Yes. Many people see both. A pain management physician can examine nerves, order imaging, prescribe medication and offer procedures that chiropractors don't. If pain isn't improving, travels down an arm or leg, or comes with numbness, a medical evaluation is the next step.
What's the difference between a chiropractor and a pain management doctor?
Chiropractors are licensed health professionals who focus on the musculoskeletal system, especially the spine. Care usually includes spinal manipulation, soft tissue work, exercise advice and other hands-on treatments. Many people find it helpful for neck and back pain after a crash.
Pain management physicians are medical doctors, often trained in anesthesiology or physical medicine and rehabilitation, who complete additional training in diagnosing and treating pain. They can:
- Perform detailed neurological exams
- Order and interpret imaging such as MRI and CT
- Prescribe medications
- Perform image-guided procedures like epidural steroid injections, medial branch blocks and radiofrequency ablation
- Coordinate with orthopedics, neurology and counseling, and refer you to an outside physical therapy provider when it fits
The two fields overlap in some areas and complement each other in others. Seeing one doesn't rule out the other.
When should a chiropractic patient also see a pain doctor?
Consider a medical evaluation if:
- Pain hasn't improved after several weeks of care
- Pain travels down an arm or leg, especially below the elbow or knee
- You have numbness, tingling or weakness
- Headaches, dizziness, memory trouble or confusion started after the crash
- Pain wakes you at night or is getting worse
- You need imaging that hasn't been done
- Pain is limiting work, sleep or daily life
Some symptoms need emergency care no matter who you're seeing: loss of bladder or bowel control, numbness in the groin, sudden weakness in a leg, or severe headache with confusion or vomiting. Call 911.
Will my chiropractor be upset if I see a doctor?
Good chiropractors refer to physicians when symptoms call for it, and many work alongside pain management and orthopedic practices. It's your care. You're allowed to get another opinion, and you should tell each provider who else you're seeing.
What happens at a pain management visit?
The first visit usually includes:
- A detailed history of the crash and your symptoms since
- Review of any prior treatment, including chiropractic notes and imaging
- A physical and neurological exam
- A discussion of what's likely causing the pain
From there, the physician may recommend imaging, medication, a referral to an outside physical therapy provider, an injection to diagnose or treat the pain source, or simply continuing your current care with a plan to recheck. Procedures are recommended only when the exam and history support them.
Can I keep going to the chiropractor while I see a pain doctor?
Often, yes. Some people continue chiropractic care while a physician manages medication or procedures. Your physician may suggest a pause in manipulation after certain procedures, or if imaging shows something like a disc herniation with nerve compression. Talk it through with both providers so your care fits together.
Duplicating the same kind of treatment from two places rarely helps. Coordinated care, with each provider doing what they do best, usually works better.
What can a pain doctor find that might be missed?
Most neck and back pain after a crash comes from soft tissue strain and resolves. But some causes need medical diagnosis:
- A herniated disc pressing on a nerve root
- Facet joint injury that's keeping pain going for months
- A fracture that wasn't caught on early X-rays
- A concussion causing headaches that were blamed on the neck
- A shoulder or hip injury that's referring pain
Finding the actual source changes the treatment.
Is it better to see a medical doctor first after a crash?
A medical evaluation is a good first step because it can check for injuries that need imaging or urgent care, such as fractures, nerve problems or concussion. After that, many people do well with a combination of medical care, physical therapy and, if they choose, chiropractic care.
Can my care be in Spanish?
Yes. All SpineLUX services are offered in Spanish. Questions about payment? Call 972-920-9111 and our team will walk you through it.
Where can I see a pain management physician in Texas?
SpineLUX interventional pain management physicians evaluate accident-related neck, back and nerve pain, and coordinate care with orthopedics, spine care, neurology, imaging and counseling. Clinics serve Irving, Houston, San Antonio, Live Oak, McAllen and El Paso, with intake in English and Spanish. The Irving clinic is at 100 E Royal Ln, Suite 125.
Call 972-920-9111 to schedule.
How do I tell my chiropractor and my pain doctor about each other?
Just tell them. Bring a list of everyone you're seeing to each visit, along with your medications. With your written permission, offices can share notes so each clinician knows what the other is doing. That helps avoid repeating imaging and helps time treatments well, such as spacing manipulation and an injection.
What questions should I ask at my first pain management visit?
Ask what the physician thinks is causing your pain, what tests might help, what the treatment options are and what each one involves. Ask what you should keep doing with your chiropractor and what, if anything, to pause. Ask what improvement should look like in four to six weeks, and what the next step would be if it doesn't happen.
Is it safe to keep getting adjustments while I see a pain doctor?
For many people, yes. Your pain physician may ask you to pause neck manipulation if there are nerve symptoms or certain imaging findings, or to space adjustments around a procedure. Ask directly so both clinicians are working from the same plan.
This article is general information, not medical advice. Treatment depends on an individual clinical evaluation, and results vary.
Common questions
What else do patients ask?
Do I need a referral from my chiropractor?+
No. You can call SpineLUX directly. Bring any records or imaging you have.
Will a pain doctor just give me opioids?+
No. Medication choices depend on your exam and history, and many plans use non-opioid options, therapy and targeted procedures.
Can a pain doctor order an MRI?+
Yes, when the exam and symptoms call for it.
Should I stop chiropractic care before my visit?+
Not unless told to. Bring your chiropractic notes so the physician knows what's been tried.
What if both say different things?+
Ask each to explain their reasoning, and share records between them. Coordinated care works best when everyone's on the same page.