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Advise Please...

gmiller22ggmiller22 Posts: 34
edited 06/11/2012 - 8:55 AM in Upper Back Pain, Thoracic
Just wanted to let everyone know how everything has been going. I went back to the Dr about the Vicodin making me sick, he gave me Phenergan (sp) for nausea and so far seems to be okay. I stopped the Cymbalta because I couldn't deal with the side effects and it didn't seem to help with my pain either.

The Doctor is sending me to an Orthopedic, I just have to find one close to my area that accepts my insurance. I don't know what to expect with them but I thought they were bone Dr's and since I have had X-Rays in the past that show arthritis and bone spurs I don't see what more they could do since my Dr said that was not the cause of my pain.

The Dr said my muscles are really tight and that could be an underlying issue so since he doesn't know what else to do he sending me to someone else (that hopefully can help)

Does anyone know what to expect for my first appt with an Ortho? I am not quite sure what they do... and i am a little nervous.

Really frustrated about having to spend spend spend and not getting any answers and just being pushed around....

I did some reading and I feel like I could have Myofascial Pain Syndrome or possibly Fibermyalgia but the pain is not all over my body just parts of it, and lately my ankles have been hurting and very tight feeling along with my neck, shoulders, calf muscles, lower back and a pain on my right side under my butt...


  • I guess your MD's referring you to an Ortho vs. an Ortho Surgeon. When you call for your appointment with the Ortho they will need to know what part of your body to be evaluated (spine, hips, knees) - different Orthopedists do different areas - go for the one troubling you most.

    Bring your x-rays with you (I guess you don't have MRIs?). They will evaluate the area - be able to describe where your pain is, how severe it is, what does it feel like (dull ache, sharp pain, heat, electric, numb), does anything relieve it or make it worse, does it come and go. They may have you bend, twist, test reflexes, etc. They might take more x-rays. Things vary from Ortho to Ortho but this will give you an idea.

    The Ortho will determine appropriate next steps. I hope this helps.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.
  • Thanks Karen that is very helpful information.

    It is an Ortho not an ortho surgeon. I am going to ask my regular Dr for a copy of my file so this Dr can see when it started and how it felt etc. I did have an MRI of the t-spine but it came back negative but I will bring the CD that the images are on and see if he can find something maybe my Reg Dr missed (i have been told family Dr's are not trained well to read MRI's)

    I think I am going to start a journal and track my pain from day to day, that may help him better understand what is going on.

    Do you know if you have to be referred to a PM doctor or can you just call and make an appt with one? My Dr has not mention that to me but I live in constant pain everyday and it has really taken a toll on my every day life and I really need some relief.

    Thank you for letting me vent and giving me great advice. I will follow up after my appt.

    Hope its been a nice summer for you. :D
  • Your Family Dr. can send you to a PM Dr. but perhaps the Ortho Dr. can help with injections and pain meds if he's not a Surgeon.

    Do you have numbness, tingling or pain in your leg? I hope your appointment goes well and this Dr. will help. Charry
    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
  • delete this double post please.. Laptop troubles..
    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
  • Your insurance determines whether or not you need a referral. There should be a phone number on your insurance card to call and they can tell you. If you have an "HMO" type insurance you usually need a referral. If you need a referral your insurance can tell you the process.

    Your doctor may be able to give you suggestions of doctors, or your insurance company could provide a list of orthos.

    I agree with you that specialists may be better trained to read MRIs.

    Good luck.
    4 level ACDF C4-C7 5-2-11, laminectomy & discectomy L4-L5 1/26/12, ALIF L4-5, L5-S1 12/10/12.

  • I don't have numbness in my leg but I have tingling a little bit on my leg but its mostly my feet. I was just diagnosed with Raynauds Syndrome which is where my blood loses oxygen and my hands and feet get cold and turn purple and blue but I have been doing a lot of reading on line about it and its also a common disease in people with Fibro. It seems the more i read about Fibro or Myofacsial Syndrome the more I am convinced I have it, but how do I tell the Dr that? I have a bunch of symptoms that I have related to Fibro but I have never had the trigger points tested so I am going to have the Ortho do that, if he can... who knows.

    What is the difference between an Orthopedic vs. Ortho surgeon? The Orthopedic will do everything to avoid surgery? I am a little hesitant on cortisone shots and injections like that because my dad had them done in the past and they put him down for about a week from pain, and after that the pain didn't become any better but I might give it a try.

    I just don't think they know how to treat the pain since I don't have a diagnosis yet, which is really bothering me and I feel like my Dr is giving up on me and that's why he is sending me some where else...

    I know its going to take time but I wish it would just happen a little faster. I don't know how much longer I can deal with this, I've suffered for 4+ years only going to the Dr and few times because lack of insurance but now that i have insurance i am trying to stay on them but it costs quite a bit of money to keep going to all these appts.

    I must say I love this site. This is the most helpful friendliest, knowledgeable sight I have ever found and it is becoming an addiction LOL. :))(
  • I hope you get answers and have some relief soon. The important thing about the Ortho is that you have one who specializes in the spine. I've had injections in my hips, back and neck. The back and neck is more of a production because of the proximity to the spine where they do the injections. I've had good luck with some (relief up to a year) and other especially more recently which don't help.

    I'm sorry to recommend another doctor, but maybe you should see a rheumatologist. They deal with osteoarthritis, fibro and other inflammatory issues. Mine has helped deal with flares, etc.

    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.
  • Dito- Good Luck.

    I also have had many steroid injections with mixed results. The one in my kee was a life saver before my surgery. The ones in my spine never lasted more than a few days at most BUT try to remember that these are not just for treatment but also for diagnostics. If you have good relief but it only last for a few hours then perhaps the dr found one of your hot spots and the numbing agent that comes with the injection is in the right location.

    Also I would only get spinal injections under the fluoroscopy. I truely hate the injections but there have been a few times I was so desperate for relief (even if for only a day) that I asked my NS for a refferal for them. Now that I am in PM and my meds control my pain (for the most part) I would be hard pressed to ask for another, but if it was diagnostically needed I would not hesitate.

    Good luck with the Ortho. I am curious how it goes.

    Hang in there :)

  • HI,
    Yes, I also have Raynaud's Phenomenon...it's an interesting thing...feel sometimes like a lizard changing colors! A rhumetologist would do that diagnosis for fibro/myofacial. I also have myofacial pain syndrome and fibromyaliga ...not a disease, a syndrome...Antidepressents that are SRI's work well, as well as sleep meds...amitriptyline works the best for me... People with this syndrome have a good chance of naturally having less serotonin (feel good chemical produced in your brain) SRI's are serotonin reuptake inhibitors...these drugs keep the serotonin circulating and not be absorbed as would naturaly happen. Hence, you feel better though nothing has really changed...but feeling better is what's important! It's a sort of chemical imbalance..
    Good to be checked out by a good ortho...but they would not treat the fibor/myofacial thing... you'd need a rhuemy or if your primary knows anything about it, he could manage your meds. I have 4 ortho surgeons, and 2 don't believe that myofac/fibro even exists! They tend to go with what they SEE! Ok, as long as they're good at what they do when I need them!
    Good luck on everything and I hope you find some relief soon...the correct meds for the correct condition make all the difference!!
  • YES Frannie that is exactly how I feel, just like a lizard LOL. I have had it for years and never knew what it was then finally it was doing it while I was at the Dr's and he knew exactly what it was. It doesn't really bother me just makes my feet super cold and sometimes it can be embarrassing cause people ask why my feet are purple... but now I have an answer to tell them instead of saying I don't know :)

    You were saying that SRI anti-depressants work for Myo and Fibro? I was on Cymbalta for about a week but couldn't stand the side effects and didn't notice a difference in the pain so maybe I don't have that?

    I was just put on Flexeril (muscle relaxer) and have noticed ever since I started taking it in (in the evening because it makes me tired during the day) when I wake up in the morning EVERY muscle in my body hurts, even muscles I didn't know I had, and i never noticed it before i started taking the Flexeril, but shouldn't that make my muscles hurt less instead of more? The pain usually lasts really strong for about 4 hours once i get up but lightens up as the day goes on. I'm going to give it a little while and hope its just my body getting used to the meds but if it keeps happening after a couple weeks i am going to call the Dr.

    I am going to look into a Rheum Dr after I go to the Ortho, ill see what he says and then go from there.

    Thank you for the advice. I love this site... Its even more addicting then facebook :)
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