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croppingmom

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I have been on and off this board for awhile with lower back questions. I have finally decided to go see a specialist for my lower back pain. The pain is now radiating into my left butt cheek and down my leg into my knee. If I sleep on my back to long my leg will go nurab or get a hot sensation to it. I want to ask should I see an orthopedist or a pain management doctor. I have never had an mri or ct just xray and the dr or chiro always says pinched nerve. I have done pt several times. I have lost all of my extra weight and workout about 1 hour a day. It depenRAB on the pain level I am at for how intense the work out is. I can actually feel and see my abs now. They are not even close to a six pack. I hurt even just sitting typing this. I have not found one position were I am at complete relief from pain. I have been taking pain killers and muscle relaxers but they don't seem to be doing the trick. This rx is from last time I hurt my back in deceraber.
 
Let me tell you the steps I had to go through for the same thing which more than likely is due to your L5 and or S1. I saw my primary doctor who couldn't help so he sent me to PT which didn't help so back to the primary I went. From there he sent me to a pain specialist and I did that for a year but the pain got worse and then I had it in both legs and after so long the PS will release you back to your Primary where upon you can ask for a referral to an Orthopedist who will evaluate you. Make sure he does more than just take x-rays because those don't show as much as an MRI! Make sure you keep a log of your pain level and when you have it, when it gets worse, where it starts and stops and whether or not you get more symptoms and rate you pain from 1-10 because this is what he'll ask. I hope I've helped you some. Please keep us posted. I know its no fun but you can try lying on your side with a pillow between your legs or if you lie on your back put the pillow under the leg but as far down as the thigh. You can also find out about the tins unit which gave me relief. Just don't give up and don't let their attitudes daunt you bug them if you have to about how you feel or see another doctor. I'll be looking out for you. Feel better and God Bless
 
I agree with the others. In addition, depending on what the first specialist tells you, you will want to get a second opinion. And if surgery is recommended, you may even want to get a third opinion. Often there will be a difference in opinion between neurosurgeons and orthopedic spinal surgeons. Usually the diagnosis will be the same/similar, but often, there will be a difference in the "amount" of surgery each will recommend.
 
I saw an orthopedist yesterday. He did x-rays that showed narrowing between l4 and l5 and said something about my response on my left leg when he was pushing,pulling and poking it. I now am scheduled to have an MRI tomorrow. On the paper I take to the MRI place under Diagnosis/Clinical history he wrote Radiculopathy and Facet Arthropathy and l4 degenerative. He said I have no muscle spasms at this time, which would explain why the muscle relaxers aren't doing anything. I was told to take 2 aleve in the morning and at night. I follow up with the ortho on June 3, will keep you posted.
 
I'm glad you've been able to get the ball rolling. These back issues do take time, but at least things are moving.

Take care,
Emily
 
If you haven't seen a specialist yet, I would do that next. You need that MRI and maybe a CT scan so you can get a real diagnosis, not just a best guess. The pain management doctor can always come in later. But without a proper diagnosis, you really don't know what the best direction is for you.

You can see either an orthopedic spine specialist or a neurologist who specializes in spines. Make sure whoever you see has done a fellowship, as they have more extensive training and experience.

Let us know how it goes. I wish you the best!

Emily
 
I just started crying when I left the orthopedist today. I don't really know to much more than the first appointment. I guess the good news is I don't have any bulging or herniated disc. I do have ddd at L3 and L4. He still did not answer my question of why my left butt cheek hurts all the way to my knee and then my leg will go nurab/heavy feeling. He gave me a rx for a pain killer and sent me onto PT to get my core stronger. I want to know what is causing the pain and how to fix it or make it not happen anymore. I think I would like to see another doctor but from asking around he is the best spine ortho in our area. Should I see a neurosurgeon now. I am confused. I was worked in at the physical therapy office for today. He gave me different exercises to do than the last one. I feel like a wimp for hurting this bad and nothing showing on the mri that is wrong with me. I am tired of hurting. Thanks for listening.
 
Please research these subjects... They should help understand your back pain. If you feel you can be helped by chiropractic and physical therapy you could that a try. From what i read around the web... injections can and cannot work....

right now my treatment is going to be Fluoroscopic guided injection than maybe or Spinal decompression, with physical therapy and back stregnthening and the last thing i will try is Arthroscopic Microdiscectomy

1 Intradiscal Electrothermoplasty (IDET)

2 Radiofrequency Discal Nucleoplasty, (Coblation Nucleoplasty), DISC
Nucleoplasty Percutaneous Discectomy

3 prolotherapy

4 Spinal decompression, with physical therapy

5 Epidural Injections

* caudal block
* translurabar
* transforaminal

6 Facet Injections

7 Selective Nerve Root Blocks

8 Sympathetic Blocks

9 Intrathecal Pain Pump (Morphine Pump)

10 Radiculopathy

11 Fluoroscopic guided injections

12 Arthroscopic discectomy

13 Arthroscopic Microdiscectomy

14 endoscopic discectomy

15 Percutaneous endoscopic interlaminar discectomy

16 Percutaneous Laser Disc Decompression was pioneered by Dr. Peter Ascher and Daniel S.J. CHOY

17 Trigger Point Injections

18 Modalities
 
Start with a specialist (orthopedic spine surgeon or neurosurgeon who works on low backs). Most likley they'll need to get imaging (xrays, CT, MRI, etc) and then determine what is going on. A Pain Management physician can only help once you know what the real problem is (diagnosis) which can only really be known by imaging results.
 
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