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Need some advice and feedback

pugloverppuglover Posts: 22
edited 06/11/2012 - 8:47 AM in Lower Back Pain
I was hoping some of you out there could give me your opinion on my situation. I will try to be brief. To my knowledge I did not suffer an injury, I just woke up about 3 years ago with severe lower back pain. I was referred to a NS who did a discogram and told me I had DDD, and a bulging L5 S1 disc with a grade 5 annular tear. He said I was an excellent candidate for an artificial disc replacement, or a fusion. He was a very reputable surgeon. I was freaked out by surgery because I was 38 at the time and had not tried any conservative therapy. I told him I wanted to try more conservative methods first, and he warned me that he didn't believe I would get any relief. I got into a pain management clinic and tried epidural steroid injections, facet injections, and a nerve block, all with no relief. My pain doctor put me on oxycodone and told me she felt I had exhausted all conservative methods and that I need to have surgery. So, I just tried to manage the pain with oxycodone, as I found out my husband was being transferred and we were going to be in the middle of a move and it was no time for back surgery. We moved to Houston in January of this year, and I finally decided it was time to try to deal with my back again. I found the name of a good NS and called to try to get an appointment, but rather than making an appointment for me, they just scheduled me an appointment for an MRI. Then they called me, without me ever seeing this doctor or knowing my history at all, and told me "I'm not surgical" so they can't see me. I told them I was told three years ago that I was surgical due to the annular tear, and they said the mri didn't show any annular tear, only some disc disruption or bulging, and I should get in with a pain clinic. So, I am confused, and feel extremely frustrated. I am tired of constantly living in pain and don't know where to turn. I feel like I did the pain clinic thing and got nowhere. Is it possible that the annular tear wouldn't show up on the MRI? It isn't that I want surgery, I would rather not have surgery, but my back is dictating every moment of my life right now and I need to get help. I appreciate anyone's thoughts.


  • You mentioned a lot of conservative therapies, but did not mention a very important one- physical therapy! Physical therapy is usually the first step, I'm surprised by how many people never see a PT!

    Can you try a different NS, and this time have your records with you before you go in? Or you can also try an orthopedic surgeon. Good luck! I sure hope you find some relief!

    And in the meanwhile definitely get with the pain clinic and see if you can get the pain managed!
  • Get a second opinion. Call your old doctor and have them send you your records. Also aske them if they can recommend any one in the area. Maybe they know something you don't.

    I find it alarming that the doctor didn't want to talk with you and find out first had what sets off your symptoms and order more tests.

    Also the PT will help- and it needs to be documented that you at least tried PT and what the results were.

    Good luck.

  • I don't have experience with the lumbar area but I know that my rotator cuff tear almost healed itself in 3 months of PT. When they did surgery the doctor was shocked.

    Pug I would find another doctor, not necessarily a surgeon yet, and take your new MRI with you. Maybe there has been some healing. I would also get that last MRI so the doctor can compare. Maybe that area isn't showing well on the new one.

    Whatever the case I think you should get another opinion. Obviously that surgeon is to busy. What's interesting is how he can order an MRI without seeing you. Wonder what they may try to bill to your insurance. I would watch for that.
  • Puglover, I say good for you! You used common sense and refused surgery. If it's back pain only then back surgery has a low success rate, PT should be the first thing to try. I would also suggest that you try a sports medicine doctor who treats backpain without surgery and preferably one that uses Prolotherapy injections.
    Surgeons are biased towards surgery of course and they will lean towards surgery. The truth is that they are not always aware of all of treament options available for backpain.
    Also get a copy "Healing Back and Joint Injuries" by Dr Valdez 2009. The book discusses all of the treatment options including Prolotherapy and Surgery, and when they should be and not be used.
    Good luck and gather all of the info from as many as different sources as you can, then you can make a intelligent decision.
  • Thank you all for your advice. I did ask my first neurosurgeon if I should try physical therapy and he said no, that nothing besides surgery would help. Clearly spoken from a surgeon's point of view I think. When I was gathering my records before the move I did ask for some names of doctors in the Houston area, and he said he knew of noone in this area, so I have been on my own trying to get established here, which is difficult because it is so big. My pain doesn't feel like it has changed, that is why I am confused. I am open to physical therapy, just need to get in the right hands I guess. Thank you all for your kind replies.
  • your first doctor was right. Physical therapy is not going to help repair an annular tear in your disk. I had three discs, torn through the annulus from left to right, clear through all three discs. Physical therapy sent me into convulsions. Do get a second, and if necessary, a third opinion. MRIs do not show the whole story of discs. You most likely need a discogram.


    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • I have had docs place orders for x-rays and MRI's prior to my first office visit. It helps to reduce the amount of time I have had to wait for different procedures and surgery. The only part of your experience that surprises me, is the phone call and lack of a face to face office visit.

    I agree with Linda that if you can get another opinion it would be worth the wait. Houston is so large, I would be there's an incredible number of surgeons you can get an appointment with.

    Best wishes,

  • I truly applaude your use of common sense and not jumping into surgery but as others have stated to you, yourinjury will not heal with therapy, I tried that when my first surgeon said I was not opperable. Second week of therapy I went down with no feeling in my left leg for about 36 hrs. I went to my family doctor and got in with another neoro who got me a second mri that didnt show alot then he sent me for a diskogram, I was in surgery 7 hours after the test. I personaly do not beleive in mri's as I also was miss diagnosed for a knee injury with one that almost cost me my foot do to lack of blood. arm yourself with all your records to take to the surgon, be very clear with the surgeon about your expectations and pick one that wants to work your case with you. this can take some time so getting your pain controled should be your first step.
    2 low back fusions. 1 neck fusion. Lots of therapy, injections, and so on.
  • :/ .hhi there.i had an accident on 31 july 2010.then dr found that its coz my L1 fracture vertebrae and the anterior superior corner of the body T11 and L3 vertebrae.
    i had been rest abaout 2 month.
    then last few days i went for a drive but it verypainful on my back then i see my doc then he said i should undergo small operation in order to put some type of cement to release my pain and back to waork.but i 've no idea ....

    can any body give any ideas and i really need advice from specialliest on this.....please
  • Puglover,
    Good job you high tailed it away from slice & dice doc.
    Now as for this guy from Houston, what an echo trip! No physical exam
    No Work-up? Insane.
    Waste of your time. Sorry for you, adds to your suffering!
    As previously posted, Houston is a BIG city, do a little research and line up 2 or 3. Might want to call the OR nurse station for their opinion, usually, very informative. My NS, that I selected made me submit new patient paperwork & most recent MRI, in advance, he is big ego doc, and well deserved.
    You will find the right one. Another option is an ortho/spinal surgeon.
    Good luck,
  • a reputable spinal surgeon and get his/her expert opinion .i too have been down this road {in the uk} i have already had 2 operations and been through the pain clinic and had all the normal treatment for spine pain including acupuncture /physio various injections .and now i too take oxycodone and i am waiting for a multi level fusion with one of the uk's finest surgeons .its take 3 years to reach this point as 5 other surgeons were unable to operate due to the nature of the damage and there own capabilities ..its take many hours of trawling the net and talking to others that had treatment with this man and thankfully he is only about 30 miles from my home .before you embark on surgery make sure you fine the right surgeon ..there are a few things you can ask yourself before you commit to surgery this should tell you if you are suitable and if its your time to go down this risky option ..can you .work/sleep/drive/walk/run/have sex/got to the toilet{sorry} and do you feel that you can't taken any more pain ..i spend my life in my recliner taking pain killers .i have gone from a very fit slim active healthy man to an over weight unfit man in constant pain ..so for me its the only option for you it may not be the right thing to do if can can do most of the things i mentioned ..i can do none of them !
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