Primary spine practitioners (PSP) (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 an