I'm curious about what an Orthopedic doctor does vs a Nerosurgeon in regards to spinal disorders. I have cervical Disc Degeneration Disease involving C4-C7 with severe nerve damage. I've been to two Neurosurgeons for evaluations, one who was too anxious or surgery (which I declined) and one who said surgery isn't my best option and referred me to Pain Management doctors, whom I've been seeing for two years. My problem is the PM doctors want my GP to prescribe any pain medications. My GP is very cautious with them and is giving me a hard time when I ask for refills of my hydrocodone 5/500. She said if I keep asking or them she'll make me go to an orthopedic surgeon. I do not want surgery since it seems so many folks that have it for my type of condition have little success. I'd like to know what different experiences people have had with the two different types of doctors.
An orthopedic surgeon is trained to deal primarily with the bones and joints - the residency training period after internship is 3 or 4 years - then a fellowship in spine may be an additional year.
A neurosurgeon is trained to deal primarily with the nervous system (brain, spinal cord, nerve roots and nerves) these are delicate tissues and neurosurgeons are known for delicate work and specifically for protecting the nervous system and avoiding injury to these critical structures. - the residency training period is a minimum of 5 years - some programs are 6 to 8 years long. - there are only about 3500 board certified neurosurgeons world-wide.
Typically, if an orthopedic surgeon is doing a substantial spine operation, a neurosurgeon will be there as well. If a neurosurgeon is doing an operation that extensively involves bone, joint or the possibility of fusion, then an orthopedist may be involved as well.
Orthopedic surgeons residency training period is a minimum of 4 years.
I want to add that I think surgery would benefit you. I also suffer with a Degenerative back and I have had 2 fusions which have helped me a great deal. For a while , I was at a place where I did not have to take pain meds. I would really reconsider. Neurosurgeons really know their business.
It is a shame that your PCP is so reluctant to prescribe pain medications for you. I would consult with the PMP and discuss this with him/her. In my state, Wisconsin, PMP do not prescribe pain medications on an on-going bases either.
If my PCP did not prescribe me pain medications I can assure you I would be searching for a new PCP. If you are not comfortable undergoing such an evasive surgery you should not be forced into one by your PCP. Our PCP should be our advocates and respect and honor our wishes, as long as our wishes are not medically harmful or contraindicated.
Molly has explained the difference between the Neuro and Ortho physicians. My mother also has DDD and developed Spinal Stenosis. It was an excellent Neurosurgeon that performed her surgery to relive the stenosis. There was never an Ortho involved. If your nerves are involved you should be evaluated and treated by a Neuro in my opinion. They have specific training and experience to deal with nerve involvement. Ortho's are good for a hip, knee replacements or diseases or conditions of that nature. When it comes to spinal issues where the barrage of bundled nerves are located I would feel much more confident with a Neuro. You may want to seek a third opinion, but be sure he/she is not connected with either of the two you have seen previously. My mother's surgery was a success and her pain has lessened but she is not pain free. Often after back surgery we are not pain free and you may require opiates for some time. That is another reason to see a PCP that is comfortable in prescribing the pain medications that you require. I know it is a hassle to locate another physician but if she is not doing the job that you have hired her to do why would you continue to maintain her employment?? And please remember our physicians work for us, they are not Gods.
I wish you the very best. Please keep in touch and let us know how you are doing. I will look forward to your next update. We are here almost 24/7. Peace, Tuck
Thank you both for you responses! To me surgery is a last resort. I've read too many postings and spoken to to many people who were not successfully relieved of pain with multi-level disc surgery. For now, the pain management treatments work pretty well, but the wait to get the treatments is gettng longer with appointments harder to get. It's the waiting time once the pain returns until I get the treatment that is when I need the pain medication. I'll talk to my PM doctors and see if they can suggest something or at least give my PCP a call. She's a good doctor otherwise and generally does listen to me, but I think all docs are under pressure to watch the pain meds.
I agree with you. Surgery would be my very last option also. Some ppl do not have a choice if they have spinal stenosis but if there are choices mine would be not to have surgery.
I am glad you are pleased with your PCP. That is important. Maybe a call from your PMP will ease her concerns. Every state is different and though in WI they do not hand out narcotics like M&M's most PCP usually will prescribe medications to make their CP sufferers comfortable.
Good luck to you. I hope you are successful in working something out with your physician. Take care, Tuck
I also think that Surgery is a last resort but you seem to be hurting to the point where maybe it isn't such a bad idea. It would at the least take the pressure off the area.
I really hope your PCP will shape up and make you more comfortable. If he doesn't then maybe it's time to move on to another Doc. I know it;s easier said than done but maybe it's worth the while to find not only a pain Management Dr. but a new PCP as well.
I just hate to see others not get the relief they need. I wish some of those Docs could live in our shoes for one day !!! They would in turn give you the meds you need to be comfortable. I certianly hope you find some good care in the future,
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