It is not always the case that you need a referral. http://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf
I am able to call my Physical therapist and make an appointment directly with him without going through my Dr. Though initially I did find my PT through my internist. Prior to that I had seen an orthopedic MD. Prior to PT I would need hip injections 4 times a year. Since starting PT about 5 years ago I have lessened the injections to the point that I haven’t had one in 2 years. When I feel or see myself getting out of alignment or having any pain I make a direct appointment with the PT. My insurance covers it without a referral.
I’m not advocating this approach for everyone but in this case I doubt the OP D has a serious back problem. A few sessions with a PT might be helpful.
Why is your daughter unwilling to see a chiropractor?
I agree with the recommendation for a physical therapist. I got a referral from my regular doctor to see a PT and it was a HUGE success. It sounds to me like your daughter probably needs to strengthen back muscles, and a PT can assign quick and easy exercises which at least in some cases (including mine) can work wonders. I haven’t see the PT in a few years, but about one minute of exercise three times per week still works wonders to maintain whatever fix the PT created.
There’s an awful lot of health misinformation on the internet. Unless she is very sophisticated about identifying evidence-based sources, she could end up with some very bad advice.
I will strongly agree with first step being to see a PT. Both my insurance and my daughter’s plan (very different companies in different states) do not require a referral for PT. However for my daughter’s plan, the PT does need to write up the issue and get it pre-approved by the insurance company (although it allowed for 3-5 PT visits in a calendar year without this step.) A great PT can be a miracle worker - a couple of my family members were cured by PT treatment (one had a chronic condition which dozens of doctors including other PT and chiropractors couldn’t fix.)
I had some back issues for which my doctor suggested yoga/stretching. I found a great yoga instructor (he is also a personal trainer and trained in lots of types of exercise.) He is also a miracle worker and has gotten me straightened out.
Unfortunately, my experience has shown that for anything not routine, not every PT or yoga instructor will work - you need the right one! One tip I suggest is not to go in saying it is my back - have them do a complete evaluation to determine exactly where the problem lies. Often, a problem manifests itself in a strange place - a problem with your arm causes you to move differently and shows up as back pain.
Thank you again everybody - so much good advice.
@calmom I am sure if it came down to it I could convince her to see a chiropractor, but she absolutely hates the feeling of her back and neck cracking so she does not want to do that as a first step.
I wouldn’t see a chiro either.
Ive got biking friends who swear by their chiros.
If this isn’t something else, back pain comes in many forms, from many causes. And yup, sometimes it’s stress.
@lookingforward My dad used to go to a chiro for his back all the time. They kind of freak me out but I went a few times when I was pregnant. D21 refused to turn and I was trying to avoid a C-section. I was told I could try all sorts of things including a specialized maternity chiro. It was a little scary but since I was about 7 months pregnant and huge they were very gentle with me! Didn’t work though, ended up going for a version which did work.
I also agree stress could be making it worse - D19 is always up super late doing homework and is completely stressed about her Pre-calc class as well as a few others I’m sure.
Ask for a referral to a PT if you need one. That would be where I start.
I have chronic joint problems and have tried it all- meds, chiro, PT, la-la-la. The thing that has helped me the most is a massage therapist. I go every other week. It’s expensive since it’s not covered by insurance but to me it is totally worth it.
@momtogkc - my daughter also made similar comments to me, about being scared or weirded out by the idea of a chiropractor – when I had mentioned my own experiences. But then my daughter wrenched out her neck and upper back, missed a day of work, all a week before she was scheduled to go on an outdoorsy trekking vacation – so she made an appointment with a local chiropractor and was very happy with results. We’re on opposite coasts and she did not tell me about her experience until after the visit, so I’m guessing that she probably got a recommendation from a friend or coworker.
My chiropractor also has massage therapist, and it’s possible to just book a session with the massage therapist.
I asked because your description in the OP was very much the sort of thing that chiropractors focus in. Pediatrician thinks its stress relaed, daughter says “everything feels tight and she feels like she always needs to crack her back and neck but she hates doing that.” The thing with the chiropractor, for me, is that they “crack” the back or neck in a way that it doesn’t need to be cracked again. But that’s an oversimplification – my chiropractor helped me with my posture and encouraged me to take up yoga – and I rarely need to see the chiropractor. But for me, when I was having fairly intense back pain, I experienced immediate relief from the first visit.
I wouldn’t recommend a chiropractor if you thought there was some other more serious medical condition – but I know that my own back pain was caused mostly by my sedentary work, sitting hunched over a computer, and poor posture. So for me, long term, the yoga is the key - but the chiropractic adjustment was a big help at first, and still where I go if I start to experience what I would describe as a “stitch” in my back.
I would recommend a spinal doctor. Orthopedics generally do not treat spinal issues. Chiropractors can aggravate it or solve the problem. For me it worsened the issue. Dont pass it off as a psych problem until you investigate medical issues. You have people who think everything is a psych disorder when its not an obvious med condition.
I had periodic low grade back pain for years. I had sort of a love/hate relationship with the chiropractor. I do believe it helps to keep/get your neck and spine in proper alignment, particularly when there is a new, sharp pain in the spine. But mine wanted me to come for regular maintenance, and that was more than I wanted to commit to. Then I started doing yoga 3 years ago and now the chronic pain is gone. Two gentle things she can start doing immediately to loosen up her back muscles is the yoga combination cat-cow pose, and also lie stretched out on her back with her arms straight above her head for a full body stretch. Doing these 2 things daily is a good health routine, particularly for those who are on the computer a lot. Cat-Cow can even be done while sitting - it’s great for long car rides!
I think perhaps you may have misread “physiatrist” as “psychiatrist”. The words look similar but the specialty is very different. A physiatrist is a physical medicine and rehabilitation physician. 
We have said to have an MD check it first, not assume anything.
OP isn’t describing many of the symptoms that hint this is a more intense disorder. So after a doc visit, we’ve discussed the rest of what she can explore.
I asked my GP once regarding lower back / hip pain. Her suggestion was PT over Chiropractor, and the reason given was that “in general” a PT’s goal is to help you, so that eventually you don’t need to return. Many chiropractor’s approach is to return for continued treatment. Both can potentially help, but she liked the PT philosophy better.
This has not been my experience.
My experience has been that I experienced immediate relief with the first visit, and visits have always been scheduled on an as-needed basis. When I first saw the chiropractor for problems, the visits were initially closely spaced and frequent – but that was directly tied to continuing pain. Whenn I say I felt immediate relief, I mean that the relief would last for a a period of days or weeks, and then I would come back. So it might have been once a week at first, then once every two weeks, then once a month, or once every six months, or once a year.
When I first went to a chiropractor more than 20 years ago it was because of a severe back and neck pain after a car accident. I think I saw the chiropractor frequently for about 3-4 months, and then infrequentliy for another 6 months or so. The pain was quite bothersome but was resolved and did not return, so once resolved I never went back.
More recently it was because of chronic worsening pain that I am sure is tied to my work & posture (sitting with a computer) – and again, I saw the chiropractor regularly for several weeks, then dropped down to longer intervals, and now I am going on average about once a year - but most of the time my yoga practice is enough to keep me feeling well.
I think my daughter’s recent visit after she wrenched her back was one time only - she hasn’t mentioned going back.
I have just started having back pain and have stopped carrying my tablet. I am going to see an orthopedist who specializes in spine issues. He will probably prescribe some PT (in my state, unless they have changed the law recently, you need to have a prescription from a doctor for PT; however, it’s been a couple of years since anyone in my family went for any) and then I can maybe get approval at work to use a regular backpack. My boss doesn’t like how they look so I have been carrying the tablet in a small bag on my back and it’s hurting. I also think I could probably use a pillow of some sort at work because I sit in a weird way to reach my computer.
One of my dearest friends is a chiropractor and I would never go to one. Part of it is that the idea of someone touching me like that creeps me out. I can’t get a massage either for that reason. My H swears by chiropractic but I got tired of paying the copays.
Every interface I’ve had with chiropractors resulted in them telling me I needed to see them once or twice a week indefinitely. I’ve never worked with anyone who suggested a course of care could possibly have an end. Maybe my spine is just really really screwed up.
I was very skeptical about chiropractic care. An orthopedic surgeon recommenced the chiro. He said I would need surgery for a congenital spine condition as a senior if I didn’t see a chiro. Best advice ever.
Some PT can be a total waste of time. You need to communicate with the PT about where you were physically before the incident. I went to one PT who treated me like I was 20 years older than my age.
Another time I had low back pain and did about 3 to 4 months of therapy. Then the PT asked if I slept on my stomach. Yes! I switched to sleeping on my back and the pain went away within days.
I highly recommend Class IV laser therapy to heal musculoskeletal injuries. I initially used the laser therapy on my dog. The Class IV laser is approved in Europe. I had a soft tissue injury last year and was pleased with the results of the laser therapy.
I am not a fan of yoga. Especially group classes where the the instructor keeps asking you do moves your doctor told you to avoid.
more: http://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body.html