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Severe pain, how do I get the doctors to listen?
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Severe pain, how do I get the doctors to listen?

I have pain on a daily basis from the many things wrong with me. My lower back pain recently got much worse after pushing myself a bit to far while sweeping. I am 5ft 10in so I do a lot of bending and I bent to far and something popped and brought on a new sharp pain that wrapped around my right hip when I bend at all or carry any extra weight in the front.
I went to my pcp last week, told her whats going on. She told me dont do anything that hurts. Gave me a back brace and mobic and sent me on my way..I was hoping for them to maybe do some radiology to make sure there wasn't any new damage in my spine.

I was avoiding doing anything to hurt my back, but I didnt want to sit around doing nothing. So Friday, I was sitting on my back pouch working on a project that involved only sitting, no bending or reaching,  I even made sure to get up and walk around to be sure I wasnt in one spot too long.    But apparently that was not enough and I did too much, I quit what I was doing when I started to get pain, but it just got worse and worse.

That night I woke up crying form the pain just laying in any way was excruciation. I had to take my Robaxin and tylenol just to get the pain down enough to sleep. I woke up 4 hours later when it wore off and couldnt get comfortable no matter the position. The pain was going through my back and right hip and down my right leg. My pain increases when I bend, cough, laugh, breath deep. It is one if the worst pains I think I have even experienced and I am even getting it if I just move my head wrong or looking down.  I seriously think I herniated a disk  from how bad I hurt.

I went to the urgent care saturday after being advised to by a advice nurse through my health insurance provider. They treated me poorly and just told me to go see me pcp next week.  I was hpoing they could have ordered a x-ray or something to make sure I didnt have a severe misalignment, but the doctor said she couldnt, even though they had an x-ray machine on site. They tried to give me steroids (which I dont tolerate well) and thats all they were going to do.  I told the doctor I was not satisfied, I am unable bend over, I cant pull up my pants, I am in alot of pain. She offered me a toradol shot and I was happy her offer that, but it didnt even help. Even with a Mobic, Robaxin and a Toradol shot I was still in way too much pain and there was nothing I could do..

I went home and cycled from laying to sitting to walking, It all was painful it in one spot for long. This is how I am still having to deal over the last couple days waiting for my pcp to get back in the office. She wont be back in until tomorrow, and no one else in my doctors office seems to think that my problems are in need of attention.  I dont understand why they dont prescribe me painkillers, isnt that what they are made for? I think they look at me as a pill seeker.

So how do I get me PCP to order another MRI to compare with my last?  There are a couple things that easly could have gotten worse.  Here is my Mri findings, that the doctors say arnt bad enough to be causing my problems. I really hope there is someone that can give me some direction in dealing with these ignorant doctors.  I am starting to just give up in trying to find the link in all of these things wrong with me.  Many be I have a connective tissue disorder?

Mri report for Stacey Janurary and March 2010
This rewrite of my report includes findings from both report combined, as some findings were not reported in both Mri's due to human judgment errors:

Cervical Mri findings:
Mild reversal of the Cervical Lorsosis is noted without Spondylosinthesis  and mild kyphotic angulation in seen with the c3-4 vertabral boby. Mild scoliosis, convex to the left at C5-6.  Mild Disk diseccation at C 3-4, with minimal diseccation elsewhere in the cervical spine.     Vertabal body heights preservered without compression fracture. Marrow signal is unremarkable. High T2 signal is seen within the central cord starting at approximately  C-3 to T-1 measuring 1.5mm in diameter. Partially visualized posterior fossa unremarkable.  

C 2-3: Unremarkable

C 3-4: Mild posterior disk buldge does not indent cord or cause canal stenosis.  Foramina  are patent.
Tiny posterior circumferential disk osteophyte complex, contacting the anterior spinal cord with minimal cord deformity. Mild bilateral facet hypertrophy.

C 4-5: Minimal posterior disk buldge does not indent cord or cause canal stenosis. Foramina are patent. Tiny posterior circumferential disk osteophyte complex.

C 5-6: Unremarkable

C 6-7: Mild posterior disk buldge does not indent cord or cause canal stenosis. Foramina are patent. Tiny posterior circumferential disk osteophyte complex.

C 7-T1: Minimal posterior disk buldge and mild bilateral facet joint Arthropathy are present. Canal and foramina are patent.

Impression:

Tiny central area of intramedullary T2 hyperintensity is present from C 3-4 to C7-T1, most pronounced at the mid to lower C6 vertebral body level, measuring 1.0mm to 1.5 mm in maximal AP diameter consistant with either a prominant central canal of the spinal cord or a very tiny syrinx.       No evidance of Chairi Malformation.


1.High T2 signal is seem within the central canal at approximately C-3 to T-1 measuring up to 1.5mm in diameter consistant with a dialated central canal or a tiny syrinx.

2. Minimal/Mild disk buldges at multiple level without canal or forminal stenosis.

3. C7 -T1  Mild bilateral facet joint arthropathy.



Thoracic Spine:

Minimal scoliosis convex to the left at T8-9. Mild straightening of the thoracic kyphosis. Mild disk diseccation is present at T8-9. Thoracic cord appearence and signal appear normal.



Lumbar spine:

Mild straightening of the lumbar lordosis. Mild scoliosis, convex to the right at the thoracolumbar junction..Slight retrolisthestis at L4-5. A small Tarlov cyst is present at posterior to anterior S-2. Conus terminates at L1-2, no lower cord signal abnormalities.  Mild to moderate disk diseccation is present at L4-5 and L5-S1.

L1-4: Mild facet arthropathy is noted.

L3-4: Tiny posterior circumferential disk buldge, mildly flattening the thecal sac

L4-5: Small posterior central disk protrusion with an associated annual tear, mildly flattening the anterior thecal sac
togather with mild bilateral facet hypertrophy  with small bilateral facet joint effusions   and a tiny amount of retrothecal epidural fat, combining to cause mild spinal canal stenosis and mild bilateral recess sternosis. no neura foraminal stenosis. Appearences are stable.

L5-S1:  Tiny right paracentral posteroir disk protrusion, not contacting the thecal sac or S1 nerve roots. Minimal bilateral facet hypertrophy   no stenosis, appearences are stable.

S-2 : Small Tarlov cyst.
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Avatar_f_tn
Well, you heard a pop at the moment your lower back goofed up, and it's been hurting worse and worse ever since, despite a few mild medications given to you.  Your old MRI shows your lumbar spine isn't in particularly good shape to begin with, and I agree with you, I think one of your disc bulges or protrusions has given way, and a nerve is being pinched, causing your current pain that goes into your right hip.

Now, normally a doc will take the conservative route, good pain control (not good enough), a brace perhaps (which you got), and sometimes they'll put you in physical therapy or at least order rest (which they did).  But you still have pain.  You COULD ask them to do some sort of X-ray or scan of your lumbar spine, to see if things have indeed worsened, and/or could be your doc will simply give you stronger drugs and see if this thing eases up on its own.  

I'm sorry this has happened to you.  I have the identical pain on my left side, it comes from the middle and goes over to the top of the pelvic bone, and this is new to my already painful lumbar area, so I assume some nerve has gotten trapped or I have bone-on-bone or I have a fracture.  I'm getting an MRI in September.  I know exactly how much it hurts.  But I'm fortunate, when I first had just the lumbar pain, after whining to my docs about this for a while, one of them finally gave me Lyrica, and the pain eased up overnight.  I'm already on regular opiate type drugs, which don't touch the back pain, rather they treat some leg problems I have, so that's why I'm telling you about the medicine I use, altho stronger opiates than mine might do the trick for you, each person is different.  

I think your doc will be responsive to you this time, since this is a return visit for the same thing as before.  Feel free to cry and break down in front of your doc.  Keep us posted.
    
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Thank you so much for responding ggreg! I needed some support!    I have an app. today, hopefully my pcp will do a Mri, but I dont want to get my hopes up too much cuz I just had one.  My pain is lessened and more tolerable, some of the inflamation (inflammation) must have finally gone down. Any one position for  very long and I can feel it just as bad as ever. It is even waking me up at night still.    I will repost later and let you know how it goes.   Thank you again! Stacey
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1175033_tn?1309511759
So I saw my doctor, I dont think she understands how much pain I am in. It really is hitting me hard when I lay down. A sharp pain that is radiating into my right hip and  sometimes my left, cramping up my spine muscles and muscle spasms. Then pain dull and super achey (achy) down my leg. Also a feeling of restlessness in my legs at night now. I cant lay in one spot very long. I cant sit very long, Im so tired of standing, and I am just so tired. I woke at 4:30 last nite. Now I am waiting for medicine to kick in enough to go to sleep.
   It is so hard to tell the doctor all of your symptoms when there is such a limited period of time!
  I told her what was going on, she said something like "I would really like you to try to go back to physical therapy again".  I just used my 12 visits allowed by my insurance so that isnt an option and I dont think that would be smart until I know whats wrong.

I told her I want to see a neurologist, she said good luck finding one here in town and that the neurologists never wanted to accept their patients. She put finding my neurologist in my own hands and said If I find someone, she will make the referral. She also gave me Lidoderm patches, helps with bad spots of muscle cramping. She wouldnt order a mri, but she did get me x-ray of my thoracic spine, lumbar spine and sacrum. I am fine with that for now. My main concern is if the Retrolisthesis has gotten worse or something is badly out of alignment and those things can be seen well with x-ray.
However,If I herniated a disk, Im not sure they would even do anything about it anyway. It will get a bit better with time.  Spondylosinthesis and retrolisthesis I think, can need more prompt  medical attention if it is causing enough damage.  

Im going to bed now hopefully, so tomorrow I can call a bunch of neurologists.
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Avatar_f_tn
I hope eventually your sleep improves.  I woke up early yesterday and today because of the pain I have in my lower back and hip, just like you.  Makes things doubly hard to stand.  But I have medicines that take it away by lunchtime.  I do know something you can do on your own, and that's to tighten the tummy muscles several times during the day, those help control the forces put on the lower back.  But not situps, rather just sucking the stomach in real tight for a few minutes, over a period of weeks.  You can also do a little easy stretching in your home to stay flexible, and some SHORT easy walks around the neighborhood too, will keep your health straight and help you sleep better.
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I do flex my core muscles a lot. My PT started having me do this a couple months back, so I actually am doing decent with keeping up on that. I would do more of my PT but that is all I can do right now without causing more pain. Plus all my muscles have been pretty tense from all the pain and spasms.  I have been walking in my home, but I cant take very big steps. I keep getting  a sharp shocker when I extend my leg after a certain point. I currently am also getting intense but dull achey (achy) pain all down my right leg.  I really thought the pain would be a little better every but it is still really intense. It really worries me that it hurts when I move my neck. bending it down and toward the right just shoots through my lower back and down my leg, a very intense pain that is hard to describe. Kinda like a stretching sensation with a lot of pain.  
I did too much yesterday and that is why i am paying for it now. I had to go to an appointment to see my GI at 9:20 am. Then across town to my pcp by 12:45. I didnt drive, but sitting in the car is just as bad. Then waiting room time sitting again, and I hurt my back the first time sitting in a car too long, and most recently re injured it sitting to long. That combined with  my height are how I got this way, I have to bend over just to wash my hands and flush the toilet. Bend over to pet my cats or feed them. Needless to say, I have mastered the art of squatting to do things  if I HAVE to.  I am keeping my back as straight as I can when I sit, hurts too much to not.  Crappy way to fix my posture though!

thanks again ggreg, I needed to be reminded to flex my tummy muscles today!


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