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Advice on Doctor in Chicago

AnonymousUserAAnonymousUser Posts: 49,671
Hello all,

I am a new member with back pain since 2004. I have been diagnosed with right leg sciatica and L4-L5 herniation.

My pain went away completely in late 2006, 2007, early 2008 after gym and weight loss.

However, due to a recent job change (June 2008) I stopped going to the gym, started working 12-14 hour days, and the stress mounted. I got 3 acute back attacks (june 2008, Sept 2008, Dec 2008) but i ignored the signs and keep working like crazy. I would fix the problem with diclofenac (NSAID) and the symptoms will go away in a week.

Well.... it got worse...

Since February i have been dehabilitated with very severe back pain, sciatica symptoms (right leg).

I did an MRI which re-confirmed the herniation. My doctor (very known spinal ortho surgeon) gave me some cortisone pills which helped immediately but the benefits went away fast.

MRI impression (per radiologist): right-sided herniation L4-L5, with imaging evidence of impingement on the right L5 nerve root. Note that there is transitional lumbosacral anatomy, and it is possible that functionally the displaced nerve root could represent S1. At L3-L4 there is minimal disc bulge and there is also very mild congenital narrowing spinal canal. Foramina are not significantly narrowed.

I tried to go swimming but the pain is too much to tolerate. It makes me swim in weird form, which makes other parts of my body hurt.

In addition, almost a week from having back pain i started having severe heartburn. The gastro-doc gave me prilosec and he does not think that it is from painkillers (which i took only a few in the beginning but careless without any food) but he does not suggest i take them anymore. So besides tylenol i have nothing else to treat pain (but tylenol does nothing to reduce inflammation).

The ortho-doc recommendation is to try cortisone injections (epidurals) and see...

Overall he is not attentive and doesn't seem to listen to me.

Recently, (3 weeks ago) I am experiencing pain (burning) in the front of my thighs (just above the knees) from both legs. SOmetimes i get tired walking up stairs.

Of course i have good days and bad days...

So my fellow sufferers after this long introduction i have these questions:

1) Do you think the pain in the thighs is attributed to the back pain and the herniations?
2) Should I do the epidurals?
3) I have my old PT exercises (from 2004). Should I do them again?
4) Did any of you try acupuncture?
5) I know its a taboo question, but what about the chiropractor?
6) Most important, can you recommend a good doctor (any specialty) that can really help me out and give some good treatment and advice.

Due to my nature (college professor) i tend to search online a lot since i dont trust the docs that i have seen thus far and it gets me more nervous. I need a doctor that will be thorough and open about options.
(Mine looks at me as a $$ bill, and he only sees me for 5 mins each time).

I am greek and in greece this condition is treated completely different. Here in the US they advice exercise and return to normal routine as soon as you can. In greece they suggest cortisone injections (in the buttocks) then rest for 2-3 weeks. if ok PT and exercice. If not ok, epidurals, rest for 2-3 weeks. etc....

I dont mind paying for healthcare but if i do pay i want the best treatment and i dont feel i get it.

I just want the pain/worry to go away so i can resume going to swim and exercise. But when it hurts I cant do anything and i am afraid i might do more damage.

I am sorry for my long message... I can give more details if you wish or at least please recommend me a better doctor.

thank you all for your patience.




  • I have herniation L4/L5 and the pain is pretty specific. Butt, side of thigh, side and back of calf, across outside ankle, over foot, into big toe.

    Front of thighs may be coming from another disk.

    I would treat your condition like a rattle snake. It can turn ugly and bite you quickly. I've gotten considerably better, but I'm not cracking champagne. I've learned better.

    You have two major points of concern. First is your disks. Whatever you decide could permanently alter your life. One bad chiro; one bad NS; getting a shot and because you feel better you do serious damage. Second is your sciatic nerve. Not keeping the inflamation controlled while your disks are healing (assuming you have that luxury) could cause permanent damage.

    I started with the 'this is really inconvenient' stage. A few weeks later i was in the 'I'll do anything you want God if you just stop the pain' stage. Now I'm in the 'Thank you God' stage.

    I honestly feel for you. Before my rupture I ran 25 miles per week and lifted weights 2-3 times per week. Now I'm giddy to just not be in pain. 2 months into this and I see at least another 4 months of conservative care and I am well aware I'm one of the lucky ones.

    Sorry for rambling. I tried to answer at least one question. haha
  • oh i know what you mean trust me. but what kills me the most is being in the dark. I just dont feel comfortable talking and dealing with the MDs here (and i work with them too).

    I dont think my case is as bad as yours, but I hate getting new symptoms... so you are right maybe the thigh problem is a new disk or the inflammation in the back, but can i safely ask my MD for a diagnosis?

    also working in a country full of workaholics you feel bad asking for time off or sick days of. I am in environment that personal time off is taboo and its your loss. You can take time off but you will not advance as fast, or even risk your career.

    When i got it in 2004 i was a student, i could be in bed for months and not care about work.

    Now i worry how will i afford to stay in bed for 2 weeks w/o staying behind and piss off collaborators etc

    My turn to apologize for rambling, and I hope you get better soon.
  • Daprof,

    Your symptoms sound familiar. My pain came and went, but this past Oct. the pain was constant. I tried acupuncture, chiropractic and physical therapy, a series of ESIs and pain meds.

    The efficacy of esi depends on the individual. I got about 50% relief. Acupuncture and chiro. had no effect on my pain. Physical therapy helped but when my pain escalated, I couldn't even go through a session.

    Before your OS does anything drastic, he/she is probably going to recommend all the conservative treatments: ESIs, pain meds, and physical therapy.

    The doctors that I consulted with were found in my city magazine. It features top doctors every year in my metroplex. I chose three and consulted with them and they each gave me about 20-30 min. Each had different solutions. My current surgeon was recommended by my pain management doctor.

    I had leg pain on the left side due a bulging disc pressing on the S1 nerve.

    About chiro....I stopped seeing the chiro. when I realized I wasn't getting any relief. I went back to my pain doc. and she advised me to stop the chiropractic therapy. She explained that all the Xrays that were taken at chiro's office don't show disc problems; therefore, the chiro. gave me an incorrect diagnosis. She also prefers physical therapy over chiro. practice.

    Ask you primary care doctor for some names that he or she can recommend.

    Sorry I can't give you any names since I live in a different city. I would give you names if you lived here (of course, i would pm you).

    Good luck in your search for pain relief!!!
  • Avoid sitting for long periods of time because it puts a lot pressure on your disc. I am a teacher and sitting became unbearable. I am limited to sit for 30 to 45 min. and then, get up walk around for at least 30 sec.

    Bending, twisting, and lifting heavy objects should be avoided since these activities can aggravate the nerve. Don't bend at your waist; squat down to pick up things off the floor. Bending and twisting at the same time is really bad for your disc if it is injured.
  • I would go to another Primary Dr to get some nerve pain meds. I'm on lyrica and amitriptyline, muscle relaxer and MS Contin. My Primary Dr gives me all my meds. If your Dr is worried about stomach problems they could try fentanyl patch. I had to go to the ER and get pain meds when my Dr was on vacation. I would even go there if the Dr didn't give meds. Unreal, I only have L5-S1 and severe pain even with all the meds. I can't imagine them not helping your pain first with meds and the ESI's. Even though a Chiropractor won't even touch your herniated disc area they could do TENs or Ultrasound but PT could do that also. I tried accupuncture and it helped a little but I only had 5 treatments and massage may have helped a little. Good luck. It's hard because we want to give you support but really none of us are Drs. but usually the treatment should include meds. Check College of Physcians online. There's even a Dr finder here as well. Good luck. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • thank you all for your honest and thorough feedback.

    Some docs did give me paid meds unfortunately i cant function with them. I can tolerate the pain but i cannot tolerate not knowing how to fix it.

    I guess i will have to try an ESI, i hope my insurance will cover it (on the phone they said that they might not unless they are sure i tried all other measures !!!)

    Unfortunately,I do not have a good primary Dr. For the last years i am on PPO and never found a good primary dr. When i was a student, the health center had some good docs but i dont have access to them anymore. but nevertheless thank you all for your suggestions.

  • I'm pretty sure your insurance company will cover your ESI based on your symptoms and the doctor's assessment. I would also stay far, far away from chiropractors because they are not qualified to deal with complex back problems such as herniated discs and nerve impingement, and they may cause you more injury. They are best suited for simple backaches and strains.

    I find ice packs very soothing for back pain because it numbs it up. Some prefer heating pads. See if a doctor can put you on a combination of an opoid, muscle relaxer, nerve pain medicine, and NSAID to help with your pain. You'll find most of us using this "coctail" to better manage our pain and it deals with each aspect of herniated disc pain.

    I hope you get in with a back specialist soon so that you can get on the road to recovery. Take care
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