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AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:34 AM in Lower Back Pain
I am seeing a new ortho tomorrow, and I am very nervous. I had an L4/L5 discectomy in 2002, and since last September I have been dealing with muscle spasms and intense radiating nerve pain/sciatica. These symptoms now include left foot pain and minor swelling, as well as poor reflexes in my big toe.

I have had bad luck with orthos in the past. The doctor who did my discectomy was a cold and compassionless man, and I vowed after my last post-op visit with him I'd never see him again. When I had a flare-up two years ago, I saw another ortho, who was okay, but when I saw him in January regarding this most recent episode, he attributed it to having just had a baby (in June '08) and carrying the car seat, bending over, etc. In essence, he did nothing. I had better luck with going to a walk-in clinic, where a doc did set me up with a portable TENS unit. It has offered some relief, but not with the nerve pain. From January on, I suffered daily and wordlessly--too much to do, no time to go to the doc, nothing is really wrong with me to fix...blah blah blah. Finally, in June, I went to the local family practice clinic hoping to become established and have them help me get to the bottom of it. They went to PT, and I went religiously (18 sessions!). At the end of July, my back just went kaput. Horrible, unbearable spasms and nerve pain that left me breathless and in tears. When I asked for the family practice clinic to order an MRI, I was refused based on ortho #2's report following our "chat" in January.

That brings me to ortho #3 tomorrow. I know I need to lose weight, but walking even a half mile keeps me up at night with pain. So I know he'll tell me that. I am hoping for another MRI to figure out what the issue is, and I have two fears:
1) What if they find nothing wrong with me? What then?
2) What if they find something wrong with me? What then?

Does that make sense?

Thanks for reading this. As foolish as it sounds, I am afraid to go to the doctor b/c I don't think I can take another cold, disinterested doctor. Ugh.

Anyone else?


  • Perhaps if you're having nerve pain you would get more empathy and relief from a neurologist or neurosugeon. Just a thought.

  • Melanie, I agree with Rusty that an ortho is probably not the doctor to see for spine issues. Unless, of course, he or she is fellowship-trained in spinal issues.

    I've found that many people get better diagnosis and treatment with fellowship-trained spinal surgeons. Can you make an appointment with one in your area?

  • by the sounds of it you first operation has come to the end of its life and you are going to need another operation..sorry.. but that's what happened to me and others with the same type of symptoms .as for physiotherapy and you doing your bit and nearly killing yourself ! i did the same thing ...i think that the surgeons are making a guaranteed repeat work load for themselves ..like you go for your operation ..recover .{sometimes!} then just when you are able to walk the send you to the physio..terrorists! and they have you back on the operation table ..if you get no joy with this orthopedic surgeon go and see a neurosurgeon and get another uptodate MRI scan because without one no one can see what has happened to your back .as for pain control i have found the pain management clinics a waste of time and i have been through the system and come out the other side .i now have facet joint hypertrophy on many levels and thoracic outlet syndrome and loads of scar tissue from previous surgeries {the latest offering was to offer me a multi level fusion ..no thank you! ..i will stick to moaning about my pain and taking my pain killers because as my family doctor has reassured me ..there is nothing now that can be done to my back that will improve my life as my back is knackered .you ..on the other hand ..may get away with another operation to remove the scar tissue that is making your leg and foot pain full.as for your back ache there is not an operation in the word that will take that away and any decent surgeon will tell you that ..they do the operation to preserve the nerves so you can walk and go to the toilet not to cure back ache ..you will still need your TENS and a good supply of strong pain killers ..if you do have another operation ..don't kill yourself with physio ..go to the swimming pool and do gentle swimming or walk in the water .this advice from my private physio {he is also a good mate too} good luck and feel free to contact me if you want
  • Thanks for your replies. Cath, the doc I am seeing is fellowship-trained in spinal surgery, so that's a starting point. I do have a neurology clinic I went to when I was having horrible headaches when I was pregnant, so at least I *know* where to go there.

    Straker--the recovery from my 1st discectomy was so excruciating it put me in a depression it took two years to recover from. The physical therapist I went to this time was absolutely wonderful. She listened and adapted exercises for me, and a good chunk of our sessions involved ultrasound to loosen the scar tissue and massage therapy. She even called the family practice clinic to advocate for me when they turned into crapweasels.

    Big day tomorrow--aside from my appt in the afternoon, we have to take our 1 year old daughter to the pediatric optomitrist to determine if she needs eye surgery. I think I'll be very happy when tomorrow is over and I will have at least *some* answers.

  • How could they deny you service?
    I don't get that part.
    You should be the one calling the shots.
    On the sunny and mild Central Coast of California

    L4-L5 endoscopic transforaminal microdiscectomy June, 2007
    L5-S1 endoscopic transforaminal microdiscectomy May, 2008
  • Without a doc prescribing an MRI, my insurance won't pay for it, and this family practice doc--who I had never even seen (I'd seen the PAs at the practice, never the managing doc) used a 6-month old physician's note saying I wasn't surgical based on a 2007 MRI to justify turning me down for the test. (The witch also wrote in my file that I needed a gastric bypass--I have never laid eyes on this woman, she's never spoken to me, she only knows what's on paper, that's it). Needless to say, I have fired them and am going another avenue for it by seeing the ortho tomorrow. I'm even taking my husband with me b/c I have seen enough sexist docs to know that if "the man is with me, I must be credible." Sad but true.

    Just to make myself feel better, if I *do* get an MRI (which I would think I would) and there is a treatable reason for my pain, don't think that I won't be firing a letter off to the stupid cow, the parent clinic, and perhaps the state medical board. I didn't deserve how I was treated, and if I can prevent it from happening to someone else, then it wasn't all for nothing.
  • I am sorry you are having a hard time finding a doctor who will listen to you. I hope this new ortho. will work out for you.

    It sounds like you are going to a well-qualified orthopedic spinal specialist. Don't forget that everyone on this board has her or his own opinion, largely based on personal experience. There is often confusion over whether it is better to see a neurosurgeon or an orthopedic spinal surgeon. In reality, it makes very little difference. What you want is a fellowship-trained spinal specialist, either an ortho surgeon or neurosurgeon who devotes his practice to spine and back issues.

    A neurologist who treats your migraines, in most cases, would not have the training to deal with spinal issues requiring surgery. They mostly study diseases of the nerves and do testing. Neurosurgeons usually specialize in brain surgery or spinal surgery. Some do both, but I would want one who devoted most of his time to the spine.

    In the US, there is increasing interest in merging the neurosurgery and orthopedic spine surgery residencies into a unified specialty that would be "spinal specialist" as the training in the two specialties is so almost identical.

    But, enough....it does sound like you have some nerve compression that is causing your sciatic-like pain symptoms. But it is not that the nerve is diseased. It is more likely that it is being squished by a bulging disc, a narrowing of the central canal or foramina, or some mechanical problem of the lumbar spine....something your new ortho can definitely help with.

    Try not to be nervous. I do know exactly what you mean about on the one hand hoping they find something so you know the cause of the pain, and yet not wanting the MRI to reveal a problem since you don't want to have to treat it! Just talk to him straight and give him an honest representation of what you're dealing with. You'll do fine.

    I hope your daughter's appointment goes well, too.

    Please let us know how to goes and come back often with your comments, questions and support. You will always find an understanding ear here.

    xx Gwennie
  • it went about like I thought it would. Doc listened as I explained my symptoms, read my PT notes, and then examined my reflexes (which seemed pretty poor in my left leg--he had to use that hammer a few times, and having me flex or raise against resistence looked pretty weak). He said an MRI is definitely in order, but he wouldn't be surprised if it was just scar tissue that is causing me problems. I asked if I was to continue the ibuprofen, and he said yes. No additional pain meds at this time, which is a mixed bag. I don't want him to think I just want drugs--I'd rather not take *anything* (and not have pain--in a dream world!), and I am not all flared up right now (that could change in six hours, though), so what's another week of pain, right? Anyway, I have an MRI set for Monday and a follow-up with him on Friday of next week.

    It's been a long day and I'm beat and my back and foot are giving me hell, so I'm gonna hit the sack...thanks again for your responses. I'll keep you posted.
  • Good. After the MRI, hopefully you will be able to better know what is going on. Sometimes it can take awhile to build up a relationship with a doctor. What was your overall impression of the new doc, his office staff, etc??
  • The office was busy!! There are about fifteen doctors in the practice...one of the larger in the state. Seemed pretty efficient. The doctor seemed nice...it's hard to judge in a fifteen or twenty minute appointment, but he came across cool and confident. What doctor doesn't, though, right? LOL.

    I'm hoping for some answers after the MRI. If it's just scar tissue, I will probably ask to be referred to a pain management doctor since there won't be any treatment that will help. We'll see how it goes...
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