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joanljjoanl Posts: 41
edited 01/18/2013 - 8:05 AM in Lower Back Pain
Good Morning all of you spine sisters and brothers:
So, my big problem is getting to the right doctor to help me diagnosis the route of my back pain. I have been to a physiatrist, two neurosurgeons, family doctor. I am now thinking of scheduling an appointment with a pain management doctor. Each doctor I have been to seems to be in their professional "rut", not thinking out of the box and looking at me like a whole person. I know from Ron's history, that he had to try many different approaches.
Background story: Fell on ceramic tile in bathroom on January 29, 2012. Xray. Was told okay, than a week later was called to say I had a compression fracture of T11. Given pt, no brace. Physiatrist said just go on with life. Fracture stable.
Continued pain in midback. Went to a neurosurgeon who ordered another xray. Said same thing as Physiatrist. Then ordered a cat scan. Cat scan showed T11, T12 and L1 compression fractures. T11 the worst with some retropulsion. Also, extensive disc damage. NeuroS said discs probably normal wear and tear. I didn't think so because before fall I had NO BACK PAIN. Why do doctors not take into consideration what you tell them?
Just saw the radiologist interpretation of first xray and it said a grade 1, 4mm reto disc slip at the L5/S1 level. I think this is the route of my pain when sitting, bending etc.

So, my question is, is there a physician specialty that you have had the most success with, treating you as a whole person and not just his "specialty". Pain is so elusive. As we all know, finding the root cause of your pain is the first big step. I don't want to just mask my pain, I want to help it and hopefully get physically healthier, if possible.



  • Maybe you should consider seeing a ortho surgeon, But also you can check out a neurologist as they are the ones just looking for a diagnoses. Blocks can be put in to see if it stops the pain, and if so they know it is the pain generator. One thing be sure you are being clear and concise as to the symptoms you are having. For example saying you have back pain won't cut it, but saying I can sit, the pain is blah blah place, will help. Journal your pain, see where it is and what is the worst of it and start from there. Keep track of what kind of pain it is wether shooting, stabbing or sharp. Keep track of what makes it better and what makes it worse. Keep in mind the more precise information you give the doctor the better it will be. Also be sure you are not saying things like my arm hurts as that would have nothing to do with back injury only a neck injury. Look at a dermatone chart and see if any of the pain patterns you are describing look close to what you have. Those are some avenues worth a try.

    Also on the compression fractures it is common for them not to show on images for a week or two weeks following the initial images. My dad went through something like that and that is how long it took for him to get diagnosed. I had asked my doctor about it and he gave me the reasoning why and how common it is. He explained to me that is why they say if the pain gets worse to follow up with your doctors.

    I think your biggest issue is the doctors are looking at the compression fractures and nothing else, which most of those are a waiting game and just need to heal while wearing the brace. Do you know if they have healed. In addition while the fractures have healed you could still have residual pain up to about the 2 year mark. If the pains are different from the original compression fracture be sure you explain that to the doctors, or if they have gotten worse.
  • TamTam, your suggestion of a neurologist is very timely for me. The pain dr. that I've been planning to go to is triple board certified in Pain Management, Neurology and Neuro/Muscular problems. Your suggestion just solidifies my decision.
    And anelsen thank you for your post. So much of what you say is on target for me. I sincerely hope that you will be able to find some answers for yourself. You have been suffering for a long time. Navigating the medical profession is daunting, especially when everyone is such a specialist. You say that you have been to many doctors. Has that included a neurologist?
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  • I've been seeing a fellowship-trained, board certified ortho surgeon for over five years and he specializes in only spine problems. He's also part of a larger group of spine specialists that only treat spine problems that include a physiotherapist, neck an lumbar specialists and PT. so they all work together to find and fix my problems. I just had my third surgery with them and am having nerve problems in my left leg. Luckily I see my surgeon this coming Friday for a follow-up and he knows I'm coming in with unexpected nerve problems.

    They've also handled my medications since all my problems began (first neck issues then two lumbar issues) so I'm with Tam on trying an Ortho. They work on bone issues with referred nerve pain whereas neuros work on nerve pain with residual bone problems. Since our spines are the main culprit (usually) that cause nerve pain and it's bone, I'd go with a "bone" doctor.

    That's just my opinion.

  • Your medical group sounds outstanding. I wish that I could find a facility that is all encompassing like yours. Most importantly, you are getting on going care from a group that knows you well and your history. I haven't had that luck. I'll have to go back to the drawing boards and do more research in my area. I live in Palm Beach County, Fla.
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