Back pain: which specialist should you see?

Back pain can follow a long day at a desk, a heavy lift, or a training session. It can also keep coming back for no obvious reason. Once it starts affecting daily life, many people face the same practical question: who should I book an appointment with?

There is no single route that suits everyone. A sensible starting point depends on whether there was an injury, how long the pain has lasted, what it stops you doing, and whether there are symptoms elsewhere in the body. Rehabilitation doctors, orthopaedists, and physiotherapists often work together, but they bring different expertise.

This article uses the same approach as our guide to the signals your body sends: check how urgent the problem may be, describe what has changed, and then choose a suitable first contact. It cannot diagnose the cause or replace an assessment.

Check urgency before choosing a specialist

Most lower back pain is not caused by a serious condition. Even so, there are times when comparing routine appointments is no longer the right priority.

Seek prompt medical advice if severe pain starts suddenly or is getting worse quickly, if it follows a significant injury, or if you also feel feverish, shivery, or generally unwell.

Seek immediate assessment if back pain comes with new loss of sensation around the genitals or anus, a new change in bladder or bowel control, or weakness and altered sensation in both legs. In Czechia, call 155 or 112 if you suspect an acute serious condition. OpenMedical is not an emergency or urgent care service.

These signs do not reveal the cause on their own. They simply mean that safety takes priority over finding the perfect specialist.

Start with what has changed

You do not need to name the condition yourself. A short account of how the problem has developed is far more useful. Note:

• when the pain began and whether it followed an injury, new movement, or change in activity;
• where you feel it and whether it travels into the buttock or a limb;
• which movements, positions, and daily activities make it better or worse;
• whether there is tingling, numbness, or weakness;
• how it affects walking, sleep, work, and exercise;
• what you have already tried and whether it helped.

“The pain wakes me every night and has become worse over the past week” tells a clinician more than “I probably have a slipped disc”. Similar symptoms can have different causes, so a useful assessment usually begins with your history and a physical examination.

When rehabilitation medicine is a good starting point

Rehabilitation medicine looks at more than the painful area. It considers how the problem affects walking, sitting, work, sleep, and a return to normal activity. A rehabilitation medicine specialist is a doctor who can review the wider health context, carry out a clinical assessment, plan treatment and rehabilitation, and involve physiotherapy or another specialty where needed.

It can be a useful place to start when pain keeps returning, has become persistent, limits daily life, or makes you unsure how to move safely again. The focus is not only on short-term relief, but also on restoring function and deciding what should happen next.

When an orthopaedist may be the better fit

Orthopaedics covers conditions and injuries affecting bones, joints, muscles, tendons, and ligaments. An orthopaedist may be the better fit after an injury, where movement is markedly restricted, when there is concern about the structure of the spine, or when an earlier assessment has produced a finding that needs specialist review.

An orthopaedic appointment does not automatically lead to surgery or a scan. It will often begin with questions and an examination of posture, movement, strength, and sensation. What happens next should depend on the findings, not simply on how intense the pain feels.

Where physiotherapy fits in

Physiotherapy focuses on movement and function. A physiotherapist can look at movement patterns, range of motion, strength, and how your back responds to different activities. From there, the plan may include tailored exercises, gradual loading, practical changes to daily habits, and support with returning to normal activity.

For stable or recurring symptoms, physiotherapy may be an appropriate part of care, either directly or as part of a plan recommended by a doctor. Medical assessment should come first if the cause is unclear, symptoms are changing quickly, or warning signs are present. Referral and payment arrangements vary between clinics and types of care.

If the pain is linked to sport

If the pain began during training, returns with a particular movement, or is holding up a return to sport, sports medicine may be relevant. A sports medicine doctor considers the problem in the context of training load and sporting goals, and may work alongside an orthopaedist, rehabilitation doctor, or physiotherapist.

Do not wait for a routine sports consultation after a forceful injury, with a visible deformity, if you cannot stand, or if the problem is worsening rapidly.

A quick guide to where you might start

This is a starting guide, not a referral rule. The Czech National Health Information Portal suggests a GP as an appropriate first contact for lower back pain. A GP may then recommend an orthopaedist, rehabilitation medicine specialist, neurologist, rheumatologist, or physiotherapist. In practice, the route will also depend on your symptoms, local availability, and how the care is funded.

Do you need an X-ray or MRI?

Severe pain does not necessarily mean that a scan is needed. NICE recommends that imaging should not routinely be offered for lower back pain or sciatica in a non-specialist setting. It is more useful when the result could change the plan or help a clinician investigate a specific concern.

There is no need to arrive asking for a particular test. Instead, ask what question the test would answer and whether the result would change your care.

How to prepare for the appointment

Bring a list of your medicines, relevant reports, and any previous scans you have. Prepare a short timeline and one concrete example of the impact, such as “I have to stop after ten minutes of walking” or “the pain is stopping me from returning to running”.

It also helps to say what you want to get back to: working comfortably, running again, sleeping better, or managing an ordinary day with fewer restrictions. Our article How to prepare for a doctor's appointment has a broader checklist.

Back pain: frequently asked questions

What is the difference between a rehabilitation doctor and a physiotherapist?

A rehabilitation medicine specialist is a doctor who considers the medical context, assesses functional limitations, and can coordinate a treatment and rehabilitation plan. A physiotherapist works more directly with movement and the restoration or maintenance of function. The two often work together.

Do I have to see a GP first for back pain?

It depends on your symptoms, the clinic, how the appointment will be paid for, and whether a referral is required. If you are unsure which specialty fits, or if several health issues may be involved, a GP is a reasonable place to start.

Does pain travelling into the leg automatically mean a slipped disc?

No. Pain that travels, tingling, and numbness are all worth mentioning, but none confirms a diagnosis on its own. Tell the clinician where the symptoms reach, whether you have noticed a change in leg strength, and how quickly the problem is developing.

Can I see an English-speaking specialist in Prague?

Yes. Availability varies, so confirm both the specialty and the consultation language before booking. It is also worth checking the price or payment route, whether you need a referral, and which records to bring.

One useful next step is enough

You do not need to diagnose yourself or map out the entire care pathway. For stable symptoms, choose a first contact that fits the main problem and prepare a short account of how it has developed.

If you are still unsure where to start, contact OpenMedical. We can help you navigate the available options within the partner network and coordinate the practical details of the next step.

Sources and editorial basis

Sources checked on 2026-08-24.

• Czech National Health Information Portal: Back pain — basic information
• Czech National Health Information Portal: Lower back pain
• NICE: Low back pain and sciatica in over 16s — recommendations
• NHS: Back pain
• WHO: Low back pain
• WHO: Guideline for non-surgical management of chronic primary low back pain
• American Academy of Physical Medicine and Rehabilitation: About Physical Medicine and Rehabilitation
• World Physiotherapy: What is physiotherapy?