I went for a second opinion this morning with a neuro surgeon and left the office in tears. He said my scans (CT scan, MRI, x-ray, and I also gave him my discogram results) look normal to him, and he would not do surgery. He said that there is no nerve root impingement, even though I have leg pain in both legs, groin pain, foot pain, buttocks pain, and numbness in my feet. He also said discograms and upright MRI's (which is what I had) are bogus tests. Let me just say that there is nothing worse than being in excruciating pain and having someone tell you that there is nothing wrong with you. I asked him how I could get better then and he said to go to a pain management clinic. Then he literally shuffled me out after spending less than 10 minutes with me. He even asked me to stand up, handed me my test results, and put his hand on my back to get me out of the office. This is after I spent $50 to see him.
Why would he say these things? Why would he not see anything wrong with me? All of my scans show problems, and they were all done by different people and ordered by different doctors. I have grade 1 spondy of L5 on S1, DDD with annular tear and bulge in L4, and herniated disc with loss of disc height at L5. He saw my fracture but blew that off and said it had been there since I was born. I am in severe pain and the orthopedic I have been working with is scheduling a 2 level fusion at our next appointment. Has anyone else had a similar experience? I am so confused and I have no idea how to handle this.
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Pure Adrenaline (11-29-2012)
Thank you daisy. I don't want to go to a pain management doctor because to me that means I will have to find a way to live with the pain. I have already tried 2 injections and they didn't work. I just don't understand why this neuro surgeon didn't see any problems. I can even see them when I look at my films (I have done a lot of research to know what to look for, plus the slippage is obvious). Everyone else who has looked at my films sees it too: The orthopedic Dr., the orthopedic surgeon who I am now working with, the 3 different radiologists who have reviewed my x-ray, MRI, and CT scan, the chiropractor, the two different Dr's who have done my injections.... I just don't get it!!!!! It is true though that none of my tests show any nerve impingement. That is a mystery to me also because I have awful sciatic pain. Does anyone have any ideas about that one?
No ideas, sorry, but I would definitely go to another doctor for a third opinion. What a horrid doctor! If he really sees nothing, well, fine, but it sounds like he was absolutely rude to you! And if so many others have seen the problem and he didn't, I wouldn't want him treating me anyway!
I too had trouble getting a surgeon to help me in 2002. I went 10 months gradually getting worse until I literally could not walk. If I tried to take a step, the pain threw me in the floor screaming. I had started to think of suicide, just cried all day and night with the pain. My tests all looked normal and was even told I was crazy by one doctor. Went to a neurosurgeon finally that could see I was in awful pain and he said he would do surgery, he said something was causing it. I had a synovial cyst that was hidden by inflamation. I was left with some permanent nerve damage from it going so long but I got back to almost normal after about a year. Thank god for that doctor, he will always be my hero. Hang in there....Sandra
I am sorry you have had to endure such insensitive treatment by this doctor. I have been dealing with back problems for a year now (2 surgeries) and have run into many such doctors unfortunately.
Since I have had 2 surgeries that didn't resolve my symptoms, I have run into 2 wonderful doctors that both said they would not have done my surgery without further testing and felt the doctor that did my surgery was overly aggressive in treatment by surgery. One of the doctors even said the doctors in the multi-doctor practice that did my surgery are known for doing every surgery they can (even if it's questionable) since they make much more money doing surgery than they do at clinicals.
As rude as this doctor was to you, consider that there may be at least some truth to what he said. Even though he's not capable of being respectful or of explaining his thought process, it's possible that he may have been trying to say that while you are in pain, you don't need surgery to fix it as there is not enough evidence of nerve compression in the spine.
I have recently seen an osteopath doctor (D.O., not M.D.) who is a physical medicine and rehabilitation specialist (a physiatrist) and this doctor has put me on a path for improvement through exercise, injections and deep-tissue massage. It is too early to know if I will get results or not, but he found some additional problems I am having such as hip bursitis, piriformis syndrome, and myofacial pain which are compounding my back problems and sciatica. None of the spine specialists I ever saw even checked for these kinds of problems. I also have terrible sciatic pain but none of my tests show any nerve impingement - he said this can happen when the sciatic nerve is constantly being irritated but not pinched, often at the sciatic notch (where the sciatic nerve exits the pelvis into the leg). He spent 2 hours with me at my initial appointment and is wonderful at explaining things! He said that many medical systems now routinely send all potential back surgery patients to a physiatrist to screen out those people who need surgery from those who don't. He is one of the best doctors I have ever worked with.
I know you are at your wit's end, but I would strongly suggest that you consider seeing a physiatrist to at least get their opinion - they typically work in a physical medicine and rehabilitation department. I would hate to see you go through an unnecessary surgery at a surgery factory like happened to me.
Megss, we care about you and want to make sure you get the best medical treatment possible!
Another thought - have you had a myelogram? I have been told by a doctor that it is the gold standard test to determine whether or not there really is nerve impingement anywhere in the spine. If whether you need surgery or not is in question, I would suggest asking for this test to make sure. If there really is a pinched nerve in your back, this test will find it.
Despair - sound familiar, been there. I am so sorry that this doctor didn't treat you better and sit you down and explain himself and your condition.
I have never had a lumbar surgery - only multiple cervical. I have lumbar issues at L4 through S1 issues so I understand your pain.
There are two ways to look at this. One is this surgeon has a standard of damage that he expects before he will operate. He could have that bar set very high or low for his practice. His practice experience could be that many of his patients don't improve after surgery so he only takes certain cases. ( i am not saying yours isn't bad, but maybe it doesn't fit his "standard" whatever that it). Maybe he doesn't like your insurance, or wants to go on vacation, or it's his enemy that was your first consult.
The other way to view this is that he is really good and doesn't feel surgery will really help you be pain free as you are looking for and didn't take the time to discuss this properly and just used the "it's not bad enough" discussion.
So when there are such conflicting opinions I would recommend you do find a third surgical opinion. I like the opposite rule so if you first consult is an ortho then my choice for a 2nd opinion would be a neuro.
This doc could have done you a favor causing you to rethink, take time and get another opinion. brendaks1 had some good advice, surgery is not always the answer and doesn't guarantee that you will be pain free - even with the best of surgeons (speaking from personal experience).
Thank you so much for your responses. I have not had a myelogram, but I am going to ask for one. Do you think it might also be helpful to have another MRI? My MRI was done 4 months ago, and everything has gotten so much worse since then.
The orthopedic surgeon that I have been seeing, and who told me that he is scheduling a 2 level fusion at our next appointment, was recommended to me by so many people, including my regular doctor. The guy I saw today I found myself, no one recommended him. Maybe he does have a certain standard of severeness before he will take anyone seriously, but to me, my case is severe. My x-ray, MRI, and CT reports all say I have spondy. Both the MRI and the CT reports say I have 2 bad discs (CT says both are herniated, MRI says one is herniated and the other has a tear, bulge, and DDD). My discogram said that my 2 bad discs are causing pain. I just don't understand why this surgeon said I looked normal. I just want my life back. I have tried injections twice and neither one did anything for me. I just cannot bear the thought of remaining on pain meds for the rest of my life. spring is coming fairly soon and I realized the other day that I will not be able to work in my gardens.
Hobble- my MRI report mentions a cyst, but I don't know what that is. I made another thread about it. No one has ever mentioned it to me beofre so I am not sure if it is serious.
If anyone else has any insight I would appreciate it!
I am so sorry you had that awful experience. I, like others who posted, think there could have been a lot going on that had nothing to do with your personal experience of pain. I have worked in healthcare and neurosurgeons are not known for their bedside manner! Even my neurosurgeon, who I went to because he has an excellent reputation, said some things that made me feel weird. But his reputation for technical expertise allowed me to let his statements kind of slide. However, the guy you saw sounded like a jerk! Maybe this particular surgeon doesn't do that much surgery on the lumbar spine (or has had some bad experiences with it) and is more geared to cervical or cranial surgeries. That's no excuse for making YOU feel that bad though!!
I would suggest that you get another opinion from another neurosurgeon. Maybe check with your friends that recommended the ortho guy and see if they went to see any neurosurgeons or someone who could recommend someone. If your symptoms have intensified, I would think another MRI might be an acceptable course of action. I got a second MRI when my symptoms changed from pain to numbness in both legs and inability to walk for more than five minutes at a time. I had the groin pain like you are having currently too prior to the numbness. I think you owe it to yourself to pursue it in this manner before considering scheduling the two level fusion recommended. It might cost you another $50 but if it makes you sure about your course of action, then it's a small price to pay. Indecision about what to do can add to your angst and make an already painful situation more so. Best wishes, Jan
The worst thing anyone could do is to rush into a back fusion surgery. I agree with the posters saying get a 3rd opinion. You are very young. While it can alleviate some pain, there is no guarantee that all pain will be gone. That doctors bedside manner sounds horrible. He should have told you WHY he feels that way. His reasons may be good. But, he didnt explain WHY. I for sure didnot RUSH. I was in pain as you are. I didnot even want a fusion. It sounds as if your pain is disc related so the spondy issue isnt a big deal as of now. My surgeon is a neurosurgeon and i trusted him with my life. I felt very confident in him. He didNOT rush me into surgery. Actually Meggs....you have only had 2 epidurals and not many PT therpy's. That is not as much as many many people try...... Trust me.....you donot want a doc rushing a surgery such as this. Its been a 7--8 weeks since my fusion and trust me....I am still NOT healed. I have a long ways still. I still have bad days and need pain meds. I know you must be in pain...and there is not a thing with going to pain management. I did....and my pain doc is excellent. He didnot push pills down my throat and that is the 1 thing I for sure didnt want. But he didnt allow me to suffer. Maybe you need different pain meds to help you deal with your pain....and then keep trying all these other things. They can help. I have had back probs for a long long time. I am 47 and wouldve waited if I could have. Good luck to you ......
I understand exactly what you are going through as I have posted threads similar to this due to seeing so many doctors and spinal surgeons that have also said there is nothing wrong with my spine even though I have had multiple imagings (MRIs and x-rays) that show there is actually problems - I have degeneration of my discs with a Schmorls node and annular bulging all at grade 3. I too have had doctors and consultants pass me off as imagening the pain like I am making it up which truly I do not believe one bit. If any doctor or consultant says that, be sure to get another opinion straight away. You are NOT imagening things at all. The pain IS real. I have also had various experience of being told to go away and live with it as they thought I just wanted them to write out sick note! I truly did not want a sick note, I just wanted some sort of a sensible answer to my problem which I have still not got after 3 and a half years of pain. I would trade my pain to them anyday as maybe then will they actually understand what it is like to be on the other side and be told to live with it.
I agree with all of the people who have posted. Certainly get another opinion as I too think that Neurosurgeon treated you badly and you don't deserve it at all. No one deserves this kind of treatment from so-called professionals.
Also, I agree with JanKR - I would get another fresh MRI if you feel the pain and symptoms have gotten worse and also the myelogram, as recommended by brendaks1.
I agree with everyones posts on here and have found each one very interesting and informative.
I am going to have to beg this new orthopaedic spine surgeon who I have been unknowingly referred onto, as my other neurosurgeon has left, to order a fresh MRI of my lumbar and pelvic region as I too feel like things have changed. My last MRI was taken before I had this bladder problem which I have a bad feeling is related to my spine problem unfortunately. I also think my surgeon should have ordered a discogram and myelogram too but they never mentioned it and only did MRIs and x-rays which are not truly accurate. Ideally you should have every test available and your surgeon should talk to you about the full availability of tests to help either diagnose or rule out what it could or could not be.
I, like you, have been told by the doctors and consultants that there is no nerve impingment according to the MRIs and I also have horrible sciatica and leg sensations down both legs. I too have no answer as to why I have this sciatica as I've only been told "I don't know why you are having the pain that you are having" or "it may be in your head" which are not very sensible or constructive answers at all really.
Maybe an MRI scan with contrast would be a good idea as well? A person on these boards told me that that is a useful test to have as it shows things up that a plain MRI doesn't.
Discograms are actually a very good tool for finding out if the pain you are having is discogenic or coming from somewhere else so it is, from what I've heard, not a 'bogus' test but I could be wrong, I'm not sure. It has been said from reading on the internet the gold standard test before considering surgery to fuse the spine as it gives the surgeon an idea of where the pain is coming from so they fuse the spine in the correct place for optimum results.
I am not sure on the upright MRIs - I've never even had that mentioned to me - I've only had the bed MRIs where you lie down and go into a cylinder.
Sorry for my long post. I just wanted to share the ideas that I had and try to give some advice that may be of use.
I really hope you find an answer and manage to find the right doctor and good luck. You are in good hands on this board as there are some great people on here.