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Question on pain management

I am scheduling appointment tomorrow for my first appointment with pain management and I have never gone to one of these before can anyone tell what will happen during my first visit just so I know what to exapect? How long is the visit? My surgeon said he’s only allowed to write a certain amount of scripts and I’m at the limit so I have to be referred he said he knows I need the medication so I need to go to pain management. My surgeon is only allowed to write for tramadol or Tylenol 3 and tramadol knocks me out so he switched me to the Tylenol and that barely does anything for the pain so I hate pain meds but I’m at the point that I need something stronger does anyone with ruptured disc know what type of medication they will give for that? Thanks in advance and for listening to me I’m just nervous about this first visit since it’s all a new experience.



  • Hi there,

      Its really impossible for anyone of us to guess what the doctor may prescribe.  I would advise you that many PMP's will not prescribe controlled meds on the first visit.  Especially now in the current anti-opioid climate we have.  I would also expect a rather long intake questionnaire along with a discussion about a Pain Management Contract.  It's also not out of the realm of possibility that you may be drug tested for a baseline.

      Go into the appointment with an open mind and ask as many questions that you have.  Write them down if you have to so you don't forget in case you are rushed a bit.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Well pain Mgmt is refusing me because I am getting injections from my surgeons office , they told I would have to transfer all care to them and I’m not doing that so I guess when my pain meds and headache meds run out I’m gonna be pretty miserable. I like my spine specialist and my surgeon and I am not about to let someone I don’t know stick needle in my spine that could cause more damage just for meds. I had epidural on the 11th that did nothing to help and that’s what this clinic wants to do more of. It’s pretty sad when you have spine pain and can’t get the correct treatment your needing. 

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  • L4_L5LL4_L5 Posts: 1,480
    edited 04/26/2018 - 5:58 PM

    It’s not at all uncommon for an injured worker to have TWO pain management doctors (one who prescribes medicine and another who does the injections).

    It’s simply not true that an injured worker must do EITHER injections OR medication. You absolutely can receive both and have both 100% covered by WC. 

    Why don’t you want to have a pain management doctor be your WC doctor? That’s a lot more common than having a surgeon be your WC doctor. 

    Why? Because pain medicine is something most people dealing with chronic pain find helpful on a monthly basis, and thus are seen monthly and receive scripts monthly.

    By contrast, ask yourself how often does anyone need to see a surgeon? Surely not monthly, but more on a “as needed” basis.

    If a pain management doctor insists only on injections and not medication, ask your lawyer for the name and number of a WC pain doctor in your area who is medication-focused rather than injection-focused (since injections haven’t helped you). 

    Be your own advocate and don’t be afraid to speak up when talking with your lawyer. It’s important you articulate to your lawyer all your frustrations and how he can assist to improve your situation.

  • My job is fighting me on the workers comp and my lawyer said it’s cause they messed up by not following dr orders causing me damage to my spine and that’s what they do when it could cost them a lot for care. I have a deposition June 4th so for now I’m on my own so I’m stuck between a rock and a hard place!

  • L4_L5LL4_L5 Posts: 1,480
    edited 04/27/2018 - 12:18 PM

    Are you saying your claim was denied? If so that would explain why all these troubles.

    If your claim was accepted then after you missed x number of days of work (varies depending on the state) your lawyer could have filed paperwork to allow you to collect lost wages.

    It’s not your employer who’s fighting you, btw, it’s the MCO.

    If you didn’t report the injury right after it happened and weren’t seen by a comp doctor within 24 or 48 hours after the injury that could be why it was denied.

    Reporting an injury ASAP and seeing a WC doctor ASAP following the injury can be very important. The longer someone waits to report an injury and/or be seen by a doctor the less believable the seriousness of their injury is. 

    You said you have the necessary medical evidence so as long as your WC doctor and lawyer can agree on and prove causation then you should be fine. 

    Good luck with things. Please keep us posted. 

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  •  I feel bad for people nowadays suffering a back injury and having a hard time getting adequate relief. It wasn't like this 10 years ago, and in a weird way I feel "lucky" that my problems began back then. I went to spine specialist for my disc herniation and was given Hydrocodone, epidural injections, and pt.  After the first surgery didn't help my pain, I was referred to pain management. They are highly trained to do minimally invasive procedures like injections and nerve ablations. The key is finding a good clinic with highly trained doctors. I know navigating workmen's comp is a nightmare and they should never obstruct needed medical care. I hope it works out for you soon. 

    Ol' Spiney..Micro-D L4-L5, TLIF L4-S1 -post op central HNP L4-S1,stenosis, retrolisthesis, EF, facet arthropathy, lumbar& cervical DDD. FBSS- Medtronic pain pump & SCS
  • I did report my injury right away and they new I was hurting and couldn’t turn my neck for 2 days after they put me in a position to lift beyond my weight limit, and I have proof they were notified same day, so my lawyer said it is a good legitimate case and we have a deposition set for June 4th so one way or the other they will be responsible for these Medicare bills so I just need to get through this so then hopefully I can get the medicine treatment I need. It is just such bull crap that a company can put you in that type of position and then know they have injured you and still think they can fight it! My dr did write me for more meds since pain Mgmt wouldn’t take me unless I dropped my dr so I’m good now, we’ll I will get by I mean. I just can’t wait to not have to take meds I truly HATE having to rely on them to get through each day. 

  • I’ll be thinking of you on June 4. Again, good luck. I’m so sorry you had to wait this long.

  • When I seen a pain dr , he reported everything back to my gp , wrote same on paper for me and gp prescribed my meds. I suppose my gp knows my body much better that pain dr, good luck

  • Because her pain doc would be WC-certified I doubt her GP would be involved as most GP’s don’t want anything to do with WC.

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