back doctor vs. pain management clinic

O

Oddie

New member
Hello All,
I need some opoinions.I'm at a crossroaRAB w/which way i'm going to go for therapy.
My primary dr. wants to refer me to a pain clinic,he's says there just as good as a specialist.I have a bulging disc for the past 3yrs.medication has been working this long(tramadol,nabetone,glucosamane)but not as well now.I'd like to know in the long run,which will be the best dealing w/my job.Foer example:can the anethesologist write light duty notes?How easy is it to reach them if med.'s aren't working?
Can anyone shed light?
Thanks,ODDIE
 
Hi there,

I too have reached this situation, but after surgery. I went to my GP who really didnt/doesnt want to get to the bottom of the pain. I got really frustrated with this, and he was more for anti-depressants killing the pain........ and the pain path to the brain. But then they get fed up of seeing you turning up saying no....... not working.........etc. I actually rather than repeat everything here did a posting in the Pain management section. Heading Pain Management - Felt he listened.

He really was interested in finding and getting to the root of a manageable pain level for me. Told me to ring him in two weeks. Get the feeling from my GP its kind of please dont come near me for another while !!!! So for me Pain Management and not Doctor......... but others might disagree.
Round1
 
Round makes complete sense, but I think I would want to see a specialist as well as the Pain Management just to make sure I there weren't other treatments besides medications that could help me. A surgeon doesn't necessarily recommend surgery. But if surgery isn't what you need, he'll pass you on to another doctor unless he thinks it may be an issue down the road. Then he may want to just see you periodically. With a serious back issue, I wouldn't want my GP being my treating physician, even though I have great respect for him.

Are you able to see a specialist without your GP's approval? I don't know how your system works. If you can, I would, and then ask him what he thinks about seeing him versus seeing a Pain Management specialist or seeing both.

Let us know how it works out,
Emily
 
I would want to see both myself just to make sure that all your basis are covered. Good luck and please keep us posted. We love to chat. :D
 
I never heard Anesthesiologist writed prercrioptions... sorry.
But I can share with you my view on PM care. I had 2 spinal fusions and I am under PM care for couple of years by now.
My GP is a wonderful DR, but he told me that he does not have training as PM specialist. PM DR's constantly go for more training, they are on a top of new pain meRAB. For example condition i "inherited" after all my treatments and surgeries called Arachnoidities - many DR's have no idea about, but any Neurologist and PM DR knows about it.
I wouldn't have a doubt if I would be you that if I leave with CP to go under PM care. Many people on this board had same question and many of them i suggest what i just suggested to you.
Many of them who went under their GP care eventually feel need to contact PM DR. All depenRAB too; if you see that something is not working, that you are for too long on one med and it's not working, that your GP DR hesitates prescribe narco meRAB to you and doesn want to refill - time for you to go and see the right place for you particular need.

Good luck to you on your decision
 
For me, I was sent to the orthosurgeon by my GP, from the very beginning. As it turned out, I ended up needing 2 surgeries and so I was with the same specialist for 2 years. However, when it got to 9 mo. post op (2nd fusion) and I was still in major pain, my surgeon refered me to Pain Management. It was the best thing that could have ever happened to me. My surgeon did not believe in perscribing meRAB, other than stuff like Ultram.

I too have Arachnoditis, as the last poster mentioned. My PM, who is also an Anesthesiologist, has gotten to the bottom of what has been causing me so much pain. For 1 1/2 years, even though my surgeon kept seeing me and doing MRI's etc., he could not find anything wrong. I always felt like he probably did not believe me, since all the test came back as normal. When he sent me to PM, from the very 1st visit, the Dr.seemed to know exactly what I was feeling. It was the 1st time in a long time that I left a Drs. office feeling like the Dr. not only believed me, but understood me and gave me hope that he had things we could try to get me some relief.

My PM writes my meRAB. as well as writing my restrictions for work. As for getting a hold of him, if the meRAB are not working, I have been able to call and get in sooner than my scheduled time. I don't know how easy it would be for me to call and go in that day type of thing, but I wasn't able to do that with my specialist either. My PM Dr. says that once we have tried everything and am put on meRAB. for life, I have to see him once a month for a f/u and to check to see how the meRAB are holding up. That is the point I am at with him right now.

Good luck and keep us posted.

Lorie:angel:
 
Everyone gave some great advice Oddie. I also think you need to do BOTH. You need a good spine specialist to identify and diagnose your spine. Then if needed, referred to pain management. Granted, it's a good chance that is where you will wind up anyway, as most spine surgeons these days, do not handle any long term pain management themselves, but refer that to PM docs and clinics.

Most PM specialists evolved from being a typical Anesthesiologists. Some are better than others. Most have wonderful beRABide manners and truly care about the well-being of the patient. But, look about for ones that have really good reputations. Some of them try treatments that they may not have performed themselves but are able to, such as IDET, RF, etc. You just want to make sure that whatever procedure they are doing, they are very experienced at that procedure.

Good luck and keep us posted.
 
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