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Need Advice - Finding right doctor -

cccaverccccaver Posts: 10
edited 06/11/2012 - 8:52 AM in Pain Medications
Hello all,

This is my first post and I need some advice about finding the right pain mgmt doctor. I'm currently being treated by my family doctor and we've done conservative treatments for 2.5 years. During this time I've consulted with a pain mgmt doctor and a surgeon. The pain mgmt doctor is no longer in the group so I'm trying to find the right doctor. I've stuck with my family doc because until now, I haven't needed anyone else. This past week has been hell on earth and I need to make a decision ASAP.

I want to hit the nail on the head the first time and not have to mess around trying to find someone who will treat me properly. If this means different medicine, which it probably does, I do not want to be scrutinized like some druggie.

A quick summary, cervical and lumbar herniations - the cervical went from bad to really bad in the past week. My current medication(s) are not coming close to taking care of the pain. In 2.5 years I've never asked for stronger medicine than my current 30mg 10/325 norco per day, but more than likely the time has come to change medicines. I also have NSAID(s), Flexiril, Amrix, and Prednisone at my disposal. I've had the best luck with the Norco, followed by good 'ole Ibuprofen. I almost cannot stand the "pill hangover" from Flexiril and the Amrix just makes me sleepy.

I might add that I'm not just looking for different medications - I'm interested in being looked at for trigger-point injection candidacy, more physical therapy, and any other non-invasive treatment.

I don't even know if a Pain Mgmt doctor is who I need to see. Spine doctor? Can anyone advise me on the proper way to find a no BS, no hassle doctor to treat serious back pain? I've got all of the proper documentation, MRI films, etc. I need advice and I'm not sure who to ask or believe. Thank you for the time. -C


  • An update to my questions (and more questions!)-

    I've been browsing for doctors offices in the city where I work. I have yet to find one that I feel comfortable with. This is partly because I cannot find any feedback without paying for it.

    I'm not even sure taking different medications could help with my current issues, but -

    Are there better anti-spasm / muscle relxer medications than Flexeril or Amrix? These spasms are down right driving me crazy - To the point of dwelling on them.

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Have your family physician refer you to a board certified Orthopedic or Neurological surgeron. This doesn't mean that they will automatically want to do surgery, but they would be the best source for evaluation of your current status, and reccomend possible updated diagnostic studies and/or therapies.

    Let us know how you doing moving forward,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • to find a competent doctor is to check with your health insurance website and see what they have listed under the specialty you are looking for.
    Then you know if they do or do not participate in your insurance, and there are some insurance websites that even have patient ratings included.
    You aren't going to find any PM doctor anywhere who is liberal in prescribing pain medications. Most of them want confirmation of the diagnosis, may want additional testing first, and then conduct urine screens, or blood levels, etc to test for medications or street drugs first.
    Establishing a trusting relationship with a new doctor takes time and pain management is a time consuming process. It takes time to establish to your doctor and even sometimes more importantly the office staff that you are a compliant, complacent patient who is willing to go through the trial and error process of finding a pain medication regimine that will work best for you.
  • I would start with your primary care doctor and work from there. Find out whom your primary believes should treat you. It would be hard to say wether you need a surgeon or a pain management doctor. If you are against surgery, then a good pain management doctor would be the way to go. Look for one that is a physiatrist, which will treat from all levels, not just medications. You might find injections, massage therapy and medicine will help. You might also need a change in the muscle relaxer category. It depends on what type of pain your having will depend on what meds you need. Just be sure to have a good file of all your previous treatments and what works and does't work. Also be sure to beable to describe the pain and what makes it worse or better. You can use the doctor find on the website to see if there is a doctors available in your area.
  • (Well they all are, really) but what Tam said about muscle relaxers is true. There are so many and each one works for different types of spasms and for each person, one works better than others.

    Over the years, I've been on Skelaxin, Robaxin, Flexiril and have now settled with Valium. It really depends on what works for you and your particular type of spasms. It will most likely be a trial and error like it was with me. One worked fine for a while, then another and like I said, now Valium.

    Luckily, with most spineys, muscle relaxants are probably the easiest medications to work with with your doc because they're so common with spine problems.

    Good luck to you. Try and digest all the information that the responders have posted here as they're very good at helping in this area.

    Take care and keep us posted.
  • Hello cccaver,
    I'm so sorry you're having such a tough time finding a dr. I totally understand that!
    I'm in Canada so things work a bit different here. We almost always have to go through our family dr (pcp) to get any type of referral. The only other way is if you are seen in the Emergency room and they refer you to a pain clinic (that was my first exp) but then my pcp put in a referral to a permanent pm dr (which was a 8 month wait!!!)]
    It's so hard sometimes to remain positive when we hurt SO bad, not getting sleep, kids running around..and the world keeps spinning..
    I find that when you are *nice and pleasant* with the receptionists it often helps..I know it sounds funny and weird but I have had better luck getting results when I really shouldn't have and getting *in* to see him when just a moment prior they were "packed". It's hard, my pcpc receptionist I believe has a real issue with me BUT I am so disgustingly sweet, I think it bothers her more then if I were rude back! Haha
    It has been 2 long years with my issues and I have had atleast 7 different drs looking at this and that and like you, all I ever wanted was for one doctor to oversee ALL these issues and not have to beg and plead. I *think* the new neurologist that I seen WILL take over for the 3 others that have been dabbling along with me. I pray he does because I have lost all sensation in my "area"..and some other things.
    Sorry for the rambling..just wanted you to know I can totally relate to the dr frustrations and the worry of being judged because of the medications we NEED to function.
    I hope and pray you have some luck! Let us know..and feel free to pm me anytime :) Have a super day!!!!
  • Muscle relaxers werent helping with my spasms at all and they did further tests and said I have dystonia in my shoulder where they severed the muscle doing a surgery. Its a constant spasm so I get botox injections in the shoulder every 3 to 6 months and they help tremendously. Im on a lot of other meds as well, but for the spasm, if you can get insurance to approve it, botox works great. Hope you find some relief soon

  • If you go to a pain management doctor and they prescribes medication and you may have( depends on what they prescribe) too go back every month you will be scrutinized. They may want to see you every month to give you the prescriptions, to see how are are doing and sometimes to take a urine and or blood to make sure you are actually taking the medication, and to check your levels, etc.... ( Can you handle this? Someone I know used to go to a pain management doctor and every time before she saw the doctor they would take blood. )

    Is the pain getting to where it disrupts your sleep? Your sex life? Is it constant? Is it so bad that you don't feel like doing anything? Can you do your normal activities that you used to before the pain began? ( bowling, golfing, running, riding bikes, walking, etc...) If you can, can you enjoy it and life much? ( Some of these are questions the pain management doctor might ask you and that might be on paper work.)

    What I would do to find a pain management doctor. I would go to my family doctor and tell them that what is going on and you would like to go see a pain management doctor about other methods of helping you. Then I would say is If You were me who would you go see? If you couldn't go see him who is next would you see? ( May not accept your insurance, but get a few doctors that they would go to. )

    I would not call up the office and ask. Most the time what the office does is look up what your insurance is the first doctor that they see takes your insurance that's who they tell you to go to.

    When I started going I needed a referral to see my pain management doctor.

    I haven't heard of those anti-spasm. Have you tried a muscle relaxer like Soma?

    Sometimes if you go to google put in Dr. ------ in ---- you can find reviews, a lot of times you have to links,that go to websites, but a lot of the times you can find reviews.
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