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B/T a Rock and a Hardplace - could use some advice

DNiceDDNice Posts: 1,962
edited 06/11/2012 - 8:59 AM in Lower Back Pain
Background: 2 microD's at L5S1 (Aug '09, Feb '10)

Result after 2nd surgery:
Reduced leg pain, increased leg strength, eliminated limp; no change to significant numbness

New Symptom: ~5 months I started with extreme pain in middle of night and upon waking when trying to move/stand. I dealt with it best I could with NSAIDs, stretching, getting up in middle of night to try to keep muscles loose.

- Called NS office. They told me have GP prescribe PT and call if it didn't work.

- GP would not send me for PT without doing new MRI. New MRI seems status quo (modic type I changes, scar tissue but all else consistent with 2 MD's)

-GP gave me choice to send me to someone he knew OR to call my NS but said keep taking NSAIDs (and gave me max dose I could take per day safely...which don't do a lot).

- Called NS office today. Reception kept pressing to go for PT before calling back. Really?
(She did say NS might just look at results if I mail them but will likely tell me try PT and if that doesn't work, he'll refer me to a Physiatrist)

So what should I do?
1 - Should I call back and just tell them I don't feel comfortable with more PT without seeing him?
2 - call my GP and tell him I need his help (he was willing to make a recommendation) and see if he says PT or Physiatrist?

I'm torn. I love my NS but he is busy and I suspect his office knows there is little he can do so trying to save us both a wasted appointment. At the same time, frustrated that I called the office twice and they are resistant to help, despite the fact that I want HIS advice.

On the flip side, I love my GP too. He is so willing to do what I want (meaning, give me the chance to connect with NS) but I suspect he knew the NS was not going to see me and he can help me navigate help through his local network.

sorry for long post.
NS is in a different part of the state than my GP.
Yeah, just worked out that way.


  • The pain I'm having is primarly at night.
    I cannot move without wincing in pain.
    Even holding on to my husband's arm or bed post, hurts like hell to move. I just grit my teeth and move.

    When I wake up, I roll out of bed but cannot put pressure on my feet for a few minutes. So I hang on the bed holding myself up with my upper body until I slowly can straighten myself up.

    I then hobble around the house for 15 mins until I can walk upright. This is a nightly occurence (at least 5 of 7 nights).

    It's frustrating more than anything and I worry I will awake one day and not be able to stand.

    During the day I'm actually really good so I suspect it's muscular/inflammation.
  • I would go to the Physiatrist to see about pain medications, PT and a neuro exam. The Physiatrist I saw at Cleveland Clinic says a Physiatrist knows about half of what a Neurologist knows and they're good for assessment and ordering tests or PT, or recommending certain exercises and meds.

    That's what I would do anyways since the NS seems so busy to see you. It's good you can get by during the day though except for the pain in the morning. TC. 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
  • Thank you Charry.
    I realize that the doctors have to send you through the 'protocol' steps so tomorrow I'll call my GP and start the process. Knowing my GP, he'l likely do the Physiatrist in parallel to the PT.

    The pain is really only a problem in the middle of the night and first 30 minutes I wake up. Aside from that, I'm doing pretty good.

    p.s. I used eCleveland Clinic for a remote opinion and pleased with the information I got. Also, my NS office said that if the PT didn't work, they would likely just refer me to a physiatrist too.

    So I suspect I'll end up the same place and the GP is more accessible.
  • A quick update...

    1) I took myself off tylenol and advil just to see if they were doing anything for my pain. They were not. The only thing Advil helps with is these 'electric shocks' I get in my foot (terrible) as I assume they reduce inflammation to the nerve.
    So the good news? I'm taking less medication.

    2) I just spoke to my GP and he is just amazing. He is referring me to a Physiatrist b/c he feels they will do both PT and PM and try to see if there is anything they can do for my situation.
    So the good news? Even if I don't get additional relief, at least I will have peace of mind knowing I am doing all I can to prevent issues walking in the future.

    3) I have been doing a lot of walking and am not seeing any impact to my pain levels (plus or minus) but I do feel better about myself

    Thanks to everyone for their continued support!
  • Great to hear some referrals happening and hope you get some results with PM and PT and Physiatrist.

    It's good you're keeping mobile. Im even using a walker now but only been out once yesterday but do feel better walking. 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
  • Just wanted to update folks. I saw the Physiatrist yesterday and while he is a little odd, I really like him and the approach!

    He did a chronological walk on my pain vs. starting with the L5S1 as the source.

    He is optimistic that with Therapy, he can improve my situation. He feels the PT I got after surgery was a good start but now I need more to add to it b/c my facet muscles are very tight. He is also helping with nutritional plan too! We are starting with 4 weeks of PT and then re-assess but he feels I should see an improvement without needing any meds or injections.

    Fingers crossed. I just am so happy with the 'holistic' approach to my pain!

    thanks for this board for introducing me to another option!
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