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- Primary spine practitioners (also referred to as PSP, Spine Care Clinician, or Spine Care Specialist, or in the broader context a primary musculoskeletal specialist or provider) are health care professionals who are specially trained to provide primary care for patients with spinal disease. The PSP has the training necessary to provide differential diagnosis, rule out serious pathology (such as infection, fracture, cancer, inflammatory joint disease) and provide evidence-based management for the majority of patients with spinal disease. Evidence-based treatment methods include spinal manipulation and manual therapy, rehabilitative exercises, patient education, motivational techniques and the application of psychological principles, particularly those of cognitive-behavioral therapy and acceptance and commitment therapy. In addition, the PSP has the ability to recognize the relatively few patients who require special tests (radiography, MRI, laboratory workup) and invasive procedures (injections, surgery) and to serve as the center of care for the purpose of providing counseling for the patient, coordination of care and long term follow up. An important aspect of this role is educating the patient on the risks, benefits and research evidence of all treatments for spinal pain so that, through a shared decision making process, appropriate choices can be made as to what is the best treatment for the patient. In addition, the PSP is tasked with helping the patient navigate the often-complex social systems, particularly for patients whose spinal disease arose from a work-related incident or personal injury. (en)
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