Which Department

Which department should I see for long-lasting back pain?

2026-09-17 · Neutral information that names no hospital, doctor or region. No rankings, recommendations or reviews.

Short answer

Orthopedics(정형외과) is generally the first department to consider for persistent back pain, as it specializes in musculoskeletal conditions that commonly cause this symptom. Depending on findings, you may be referred to Neurosurgery(신경외과) if nerve or spinal cord involvement is suspected, or to Rehabilitation Medicine(재활의학과) for functional recovery support. Pain Medicine(마취통증의학과) may also be involved when pain management is a primary focus.

Which department

  1. 1Orthopedics (정형외과)
    Orthopedics handles conditions of the spine, muscles, and joints — the structures most commonly involved in long-lasting back pain. This department can evaluate structural causes such as disc problems, vertebral issues, or degenerative changes. — First / second line: A local orthopedic clinic (의원) is generally a practical first stop for persistent back pain without neurological symptoms. If imaging or specialist evaluation beyond the clinic's capacity is needed, a referral to a hospital-level facility may follow.
  2. 2Neurosurgery (신경외과)
    Neurosurgery focuses on conditions where the spinal cord, nerve roots, or surrounding structures are involved, which can manifest as back pain accompanied by leg weakness, numbness, or radiating pain. — First / second line: Many patients are referred here from Orthopedics or another primary department when neurological symptoms accompany the back pain. However, direct visits to a neurosurgery clinic are also possible; a referral letter (진료의뢰서) is generally required when visiting a tertiary hospital (상급종합병원).
  3. 3Rehabilitation Medicine (재활의학과)
    Rehabilitation Medicine addresses functional limitations, movement disorders, and pain related to musculoskeletal or neurological conditions. It plays a role in assessing physical function and coordinating non-surgical approaches. — First / second line: This department is often involved after an initial diagnosis has been made, though direct visits to a rehabilitation medicine clinic are also possible for ongoing or chronic back pain. It is particularly relevant when the goal is restoring daily function alongside pain management.
  4. 4Pain Medicine (마취통증의학과)
    Pain Medicine specializes in the evaluation and management of chronic or complex pain conditions, including persistent back pain that has not responded well through other avenues. It takes a dedicated focus on pain as the primary concern. — First / second line: Patients may visit a pain medicine clinic directly or be referred there when pain control becomes the central issue. This department often works in coordination with Orthopedics or Neurosurgery rather than replacing them.

Go to the ER / call 119 if

If any of the following applies, do not choose a department — go to an emergency room or call 119 (Korea's emergency number).

  • Sudden loss of ability to move or feel the legs, or inability to control bladder or bowel — go to the emergency room or call 119 immediately.
  • Back pain following a major trauma (such as a fall from height or a traffic accident) with inability to bear weight or severe neurological symptoms — do not wait; go to the emergency room.
  • Severe back pain accompanied by high fever, chills, and rapid deterioration of general condition, which may suggest a serious spinal or systemic infection — seek emergency care.
  • Back pain with sudden onset of chest pressure, difficulty breathing, or signs of shock (pale skin, confusion, loss of consciousness) — call 119 immediately.
  • Rapidly progressing weakness in both legs or a sudden inability to stand after back pain — go to the emergency room without delay.

Before your visit

  • Note when the back pain started and whether it began gradually or suddenly, as this information helps the doctor assess the likely cause.
  • Track which positions, movements, or activities make the pain worse or better, and be ready to describe the pain's character (sharp, dull, burning, radiating).
  • Record any accompanying symptoms such as leg numbness, tingling, weakness, or changes in bladder or bowel function, as these may indicate nerve involvement.
  • Bring a list of any medications, supplements, or treatments you are currently using, including any you have already tried for the back pain.
  • If you have had previous imaging studies (X-rays, MRI, CT) or medical records related to your back, bring copies or digital files to the appointment.
  • Consider whether the pain affects your daily activities or sleep, and be prepared to rate the severity — this helps the doctor prioritize the evaluation.

General principles

Long-lasting back pain can stem from a wide range of causes — musculoskeletal, neurological, or less commonly, from other organ systems. Because of this variety, the initial department a patient visits often determines the direction of evaluation; Orthopedics and Neurosurgery are the two most common entry points in the Korean medical system for this symptom.

In Korea, the general care pathway typically begins at a local clinic (의원, 1차), where an initial assessment and basic imaging may be arranged. If the situation warrants more advanced evaluation or treatment, the clinic physician may issue a referral to a hospital (병원) or general hospital (종합병원, 2차). A referral letter (진료의뢰서) is generally required when seeking care at a tertiary hospital (상급종합병원) such as a university hospital under the national health insurance system.

The diagnostic approach to persistent back pain generally involves a combination of clinical history, physical examination, and imaging studies such as plain X-rays or, when indicated by the doctor's assessment, MRI or CT. The choice of imaging and further tests is guided by the clinical picture and is determined by the treating physician.

When back pain persists over a long period, care often becomes multidisciplinary — meaning more than one department may be involved at different stages. Pain Medicine may focus on symptom management while Orthopedics or Neurosurgery addresses structural concerns, and Rehabilitation Medicine may support recovery of function. The doctor seen first will generally coordinate this pathway based on the individual situation.

FAQ

Should I go to a local clinic (의원) first, or go straight to a hospital for back pain?

In general, starting at a local clinic (의원) is a practical and common approach for persistent back pain without severe or rapidly worsening neurological symptoms. The clinic physician can perform an initial assessment and, if needed, refer you to a higher-level facility. Visiting a tertiary hospital (상급종합병원) directly without a referral letter may affect your insurance coverage, so it is worth confirming with the institution beforehand.

How do I know whether to see Orthopedics or Neurosurgery for my back pain?

Both departments handle back pain related to the spine, and in practice there can be significant overlap. Orthopedics tends to be the more common first choice for general back and spine concerns, while Neurosurgery is often more specifically focused on nerve or spinal cord involvement. If you are unsure, starting with either department at a local clinic level is generally acceptable — the doctor will guide you further based on your specific findings.

What kinds of tests are generally done for long-lasting back pain?

The specific tests ordered depend entirely on the doctor's assessment of your individual situation, so it is not possible to predict in advance what will be recommended for you. In general, plain X-rays are a common initial imaging step, and more detailed imaging such as MRI may be considered when the clinical picture suggests it is needed. Any decision about testing is made by the treating physician after examining you.

Is there any difference in how back pain is evaluated in older adults compared to younger people?

Age can influence which underlying causes are considered more likely — for example, degenerative changes are more common with age, while other causes may be more prevalent in younger individuals. The clinical evaluation process is broadly similar across age groups, but the doctor will take age and overall health status into account when forming an assessment. If you have concerns about age-specific considerations, this is a useful topic to raise directly with the doctor at your visit.

Related questions

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This page is general medical information and does not replace diagnosis, treatment or choosing a clinic. Consult a doctor for any symptom. In an emergency, go to the ER or call 119 immediately.