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First appt with PM doc tomorrow

SockertonSSockerton Posts: 2
edited 06/11/2012 - 8:54 AM in Sacroiliac (SI) Joint Problems
I have been dealing with low back, butt and left thigh pain since March. Even though I had no insurance, I ended up going to the ER twice in one week with this pain.

Long story short - my doctor thought it was a ruptured disc and after the MRI results showed a only a slight bulge, totally blew me off but still gave me a referral for PT and pain management.

After 3 weeks of PT with no improvement, the therapist finally did a bunch of tests and told me that I had left SI joint dysfunction. Started treating me for that with some relief.

In the meantime, I had an appointment in May with a PM doc (after a 6 week wait for an opening) only for them to call me the MORNING OF the appointment to tell me that there was a problem with my (new)insurance, they couldn't see me until it was resolved and their next opening was in 8 weeks. I found another PM doc and my first appointment is in 10 hours.

I'm so nervous. I have been in pain for 5 months. I was taking so many NSAIDS that they damaged my kidneys. My doctor told me no more NSAIDS and to use Tylenol. Which does nothing. The only other thing I have is Flexeril.

What should I expect tomorrow? I read on here about testing for SI dysfunction and injections. I'm scared that he won't give me anything for pain. I'm in tears worrying about this. I can't deal with the pain. My MD doesn't seem to care. I guess I'm worried that this guy is going to send me home with a bottle of Tylenol.


  • When I went for my first appointment with a Pain Management Dr. I had to give my history and names of Drs I had seen and was asked what makes the pain worse? When you walk, sit, or stand and what relieves it? Laying down, warm bath, icing..I also had an assessment with me walking and brought my cane with me and walked with and without it. Bending forward and back from the waist and if it's sore when you did it and also do you have any radiating pain to your leg, hip and leg, calf or ankle or toes?

    You can check a dermatone chart and find out where what area is affected to see if it matches yours. I've had facet joint injections and SI and a hip injection and an epidural for the leg and foot pain and numbness with some effect. But your Dr. will let you know the treatment plan.

    Let your Dr. know if pain awakens you or if you take a long time getting up in the morning due to numbness, pain or stiffness. It may help to keep a pain diary and they can be found at many pain sites but you probably may not get that done in time for tomorrow.

    I'm sorry you've had pain for so long without any pain medication and I would say if it's true you can't walk or sleep without pain. You have a right to have pain relief and it's awful you have gone so long without proper pain relief.

    How old are you? Sometimes for many reason some Drs are reluctant to try some meds. My Dr. gives me slow release narcotics and started low but was able to get it increased slowly to where I can tolerate the pain but no one is ever without even on pain meds. Therefore maybe the injections could help.

    Just wanted to wish you all the best for tomorrow and many of us are nervous when we see the Dr or Specialist. Keep us posted and hope the Dr. will help you feel at ease and get you some relief. I've seen 3 PM Drs. but my Family Dr. gives my pain medications but I know in the States things are different there then in Canada right now. Take care. Charry

    Lots of info also from Spine Health Articles http://www.spine-health.com/treatment/back-surgery/preparing-meet-a-spine-surgeon-or-spine-specialist
    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
  • The appointment went horribly.

    He was offended that I told him the PT thought it was SI joint dysfunction. He proceeded to tell me a list of reasons why it wasn't. Then he told me my lumbar MRI didn't look that bad and how can I be in that much pain. And made a comment that I am only 31.

    Basically, I was sent away in tears with a prescription for Neurotin. Told me to continue to go to PT, but he wanted me to go to a different one. Oh, and take Tylenol.

    He also didn't seem to care that I told home I have renal problems, because Neurontin is filtered exclusively by the kidneys.

    Even so, I started the Neurontin today and it dropped my BP to 100/60. I am usually hypertensive with my average BP 130s/90s.

    I'm am crying as I type this. I am so f-ing done with all of this. Apparently the doctors know my pain level better than I do.
  • Sockerton,

    The experience you've had with your doctors is just terrible. I don't know what area you live in or what your insurance covers. Can you get recommendations for primary and specialists from friends or insurance, or check on-line, or if there are any support groups in your area.

    I am sorry they didn't listen to you and hear your pain. Welcome to the site - maybe you can gain some information and support. I think Charry's response was so thorough - I've never heard of a dermatone chart, and I'm going to look that up.

    Take care.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • I hope the medication helps and try icing your back to get relief also and alternate with heat. If you're having pain in your hip and butt maybe get your GP Dr. to send you to a Neurologist for an EMG/nerve test if you're having any numbness in your hip or leg. A Sports Dr. or Physiatrist would be a real help also as they do injections and massage also.

    Try not to bend from your waist anymore and crouch instead and turn your whole body and don't twist your back. Always support your back while getting up from the bed or a chair.

    If you can get into warm water community pool and just walk in the water can be helpful for pain also as well as finding a Physiotherapist who does aqua therapy.

    Please read the Dr. written articles on bulging discs in the articles section there's a lot of info to help you. Check out SI joint pain above this post to see if you have these symptoms your PT mentioned.
    I had a herniated disc and annular tear that healed on it's own doing PT, massage and acupuncture. I just bought an actipatch for my back and getting relief with this treatment. Don't give up looking for referrals from your Dr. to find a Dr. willing to help you. Take care.
    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
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