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What to expect from my first pain management appointment.

I am very new to this forum. I've had two surgeries, L5/S1 then a year later L4/L5. My surgeon says that I have perminant nerve damage leaving me with the option of a SCS or more epidural blocks. My Chiropractor and I both believe that I am not quite ready for the SCS. He is setting me up with a PM Dr. that has done two of my epidural blocks in the past. I was wondering what to expect. Also, I've heard that they drug test you, if so why? I have no problem taking one but was wondering why.

Thanks in advance,


  • Hello and welcome. I just wanted to ask why your working with a chiropractor vs a spine specialist such as your surgeon or in that line of specialist? Just because I was advised once my back was damaged beyond a point. I should not be treated by a chiropractor. I'm justices asking. As far as pain management. If they take you on and are going to treat your pain with medications, they want to make sure your not using other substances. Thats one reason. Among others that other s will be by to explain. I just really advise you should check into being treated by chiropractor. I wish you the best.
  • Thanks for your concern. I have been seeing a Neurosurgeon. He was recommended to me by my Chiropractor who happens to be a family friend. He is well known and very respected by most of the surgeons in my area, shocking I know. My surgeon is aware that he is treating me and has given his blessing. The surgeon does not think that my Chiropractor will be able to help me with that portion of my back but has no problem with me going. He, the surgeon says that surgically nothing will help other than maybe the SCS. He says I can treat it with medication or blocks if I don't want the SCS. Because I trust my Chiropractor so much I look to him to advise me, sort of a second opinion so to speak. He has never harmed me. He has been honest and firm with me when needed. He is the whole reason I went to the surgeon to begin with. He sat next to me, held my hand, looked me in the eye and said, "it's time". His exact words after that was, "you don't have to do anything, just listen to what he has to say and if you don't like him, I'll find you someone else, but it's time". He has always had my best interest at heart. It would take forever for me to go into all the stories but I've been a patient of his for about five years and he has talked me off the ledge so to speak many times over the years.
  • your visit to the PM doctor is more fruitful than mine. All they had to offer me was the SCS and there was no way I was letting them install a device in my butt. I think there are good pain management clinics out there, but I certainly was not sent to a good one.
    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • i have a problem with chiropractors, they will not for the most part use meds, just blocks or twisting and turning. i would go to a neurosurgeon or an orthopedic doctor first and get mri's disographies, etc. they can set you up with a pain dr but be careful. there are certain things one should and should not do. first, don't demand narcotics. they will probably start you with weaker ones and go to stronger if you need them. you will probably have to sign a contract and no mine does not require urine or blood tests. work with them and don't get defensive with them. they have to deal with people all the time demanding narcotics and there are things they look for. ie they will bend you etc and most people with back problems don't have pain with some of the things they do. if you yell and scream at every little test, it puts up a red flag. don't say NAISD's don't help, another red flag. if you don't like him, try another. i believe clinics are not the best for pain drs. i have an individual one who is also an anathesiologist which most pain drs are. be friendly and don't demand and don't constantly complain about your pain. you would not be there if you did not have pain. remember they deal with all types everyday as i just mentioned. they tend to be a little standoffish at first. i have had 2 for 12 years, one retired and the other i have had for 5 years. no problems. good luck
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • @Isteller
    The PM Dr. that I will be going to eventually has done epidural block on me in the past, 2 actually. He has a good reputation as a very kind, caring man. He is known to patients and his peers simply by his first name. The first time I met him was in the pre-op before a block. He came in and said, "Hi, I'm Fred. Awww, bless your heart you sure are hurting. Don't worry, I'm going to do something about that." Then he bent down and gently gave me a hug. I have not seen him outside of the hospital as a PM patient though. I'll let you know how it goes. I too do not want a SCS.

    I have had two MRI which were ordered by my Chiropractor so I could take them to the Neurosurgeon that he set me up with. My Chiropractor is not one that will continue to work on someone that he can't help. This guy actually has a conscious. He is the one setting my up with the PM Dr. I really don't want narcotics as much as I want to figure out how to make the cramps stop so I can sleep. I can deal with pain during the day. Been doing that for years. I am use to hurting and would not know how to act if I didn't hurt. I just have to be able to sleep. I am still working and driving 130 miles round trip a day. I am much more fortunate than most people on this forum because I am still able to do these things. No, I'm not arrogant enough to think that one day I may not be able to do what I do because there are SO MANY things that I can't do that I use to be able to do just a few years ago. I am thankful for what I can do. I don't want to complain too much because I know it could be so much worse. I have some really good days, even several good days in a row. Lol it's the bad days that really get to me. My goal is to have more good days than bad. I just know that I don't want a SCS.
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