How Primary Care Doctors Are Leading the Way in Non-Surgical Back Pain Treatment—and Helping Patients Avoid Unnecessary Surgery
- cassis101
- Jul 7
- 3 min read
Updated: Jul 9
By Deborah Westergaard, MD
Board-Certified in Pain Medicine and Anesthesiology
Regenexx-Affiliate
Pain Experts Dallas–Plano
The Broken Back Pain Referral Pipeline
If you've ever watched a vibrant, successful person spiral from a simple back strain into multiple surgeries, you've seen the broken pipeline in action.
Here’s how it typically unfolds:
A patient develops back pain—perhaps after a long flight, a round of golf, or just from the wear and tear of leading a high-performance life.
Their primary care doctor, often under pressure from the patient or the insurance carrier, refers them directly to a surgeon.
The surgeon, bound by insurance requirements, refers them to a pain management doctor—but only for a short sequence of epidurals or nerve blocks. It’s procedural.
When those stop working (as band-aids usually do), the patient is sent back to the surgeon
What began as a minor issue has now become a surgical case.
This loop doesn’t just fail patients—it burns out doctors too. It turns meaningful medical decisions into box-checking exercises dictated by corporate algorithms. And worst of all, it often prevents patients from exploring regenerative, long-lasting solutions that could restore function and delay or avoid surgery altogether.
Flip the Pipeline and Restore Clinical Wisdom
There’s a better way—one rooted in precision, collaboration, and trust.
Primary care physicians and concierge doctors are the new gatekeepers of smarter spine care. They’re no longer passive participants in the surgical algorithm. They’re stepping forward to guide patients to a more thoughtful path—one where interventions aren’t automatic and where surgery is considered only after intelligent, regenerative options have been explored.
At Pain Experts, we partner with referring physicians to:
Identify the true source of pain using advanced diagnostics—not trial and error
Offer interventional treatments only when they make sense clinically—not just to check boxes for an insurance company
Use regenerative biologics like PRP, platelet lysate, or bone marrow concentrate to target the root cause—not just the symptoms
Refer to surgery only when it's clearly the most appropriate, not by default
This approach not only protects patients—it honors the primary care doctor’s role as a healer and protector of long-term health. It allows the referring physician to retain leadership of the patient’s journey while bringing in a trusted specialist who isn’t locked into a surgical referral loop.
From the Inside: A Look at the Pipeline I Left Behind
As someone who worked within the traditional surgical pipeline for years, I understand its inner workings.
In many cases, they progressed to surgery because the non-regenerative options ran out.
I created Pain Experts to do things differently.
Now, when a patient is sent to me—they’re given a full diagnostic workup, a custom treatment plan, and regenerative options that are designed to create resilience, not dependency.
And when surgery truly is the best option? They go forward with the confidence that every other door was opened first.
Let’s Change the Standard Together
Primary care and concierge doctors: Let’s collaborate. If you’ve been frustrated by the limitations of the standard pain-to-surgery pipeline, send your patients to a specialist who sees regenerative solutions as a first-line priority—not a last-ditch alternative.
Patients who expect more: If you've been told your only options are “take this medication” or “have this surgery,” it’s time to discover what else is possible. You deserve more than a protocol—you deserve a plan built just for you.
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