I have a good size herniated disc. I am puzzled. 2 spine doctors are saying I need spine surgery and one is saying no. What should I do?
My disc that has herniated is around 10 mm. I am totally confused. Please help.
I would say that if 2 spine specialists say you need surgery , then you probably do. How long have you been living with this? Most people decide to have surgery when they are not able to go about their regular daily living activites, or if the pain is not manageable.
What does the 3rd doctor suggest if not surgery?
Stick around, the people here are great! If you do decide to have surgery, there is tons of info on this site about how to prepare and the people here are very supportive either way!
Two surgeons are saying I need surgery. They think I have pain running down the lower extremities. The other is answering in the negative. The last one says I don't need surgery due to the fact that I have low back pain only and no leg pain. He is
also saying that he had done surgery on a patient with low back pain and after surgery he still had low back pain. I am perplexed. I have one level only which is l5 to s1. It is a large disc herniation. It is 10 millimeters. Isn't that a very big disc herniation? What could be the reasons that I need surgery.
Last edited by sweetgirl9860; 10-29-2007 at 08:54 AM.
I am confused when you say they think you have leg pain, do you have leg pain? It should be up to you whether you have pain in the extremities, not the doctor.
In my opinion leg pain should not factor into whether you have surgery or not. What does matter is the amount of pain you are in. Is it affecting your daily life? How long have you had this pain?
Surgery is a last resort treatment when it comes to backs. Make sure you have tried all other treatments such as taking anti inflammatory meds, physical therapy, maybe some cortisone shots, etc. The reason it is a last resort is because surgery is very painful in itself, and can take many months to recover, even up to a year. You will likely wear a brace for 6 months with no lifting, bending or twisting.
I hope I have helped some, if you have more questions, ask away!
Last edited by HBMod07; 10-29-2007 at 06:21 PM.
Reason: Please do not direct users to search outside the boards. Thank you
I told this 2 surgeons that I do not have leg pain. My pain only touches my left buttock. But after examining me one spine surgeon said I do have lower extermity pain. He is writing this in his medical notes!! I am saying NO and he is writing in his note saying YES!
My pain also has changed since I saw the 2 spine surgeons. After that I saw the neurosurgeon who is a spine surgeon who told me that he recommends conservative treatment. My pain is centered around and on my lower(lumbar) spine. That is I mean it is only on my lower back.
I only get buttock pain now when I am sitting on a chair. But when I saw the 2 spine surgeons I told them I had buttock pain.
But I have realized now after in tune with my body that:
My pain in around and right on the lumbar spine area.
But it is bothering me very much. It is around 7-8 on a pain scale of 10.
It is constant but shifts or decreases when I change positions. But only for a moment.
It increases when I am sitting on a chair, coughing, bending forwards. But it is always there.
The one spine surgeon who said that he didn't recommend surgery said that due to the fact that I told him I only have pain around and in my lumbar spine. That there was no leg pain. He says he thinks it is coming from my large disc herniation. He said he thinks pain is radiating from my l5-s1 lumbar disc and that it is mechanical pain.
I can feel it now increasing as I am sitting on a chair typing this.
I am very desperate as I don't know what I will do.
Last edited by HBMod07; 10-29-2007 at 06:22 PM.
Reason: Please do not direct users as a Moderator
Sweetgirl - 10 mm seems big (but I'm not a dr.) and forgive me if you've given this info prior - have you tried corisone oral or injections? It seems great that you don't have the radiating pain. I'd probably be of your like mind. I wonder if you could shrink that disk some if you wouldn't need surgery. Is PT (land or water) a possibility? My husband had bulges in lumbar - I'm sure not that big, but he was in some major, sharp pain and pilates-based PT and a round of oral steroids really helped him. He continues doing the exercises and he's done OK. We know he'll always have to be careful and such, but hopefully he can avoid that invasive and no-guarantees surgery.
Anyway, I hope you can find something that works for you. I agree you should exhaust everthing you can think of before trying surgery, without being careless to your safety. Is that why the surgeons are urging you? Are you at risk of something bad happening? <wince>
Thanks for replying. I have gotten 2 cortisteroid injections. I am going to a back specialist who is not a spine surgeon. I am getting PT in his office. The Pt has done is tens machine, ultrasound, and one exercise in which I am lifting some weights on with my chest, back and shoulders. It is not free weights but is done on a machine. My PT looks depressed. his heart is not in his job. He says since I have a 10 millimeters herniation he is not so sure he can help me.
When I told this to the doctor he did not believe me. In afterthought I am opining that he does not care what treatment I am getting through his PT.
My doctor is also confusing me. One time he said that I need surgery. He mentioned that I had a 10 millimeters disc herniation so I need surgery. After I went to first spine surgeon who said he recommends surgery. I came back to my doctor and he said since I have only low back pain I need chronic care therapy. He is totally confusing me. His partner says I need surgery and he says I don't.
Do I need to change doctors?
Maybe change doctors, definitely change PT's. Your PT sounds way too conventional and uninspired. You need someone who is committed to your case. There's a heck of a lot more you can do besides what you mentioned. With a frank herniation, some PT's will actually try to put it back in by positioning you. My husband had good results with that. Then you do exercises to stabilize your spine to keep it there.
I'd speak frankly with both your PT and dr. that you're committed to trying all modalities before surgery, such as (I'm filling in here...) water PT, pilates, oral steroids, etc. Can they both be supportive and timely in this attempt or would you be better off going somewhere else set up for that type of approach?
So, no need to insult them. Maybe they're not a match for you. Just, take care of you and what feels right for you. We're here for you. Be strong, and polite.
My doctor came up and asked me to choose between surgery and chronic care. I told him that the pt was not doing any exercises and he did not want to believe. I had 7 physical therapies with only tens machine care, ultrasound, icepack and 1 lifting exercise. The Physical therapist is the head of the overall physical therapists. I am wondering if this is what is called a physical therapy. Shouldn't I be doing more exercises?
This doctor has become verbally abusive and threatend to go out the door if I didn't choose surgery or chronic care right there and then. He put pressure on me to choose between the 2. I couldn't think at the moment as I was speechless and my mind became numb. He was acting very bossy and so I said chronic care!
After chronic care he will 100% cut off my treatment. Whether it helped me or not. That is definite as I have talked to some people who had chronic care for their low back and they told me it did help some but not much. I am at a loss.
Whereas all he has done is to confuse me by sometimes saying I need surgery and sometimes saying I don't because all I have is low back pain. I think he is covering himself and also that he is incompetent. Only things he has done is 2 cortisteroid injections and 7 bogus physical therapies. He has become really verbally abusive.
I am so sorry but I didn't tell you I am getting treatment on worker compensation injury. I have very few choices left.
I am being told by the doctor that I cannot use my health insurance to seek treatment. But I am not getting competent treatment either.
Last edited by sweetgirl9860; 10-30-2007 at 03:57 PM.
I'm confused about what kind of doctor you are seeing. The only two types you should be considering are a Neurosurgeon or an Orthopedic Spine Surgeon. In addition, do you have a copy of the MRI and the MRI findings?
If I were you I would insist on referral to another doctor. If you have no luck perhaps you can contact the TX department of WC.
First of all the size of a herniation really is not an indication for the need of surgery. Larger herniations tend to shrink at a higher rate than small ones. You can have a very large herniation with no symptoms or a small herniation with severe symptoms.
The important thing is that there is no progressive nerve compression which is not improving. Mechanical back pain is not relieved by surgery that is why the doctor is not recommending surgery. Leg pain which is not improving and in fact is getting worse is a consideration for surgery. You have stated that this is not the case.
Sounds like a couple of these guys are a little to hasty with the knife. Honestly I can't believe they even recommend surgery with what you have told us your symptoms are.
Oh, boy. I am so sorry you're going through this! I know there are other folks dealing with WC. I am not at all familiar with it so I will not speak to it. But, I would encourage you to continue advocating for your needs. And feeling pressured by this doc and PT is not a good sign. Stay strong!
The doctor I am seeing is a doctor of osteopathy. He says he is physical medicine and rehab doctor and one day I saw the tag ID on his shirt and it said physiatrist. I don't know what that means.
There is another doctor in his office that he send me to. He is an orthopedist spine surgeon. I told him that I have only low back pain and left buttock pain.
He examined me and said I also have lower extremity pain. So he recommended surgery. I read his report and he said although most of my pain is midline lower back pain, I also have lower extremity pain!
He then said surgery will also help with my lower back pain!
Then I went to another spine doctor. He was a neurosurgeon spine specialist. He examined me and I also told him that I have only lower back pain and left buttock pain.
Then he said he does not recommend suregry due to the fact that in his opinion it will not help with my lower back pain!
One doctor said yes it will help with midline lower back pain and another said no it will not help with lower back pain!
I am sorry but I just read my MRI report and it says that my l5-s1 disc on lumbar spine has extruded at a level of 10 millimeters. I don't know what extrusion means. Does it mean hernaition?
I must also add that my MRI is almost 11 months old.
I should also tell that my treating doctor - the physiatrist=physical medicine and rehab doctor has told me on my face that workers compensation insurance will not pay for a new MRI. I am suspicious of his intentions.
I am saying this due to the fact that when I went to the neurosurgeon he told me that since my MRI is 11 months old I would need a new MRI done. And he also said that workers compensation insurance will approve and pay for it!
This has taken away my peace of mind not that there was any since I injured my low back. I keep getting up at night and I keep getting dreams or one can say nightmares.
I also am stressed by the verbal abuse and pressure put by this doctor of osteopathy =physiatrist=physical medicine and rehab who pressured me to choose between surgery or chronic care right on the spot, right there and then in one moment.
What kind of person would do that?
Last edited by sweetgirl9860; 10-30-2007 at 11:34 PM.