing in spondyloarthritis when they were uncertain about or unsatisfied with the care they were receiving.

“I went to another doctor this week for a second opinion,” one member shared. “She told me about another medicine that she thinks will help me.” Another member wrote, “I will get a second opinion if the nerve block doesn’t work or isn’t permanent. I’m still in so much pain and so scared.”

Finding the right doctor has made a world of difference for MySpondylitisTeam members. “I want to say that my rheumatologist was a godsend. She was the first doctor who didn’t look at me like I was faking my symptoms since I was so young.”

Spartan, a North American network of health care professionals with expertise in spondyloarthritis, offers a member directory to help individuals find experienced specialists.

This doctor discussion guide can help you start a conversation with your doctor about your back pain. Print this guide, fill it out, and share the information with your doctor. Your doctor might refer you to a specialist or perform tests to help diagnose the cause of your pain.

References

1. Diagnosis of Ankylosing Spondylitis. (n.d.). Retrieved December 17, 2020, from https://spondylitis.org/about-spondylitis/types-of-spondylitis/ankylosing-spondylitis/diagnosis/
2. What is a Rheumatologist? (2018, June). Retrieved December 17, 2020, from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist
3. Shared Decision-Making. (2020, March). Retrieved December 17, 2020, from https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6i-shared-decisionmaking.html