PLEASE NOTE that the only spinal specialists are those who are qualified in orthopaedic medicine (Professor Cyriax) or manipulative medicine (Professor Maitland). NO OTHER PRACTITIONER IS A SPINAL SPECIALIST - they have only relative knowledge of spinal treatment methods which is therefore non-specialisitc and basic.
In the USA - there are no spinal specialists in the above fields because unfortunately there are no faculties offering this clinical training. The emphasis is on carrying out surgical procedures which are clinically false because they are based upon tests like MRI scans and X-rays which have no value because they invariably give rise to false diagnoses.
In the UK, the NHS has no spinal specialists - only spine related practitioners - and therefore this again results in unnecessary surgery and clinically false treatment involving thousands of patients.
All clinical tests carried out by non-spinal specialists are clinically false.
Orthopaedic Spinal Specialist
Surgical skills only - they do not examine the pathology or know how to treat patients. eg for mobilisation they refer patients to physiotherapists who may order MRI scans - surgery is usually the end result of seeing or being referred to such a specialist.
Same result as above - surgery is their only form of "treatment".
This practitioner can examine and treat (by referring to physiotherapists) but relies too often on drugs and injections of one form or another and they usually advocate surgery.
Orthopaedic Physician /Osteopathic Physician
They are trained to examine and can treat mainly by way of drugs, sclerosing and non-sclerosing injections. Some can manipulate and apply physiotherapy procedures, but they usually cannot mobilise and cannot solve chronic cases, even if they have a postgraduate speciality in osteopathy, because is it not part of their clinical training - so they advocate surgery.
They can examine, administer drugs, injections, cannot usually mobilise or manipulate and generally refer cases for surgery.
Pain Management Physicians
They cannot mobilise or manipulate and rely on practices such as anaesthetics or acupuncture before referring to surgery. They are not trained to treat mechanical disorders of the spine.
They can examine and treat and are skillful manually but less so diagnostically. They rely sometimes on X-rays which have a .5% validity, and they manipulate using standard techniques which can sometimes produce results on a hit-and-miss basis. They follow routine treatment procedures regardless of the pathology (history) of the patient and consequently they can and do cause more harm than good by tearing discs and manipulating where there are contra-indications present.
They are not helpful in solving chronic cases and sometimes refer patients for surgery when they are not able to cure a condition themselves.
These practitioners examine and treat acute cases better than they do chronic cases and they manipulate using so called long-leverage techniques. They tend to use unproven methods for relating pathology to diagnosis with the result that that do no understand the pathological relevance in regard to technical manoeuvres. A serious contraindicative neurological condition can therefore easily be overlooked and provoked by manipulation which should not be performed.
These practioners generally have no specialist clinical training at all in treating spinal disorders. They use unproven techniques, they cannot treat acute or chronic diorders, and cannot effectively manipulate or mobilise unless they are trained as a manipulative specialist in manipulative therapy. (Such therapists are very highly skilled and able to deal with all spinal disorders).
Physiotherapists receive referrals from MDs and always work under the supervision of the referrer. If they cannot cure a spinal condition (which often they can't because they lack the training and qualifications) the poor patient is then referrd back to the MD who then refers the patient for surgery.
These practitioners can treat all spinal conditions using conventional methods but they are not qualified to mobilise and manipulate. All of them receive their training in the USA. Surgery is often recommended.
Unless the spine has been broken, surgeons should be avoided at all costs because they have no clinical training in manual (orthopaedic) medicine and they have only one approach to treating spinal conditions:surgery.
Examples of surgery are: Micro discectomy, whereby the outer rim of a disc is trimmed, is a 'popular' experiment/operation that has no clinical validity and which causes chronic pain and permanent disability. Decompression via a bilateral laminectomy followed by fusion is also a barbaric operation that leads to total spinal instability and permanent pain.
Spinal surgery should be reserved only for those cases involving fractures, tumours, and substantial bone deformities, otherwise the only result will be that the patient's life will be shortened and the quality of life ruined.
The vast majority of spinal operations are absolutely useless and are carried out purely for commercial reasons. This applies even to the National Health Service in the UK where thousands of operations are carried out every year with the sole result that patients are crippled for life. This is because the sole emphasis is on surgery while hardly any money is spent on developing training facilities for teaching students about manual therapy. There is only one university in the UK offering any courses in this important field of practice (Coventry University).
Spinal surgery has developed into a financial racket with no legal or moral control over it's consequences, as very often the patient is forced to sign a disclaimer waiving their rights to sue the hospital except in the case of proven negligence.