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PM Dr says nothing can be done

sedorsessedorse Posts: 3
edited 06/11/2012 - 8:56 AM in Pain Management
Hi everybody

I am a new poster but I have visited the site several times for information. My problems started two years ago with never ending lower back pain w/leg pain. I saw my primary doctor who referred me to a Spine Center/Pain Management. My first MRI showed disc herniation at L5/S1 and I began the series of injections, epidurals, pain meds, TENS, Lidocane Patches etc. The injections helped for about the first year and I guess I though I could push myself since I didn't really feel in alot of pain and when I had a discography in June it showed further herniation from L1 all the way down to the L5/S1. I have been on Vicodin/Percocet (switching back and forth every few months to increase effectiveness) for two years now. After my discography my PM Doctor said "There is nothing more than can be done, don't believe any doctor who says surgery will fix it, because it won't. You will be like this the rest of your life". Needless to say I became extremely depressed and ended up taking a medical leave from work at the end of July. My question is should I believe what the doctor said and assume my life will be filled with pain and suffering or is there more light at the end of the tunnel. Any suggestions or comments are much appreciated.


  • I highly recommend getting another opinion from a surgeon that only does spine surgery.

    But, believe me, if you can avoid surgery at all, it is better to do so. There is definitely no guarantee that surgery will greatly improve your pain. I know how depressing it is and you will need to find a "new" normal way of life for yourself. The pain management place you go to should be able to help you with the depression. Being here with all of us will be very supportive as well. We understand.

    Best to you,


  • Hi and welcome. Pain dr can only mean nothing more he can do i am sure. Meaning other then what he has already done its now in a spine specialist hands if they want to posibly do surgery. You need a good spine dr not only pain dr. The pain dr needs to find where the pain is coming from so the neurosurgen or ortho can decide what surgery will help

    Even of mri shows more herniation dont mean its causing pain from all of those levels.
    Pain dr should never of said nothing can be done because he is not a surgen and even if you were not a candidate for surgery , the pain dr still could offer you to try nerve stimulater for pain control if he has not done it yet. Good luck. Let us know how it turns out
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • Definitely get a second opinion. There should be other pain control options like SCS or Pain Pump. At any rate the PM is not a NS/ OS surgeon.

    I would gather your records, films, CD's etc (everything) and start checking out some new Neuro or Ortho Surgeons (only fellowship trained and specializing in spinal reconstruction).

    Maybe you are not a surgical candidate for certain procedures, but maybe there are some other procedures that you are a candidate for.

    You never know if you take this one doctors word for "IT".

    Hang in there & feel better,

  • Thank you everyone for your great advice, I will start looking for a neuro/ortho doctor that particpates in my insurance. Thank you again :)
  • Gotta echo what all have said here. A PM may be absolutely wonderful in caring for their patients in pain management, but "spines" are not their area in most cases.

    NS/OS, that are Fellowship trained - many of which also work reconstruction and revisions - so they understand the workings and mechanics better. Please let us know how it goes, but don't give up until *you* feel satisfied of the answers and reasons for what you are going through.

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • dilaurodilauro ConnecticutPosts: 9,877
    I believe that the words from doctors I hate the most is when they tell someone that "There isnt anything that can be done"

    I am sorry, there are always different ways to approach a problem and there are very few problems on earth that can not be resolved.

    First thing, I would really think you need to understand what the doctor's rationale is for telling you nothing can be done. I'd be curious to here their response.

    Secondly, I would start to look for another specialist. I am not of the type that tells folks to drop one doctor and look for another. I always believe in giving the doctor their opportunity to help you. But in your case, it seems like they have already given up.

    There are some spinal conditions that are resolved with standard surgery, then there are others that require a bit more. But until all the conservative methods/treatments have been tried and surgical options explored, you never will know what the resolution to your problem will be.

    Be strong...
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I have DDD in the lumbar and s1-l4 herination. Surgery is not an option since 3 out of four docs said they would not know where to start and that I would be in more pain in a year after ther surgery than I am in now.

    I to am going through the vicodin/percocet circle and due to an incompetent PM doc got kicked out and spent time in the Hosptial.

    My GP is now handling the meds but due to the DEA haveing every doctor in my area scarred silly, will not for long so I to am looking for a new doctor. I really don't know how to approach them without it sounding like I am doctor shopping. In a sense I am I am shopping for a good doctor like you would a good mechanic. Not some schmuck that will blindly write opiod prescriptions and I end up getting hooked.

    I hope you find a solution. I personaly have been to ortho's and neurosurgens and GOOD chiroprators. The Chiropractor along with the exercises he recommends and useing the cheap version of the total Gym keeps my pain down below a 6. The meds knock it down to a 3 so I can function

    Good luck
  • SavageSavage United StatesPosts: 5,476
    It was within the first couple of visits my PM doc told me...We'll be treating you like you have cancer...
    I thought that was an odd choice of words.But doc just trying to treat symptoms/pain as they come up as no way surgery is even on the table.

    The thing about his statement though..goes along with his demeanor..like...What do you expect?...YOu're better than you were before...

    It's not always easy to speak up for myself..but I have to. And I do get treated for depression, also.

    But even so, the pain meds help..I'm not in the ER regularly...that is light at the end of the tunnel for me :)

    Good luck to you!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • I think the PM doctor may have been saying that there is nothing more that I can do, other than continue doing what I am currently doing. I have heard that from at least three PM doctors, because there is nothing more treatment wise they can offer me aside from managing my pain medication needs, which is what we do.
    I would ask him to clarify what he meant.
    And, the good news is that most herniations will resolve on their own, without treatment in two years, or so reports and studies say. It is when there is nerve impingement or nerve damage that surgery should be considered, until then, I would stay far away from surgery if I could.
    It is wise however, to see a board certified ortho or neuro spine surgeon to make sure that there is no nerve involvement. If that is the case, and medical management is all that can be done in the meantime, I would try to wait those two years and as long as your condition doesn't worsen, stay the course and see if things resolve.
    Good luck and ask your PM doctor for clarification about the comment.
  • I agree with Marianne. What I did was go to a surgeon who specializes in spines surgery. He is a Neurologist. He said surgery is not really an option for me right now, and referred me to a Physiatrist (Pain Management Doc) in his practice. So far I have had good luck staying within this practice. The Physical Therapist in their practice that I am seeing also specializes in backs. He has been great.

    I have been through a lot of doctors, trying to find the right one. If yours is a jerk, just move on! Get at least one more opinion.

    Good luck,
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