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Should I get a second opinion?
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Should I get a second opinion?

I am a 57 year old male. 12 years ago I started having pain in my right foot that felt like a rock in my shoe. I went to a podiatrist thinking it was my foot. I wore a boot for several weeks and had shots between toes and wore those special made insoles in my shoes. It didn't stop and then my back began to hurt. My PCP decided to send me to a Neurologist who sent me to have a Lumbar MRI. This was on 10/03/97 with following conclusions:
1. Transitional- L5 segmenl left pseudoarthrosis which exhibits
degeneratiwe arthritis. There is degenerative facet arthritis
bilaterally of the L5-S1 facets.
2. At L4-5, there is moderate facet degenerative arthritis bilaterally
with mild acquired central canal stenosis. There is minimal annular
bulge. There is moderate right lateral canal (foraminal) stenosis
secondary to disc bulge and marginal spondylosis and facet hypertrophy
with a mild impingement of pre-ganglionic right L4 root in the medial aspect.
of the right L4-5 foramen.
3. At L3-4, there is disc desiccation and a mild annular bulge.
4. At LI-2, there is anterior annular thickening and bulging and
mild anterior marqinal spur.
5. At TI2-LI, there is internal derangement of the disc with mild
vertical degeneration and diffuse annular disruption and bulging with a
2-2.5 mm degenerative retrolisthesis.

The neurosurgeon I took this to decided I was too young for surgery and in spite of my discomfort and pain told me as long as I could function reasonably well he didn't recommend surgery because it was only a 50/50 chance it would help. Over the past 10 years I have had various stages of pain and have had several corticosteroid injections which partially helped and at best relieved my pain for a couple of weeks to a month.

About 5 years ago I developed pain in my neck and had a cervical MRI folllowed by an injection I assume was corticosteroid. A little over 2 years ago my foot pain came back, although not as bad as before and my back began to get worse so on 3/8/07 I had another Lumbar MRI. The final impression was: Lumbar spondylosis with multilevel degenerative disc and facet disease. T12-L1: Bilateral degenerative facet changes are noted. A mild diffuse disc bulge is present. L1-L2: Bilateral degenerative facet disease with ligamentum hypertrophy is present. There is a mild disc bulge present. L2-L3: bilateral degenerative facet changes with ligamentum hypertrophy is present. Spinal canal and neural foramina are patent, however. L4-L5: bilateral degenerative facet disease with ligamentum flavum hypertrophy is present. There is a diffuse disc bulge present with slight flattening of the ventral aspect of the thecal sac. L5-S1: Spinal canal and neural foramina are patent. Bilateral degenerative facet disease is present.

Then over a year ago I began having numbness in both left and right hands being more severe in the left hand. I went to a local hand clinic and was given splints to wear on my hand and wrist while sleeping. Over the next year the numbness got worse in my left arm, wrist, back of hand, palm, thumb and all fingers. This past July I went back to the hand clinic and was given an EMG (I think that's it) which did not find any carpal tunnel but did find significant nerve compression in my neck. I was then referred to the pain management doctor who had given me the shot in my neck 5 years ago. I had a cervical MRI with the following conclusion: Significant central canal stenosis at C3-4, 4-5, and 5-6 due to a combination of soft disc bulge and disc osteophyte complex. There is complete effacement of the ventral CSF with deformity of the cord consistent with moderate central canal stenosis at each of these levels. No cord signal abnormality is clearly identified. Foraminal stenosis and exiting impingement is present at each of these levels to varying degrees.

When I took this MRI to the pain management doctor he refused to give me the shot stating that based on the MRI there wasn't enough room for him to attempt and that if he did try I wouldn't like it. He told not to lift anything heavy, or wrestle with my grandchildren, 9, 6, and 4 year old boys. They're not not going to understand why grandpa can't get on the floor and do karate and wrestle anymore. I asked him if he was serious and he said he was. He then referred me to a neurosurgeon in his office. The surgeon looked at the MRI and told my wife and I that if I didn't have surgery it would probably get worse and I stood the chance of losing the use of my arm and my hand. He then sent me to have a Cervical Myelogram and CT Scan. The results of which are: There is stenosis at C5-C6 with bilateral C6 nerve root impingement and widening of the cord. Only minimal contrast opacification is present more cephalad. There is partial opacification of the left lateral subarachnoid space at C3-C4. Almost no opacification is present in the right lateral subarachnoid space at these levels. Impression: Spondylosis and stenosis C5-C6 wth bilateral C6 nerve root compression. Poor further cephalad contrast opacification.

Instead of operating right away the surgeon decided to send me to physical therapy for 4 weeks for traction. He ask me which was worse, the pain or the numbness. I said the numbness and the pain is intermittent. I don't agree with the decision to send me to therapy before opting for surgery. I don't want surgery but I also don't want to waste money on treatment that will at the most be temporary if it works and that will probably fail altogether while my numbness gets worse and spreads. Mean while I am having more and more issues with my lower back and the pain in my right foot is coming and going although not as bad as 11 years ago. I can no longer cut my grass (walking mower self-propelled) because it takes me forever due to my having to stop and rest every 10 to 15 minutes. Using my trimmer causes the pain in my arm and hand to get worse with the pain and stiffness now in my left upper arm and shoulder and my neck.
Related Discussions
As long as you have been in pain, yes a 2nd and a 3rd opinion are well deserved.
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