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chronic nerve damage due to back problems

lincanllincan Posts: 4
edited 06/11/2012 - 8:42 AM in Back Surgery and Neck Surgery
I have had 2 back surgeries - fusion on L4 - L5 in 2005 and hemi laminectomy L4 - L5 in 2008 - I have since still had trouble with left leg pain and my left foot not being able to straighten out my toes when I walk - It seems it's gotten worse just this past year - I did end up in the ER last month because both my legs - the left being the worst - became numb
ER Dr told me that all the muscles along my spine were tight and inflamed which would cause pressure on the disc all the way down to where I had the surgery - he gave me 2 steroid shots and prescription for Prednisone and an anti-inflammatory
I also had seen my DR prior and had been and still am on Neuroton.
She recommended I have an EMG - this now shows that I have chronic nerve damage from back issues and she recommended injections or pain management - I've done the injections prior to my first surgery - they only last so long. Not sure my insurance will pay for pain management so was wondering if anyone had any suggestions as to what else they might recommend - I love to exercise but am now limited - any help would be appreciated.


  • Hi,

    Why do you feel that your insurance might not pay for pain management?

  • I've looked thru my health insurance booklet and it says nothing about pain management/clinics - also this is a pre-existing condition and not sure if Obama's new health policy covers pre-existing with insurance - The way I read was that it was children with pre-existing conditions and people that don't have health insurance -
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  • lincan said:
    I've looked thru my health insurance booklet and it says nothing about pain management/clinics - also this is a pre-existing condition and not sure if Obama's new health policy covers pre-existing with insurance - The way I read was that it was children with pre-existing conditions and people that don't have health insurance -
    I would not just assume that your insurance will not cover PM because it isn't listed. They can't list every type of treatment or the booklet would be as thick as the new health care bill. Call your insurance company and get a definitive yes or no. I would be very surprised if it isn't covered.
  • I wouldn't assume your insurance doesn't cover pain mgmt if you have nerve damage. And pre-existing conditions? That's typically only if you have a gap in insurance coverage...the US laws already protect the patient from that.

    The obama care isn't going to make a difference there.

    If you had a gap in insurance coverage, typically there is just a 'wait' period before they cover it. The reason this 'wait period' is there is because it's not fair for someone to get a job 3 months into finding out they are pregnant just to get coverage. So typically, it just says...hey we'll treat you but you have to be paying into this for 'x-period'.

    Oh, and even if your insurance doesn't cover it, you can usually negotiate prices with pain management doctor. The key is...have your surgeon write a prescription for you to see a Pain Mgmt doctor.

    If you want to be absolutely sure? I ask the pain mgmt doctor what is the CPT code you will use to bill my insurance company. Then I call my insurance company and ask them "is this code covered"?

    Don't avoid treatment b/c you are trying to 'interpret' your insurance company manual. Ask and if you don't get a good answer, ask again. If you still don't get a good answer...ask the pain mgmt doctor if they take your insurance and if they can confirm the appt/treatment will be covered. I have found that my doctors are great at helping me navigate my insurance (ok, it's not the doctor but their staff).

    Good luck.
  • Hi,

    I also suffer from chronic pain due to back surgery of a bilevel posterior 360* L4-S1 with a lami and formanectomy. I developed massive amounts of scar tissue from this surgery. I have been offered 3 options to help me with the nerve damage. One is nerve pain medications, which has been helping so much. I'm on methadone, neurotin, amtripylin, darvacett, and advil. These meds have changed my life. I can move again! But like everyone else on here. What works for me, may not work for you. You need to find your right combo of meds that will help. A good pm dr will work with you to find it.

    I was also offered 2 other options. One was caudal epidurals, and scs. Both of which I'm not to thrilled to try, so for now I'm leaving them alone. My pm dr understands my personal reason for not trying them at this time. I'm also in no rush, because of the great pain control I'm getting from meds. The first time in over 3 yrs.

    There are other option that can be offered, and that's a pain pump, acupuncture, physical therapy, deep tissue massage. and probably a few more that I missed. Like everything, it may help, or it might not. One never knows until you try it. Most of these are covered by insurance, so you shouldn't have to much of an issue.
    Bobbi Jo
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  • Bobbi Jo,
    Thanks for your post. I am currently suffering nerve issues. Low back burning pain that radiates to hip and inside thigh, rt thigh is numb. It is interesting to see your medications. I am seeing a new PM Dr on April 27th, if I make it that far. My current meds suck!! Generic lortab and flexeril. No nerve meds at all. And my surgeon is of no help. So I got them to refer me to PM. I guess we will see how it goes. But again thanks for the info!!

  • Funny you should mention that, I have L5 neuritis from L5 S1 surgery but this month started having extreme pain in lower back, fell on the ice on 3/5 started raidating pain from my right side down my hip. The spine doc (who by the way I just LOVE) did some movement tests and when he moved me one way HOLY COW the pain raidiated from my right side in my back, through my hip part way down my thigh across and down the inside of my right leg to my ankle. Felt like I was hooked up to a car battery.

    Diag. Possible L4 nerve damage... Now 2 new meds he put me on Topamax which is for seizures but calms the nerves in the brain and back, but for me helps my back, my migraines and :) my IBS. 2nd new med Zanaflex which is for ms and spinal cord injuries (it is a muscle relaxant) Now combined at night only they work out beautifully..... Just food for thought..

    Now as far as PM clinics go - most are more than pm clinics. My dr is a pm dr but also a spine dr but they specialize in pain management which is cool love it. No more pain meds, new meds are wonderful as mentioned above and they are straight forward.

    I work as a benefit rep. call your insurance carrier. unless you have had a lapse in coverage there shouldnt be a pre exsisting. If you are covered under a large group policy then you shouldnt have a problem as most cover under the large group policy. If you have what they refer to a CCC or Certificate of Credible Coverage provide it to your carrier. But typically PM clinics are generally covered. They would rather pay to have you manage it then pay to have you in rehab to get off an addiction.
  • SpineAZSpineAZ WiscPosts: 1,084

    It would be very rare for Pain Management not to be a covered specialty by insurance. For most insurance companies you can access the physician directory on-line. Most often these doctors are listed under Pain Management but it could be under another title. Since PM is less common than some other specialties if you do the search on-line be sure to say "within 50 miles" or even more. I know someone who travels over 100 miles from a rural city north of Phoenix to get to PM here.

    Someone else had mentioned, if you didn't have a gap in insurance from one employer to another then pre-ex is not an issue. For example, my husband had insurance for 5 years at work, he has taken COBRA, as long as he has that he's continually covered. If he then takes a job with an employer who offers health insurance he is fully covered with no pre-ex as he's been continually covered. Only if you had a gap of more than 60 days in coverage would pre-ex apply.

    I would think your Orthopedic Spine Surgeon or Neurosurgeon (depending on what type of doctor you are seeing) would want an MRI at this point and possibly a CT myelogram.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
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