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Ortho Specialist ... Pain Management Specialist ... who?

Hello Everyone!

I am writing to hopefully find out how the process of ortho specialist and pain management doctor works together. I have dealt with low back pain and sciatic pain in left glute for about 2 years and saw a physical therapist on my own to attend to the issues. I competed in Crossfit and was an athlete all my life from 6 grade through my senior year in college.

The pain was never consistent and PT really helped it, which allowed me to continue to compete. Last December it got really bad to the point where I was unable to work and place my body weight on my left leg. It felt like my left hip, glute, and quad locked up on me. It was so painful to walk and I had to take small steps and not move to quickly. It was so bad that I was midway in the restroom and had nothing to hold on to when it locked and I forced myself through pain to get to the toilet to sit before fainting. I literally felt like I was going to faint and screamed my husband's name. He brought an ice pack and laid it on my chest and head to keep me from fainting.

I saw my PCP and got a referral for a MRI. I learned that I have degenerative disc from L4-L5 and L5-S1 and bulge disc (same levels). There is also a bone spur due to the degenerative disc. I was then referred to a ortho specialist that took me 3 months to get in. He told him everything I went to and the PT I did own my own and my competitive back ground. He referred me to a pain management doctor (within his practice) and scheduled me for a discogram and made it seem very simple. I researched discogram and that is usually what a surgeon recommends when surgery is necessary. He never mentioned anything to me about surgery. So I made another appointment and took my husband to address my concerns. The specialist was totally different now. He listened, answered questions, and didn't blow me off. I told him that I was not properly inform the purpose of a discogram, at this point I am not ready for surgery especially when we haven't tried any conservative methods such as epidural injections, etc.

So he referred me back to his pain management doctor for epidural injections and PT and we would resume in 6 months.

How does this process work. His the ortho specialist my doctor or the pain management specialist my doctor? Also, I was told by the pain management specialist assistant that if I need pain medication that I had to make an appointment to meet with her or call the ortho specialist and see if he would prescribe anything. They work in the same office and same practice ... I guess I am just wondering if I should go ahead to make an appointment with the pain management doctor or if I need to stay with the ortho doctor and I don't even know if I am a candidate for surgery. I just know he was surely moving their pretty quickly.

By the way this is an great ortho practice and they decide what patients to take and I was selected. Additionally, I feel better about the ortho specialist since the 2nd appointment with my husband. Thank you for your help.
Lumbar Radiculopathy
L4 - L5 Diffused Annular Disc Bulge
L5 - S1 Diffuse Concentric Disc Bulge, caused neural foraminal canal narrowing bilaterally, left more significant
Sciatic pain on left left


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