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Something has GOT to give

I recently visited an orthopedic surgeon to pinpoint the cause of my back pain. His diagnosis was spina bifida (which i already knew about), sciatica (which is an extremely generalized term), and a herniated disc between the L5 and S1. He hasn't taken an MRI but intends to do so in after 6 weeks of physical therapy which started yesterday. My physical therapist is having trouble locating the affected nerve roots so she can begin treatment but all of this twisting and bending is about to kill me. Do you notice anything strange? I think I see some of the discs out of place aside from the L5-S1. At first glance it didn't look too bad and I'm wondering if he just didn't get a good enough look at it. It is an x-ray so the discs are barely visible. Should I ask for an mri sooner? I've been dealing with this pain and numbness for 10 years. It's been progressively worse. I have recently (within the last year) developed what the therapist called "saddle numbness". I was given steroid injections and told to go home and take a tylenol. For once I'd like a doctor to say, "I found your problem, we're going to do everything we can to fix it."
This guy acts like I should be able to move a mountain, when I can't hardly spend 30 minutes upright followed by 3 hours of laying down with my heating pad.

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  • jessitaylorjessitaylor Posts: 40
    edited 11/27/2013 - 4:23 AM
  • dilaurodilauro ConnecticutPosts: 9,875
    the location of a herniated disc without a MRI. Based on some clinical examinations, they may be able to 'suspect' which level, since each of them can and will present different symptoms.
    DDD (Degenerative Disc Disease) and Sciatica are terms that get used so often. DDD is overplayed, since it really is the physical aging of our spines. Everyone as they get older will show some signs of DDD. But sciatica, you have to know what is causing that! Some nerve root is being impinged.
    Your therapist does need to know the disc causing the problem. How the treatment for those nerves can differ. Unless your doctor specifically wrote a script to work on your L5/S1, I dont know how much a therapist can do.
    Asking for a MRI! That might not be as easy. Most of the time, when patients ask/demand/request a specific test or medication, doctors back off a bit. For some, its an ego thing. they want to be the ones to make those types of decisions.
    Instead, you could just talk to your doctor, let them know the problems you therapist is having (but by now, the therapist would have needed to provide feedback to your doctor, so to know that, would be interesting) and are you sure its disc L5/S1! Could it be another disc? Questions like that should led the doctor into thinking MRI themselves.
    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
  • That information. I definitely don't want to be the patient that tells the doctor how to do his job. I just don't see how physical therapy could help if we don't know what to fix. She wasn't sure if she needed to treat the spina bifida or a herniated disc or what. She said my symptoms leaned more toward needing to treat the spina bifida but she is having trouble locating the affected nerves. My next appointment with the doctor is in 6 weeks. That is also $500 in copays worth of physical therapy between now and then. I don't want to waste time and money treating a guess when I'm feeling like this.
  • dilaurodilauro ConnecticutPosts: 9,875
    perhaps you need to have your physical therapist contact your doctor to express their concerns regarding your treatment.
    All prescriptions for physical therapy are written by the doctor with specific instructions as to what area needs to be worked on. If the therapist can not do that or is having problems, then they need to speak to the doctor.

    I agree, spending the $500 in co-pays is a lot of money, especially if it is really not addressing your major problem area.
    Even if your appointment is 6 weeks away, the therapist contact with the doctor is only a phone call away.
    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
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