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Severe hip pain

meme1166mmeme1166 Posts: 10
edited 06/11/2012 - 8:44 AM in Lower Back Pain
My dad is a nurse and is 60 years old. He has been having severe lower back pain, where he has sharp pains shooting down his hips and leg. his legs and feet have started going numb. He had mri and was told herniated disc and bulging disks. One doctor said no severe arthritis, pain dr said that he thought it was something else and sent him to dr in durham. he wanted a stand up mri and insurance wont approve another one. what do u do? any suggestions? Having to work on his feet, thinking of doing disability but I hate for him to give up. any suggestions of how to deal with insurance and doctor.


  • Most insurance companies have an appeal process. You should call and ask what the protocol is to appeal their decision to deny coverage for the MRI.

    Your Legal Aid Office may be able to offer more advice if that doesn't work.

    I'd hate for him to give up too. Let us know how it's going with the insurance. Maybe more ideas will be found.

  • With the neurological symptoms it sounds like it might be worthwhile to get an opinion from a neurologist if you are getting conflicting opinions and aren't sure what the next step should be. A neurologist might be able to do an EMG or some other diagnostic test besides a repeat MRI that the insurance would approve, and a different diagnostic test may help sort out exactly what is going on.

    As far as the insurance- is it your dad that wanted the stand up MRI, or one of the doctors? I couldn't really tell from your post if it is something your dad has heard about and thought would be good, or if one of the doctors thought it was needed? I have only had one thing that we thought my insurance might not cover, and my doctor assured me that as long as he wrote a letter they'd cover it. If your doctor is willing and can make the case that it is medically necessary then he should be able to help you get the insurance approval. I think it all depends on how medically necessary the standup MRI is, and whether the doctor is willing to take the time to petition your insurance company.
  • Hip pain is common problem, and it can be confusing because there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the underlying problem.

    Hip Pain Causes:-

    Pain can arise from structures that are within the hip joint or from structures surrounding the hip. The hip joint is a potential space, meaning that there is a minimal amount of fluid inside it to allow the femoral head to glide in the socket of the acetabulum. Any illness or injury that causes inflammation will cause this space to fill with fluid or blood, which stretches the hip capsule and results in pain.
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