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pain management

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Chronic Pain
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worriedgirl
Veteran Member
Joined : Apr 2009
Posts : 1221
Posted 1/5/2018 2:08 AM (GMT -7)
ok now that I know the problem with my back now I am going from there. I have never dealt with chronic pain so I am turning here. I am stretching small amounts to help out plus coming up with a plan of action.

I have a bulging disc, my spine is curved at my hips which is pinching the spinal cord and nerves, my hips are not even my right hip is going at a downward angle which is causing nerves to be pinched in my hips and spinal cord up to my bra strap, and I have disc degeneration at the L5 and I am in the fourth stage of the 5th stages. I have started decompression treatments and I am noticing some improvements but we are starting slow and I have been told the pain will get worse before better. I am also told I will only get to about 75% better.

I called my pcp to get a muscle relaxer but he refuses to give me one and I'm not sure why. The muscle relaxer will help me sleep and my muscles relax so that I can function until I am in a spot where I can sit and move without pain so I am considering speaking to a pain specialist to help with the pain while I am in treatment or ways to manage with the pain since this may be something I live with for the rest of my life. plus I am noticing my sugars creeping up and I've worked so hard to lower them that I don't want pain to kill that.

so would a pain specialist be beneficial to me or just wait and see how the treatment plan does and deal with the pain?
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skeye
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Joined : Mar 2008
Posts : 3089
Posted 1/5/2018 4:35 AM (GMT -7)
As much as you don't want to hear this, as I and others mentioned before, a chiropractor is not a radiologist. Therefore just telling your doctor that you were diagnosed with xyz by a chiropractor and then asking for meds isn't likely to get you very far, particularly if you just call and leave a message asking for medication without actually speaking to the doctor and discussing the situation. Likewise, you will need a MD referral to get into pain management (usually regardless of whether or not specialist referral is required by your insurance, as PM's commonly prescreen records prior to accepting a new patient) and a PM doc is not likely to do anything for you (or even accept you as a patient) unless you have had documented testing and examinations performed by a physician, and typically have been in pain for at least several months, with or without already having tried and failed treatment by your PCP. And even then, many if not most PM docs will want to start with injections (if appropriate) before prescribing any medication.

I would start with your PCP -- make an appointment, discuss your symptoms, what the chiropractor said/the treatments you have been doing, your concerns, etc, and then ask the doctor his/her thoughts, and if medication might help in the mean time -- but don't necessarily expect to walk out of the office with anything, particularly until your doc confirms your claims. I have no doubt that you are in pain, and that it is of particular concern with your diabetes, but with things the way that they are today with the opioid crisis and all, doctors (PCP's and PM's alike) are becoming reluctant to treat pain and are certainly not willing to treat anything that is not well documented. And even then, pain management (regardless of who is orchestrating it) is generally a process, not a quick fix, and much of it will be trial and error, starting off with non-pharmacologic treatments and/or the lowest doses of the most benign medications.

Post Edited (skeye) : 1/5/2018 4:40:41 AM (GMT-7)

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straydog
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Joined : Feb 2003
Posts : 18323
Posted 1/5/2018 5:09 AM (GMT -7)
Skeye is exactly right. By documentation, PM drs want to see copies of medical records & testing such as MRI's Scans. Two years ago my PM dr released patients if they did not have an MRI Scans to show they had issues to back up their condition. This xray the chiro did will not get you anywhere with the drs. He had to because the DEA would have been all over him.

Access to pain medication is becoming non-existent these days.
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worriedgirl
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Joined : Apr 2009
Posts : 1221
Posted 1/5/2018 5:19 AM (GMT -7)
ok I understand that but he could at least see me. I mean the 10 mg he gave me isn't strong enough to help my kid. I have been prescribed a stronger muscle relaxer. I would gladly take my xrays in to be shown to him. I only need it for 3 weeks maybe less. I guess I'll just suffer alone. I don't want to pay for more expensive tests when I already have enough to see exactly what is wrong. I am not a dr and I can clearly see in the xray what is wrong. maybe if one of these so called doctors would have listened to me in the first place I would have been exactly where I needed to be. I went for tests because I knew something was wrong. I know my body and no one listens to me. if they would have then this could have been done and not cost me as much money as they already have.

I went to them almost a month ago and asked them for tests because I knew something was up and I was right and now I am paying the price for their lack of caring so now I have to go on their timelines. maybe I should just forget my sugars and just let them go to I mean its like it wont matter because they are going up anyways. I am not asking for opiates or anything just a stronger than 10 mg of a muscle relaxer. I am 200 pounds and that is not strong at all. It doesn't even make me tired or touch the pain.

im sorry I am in pain and im tired and I am tired of no one not caring! my chiropractor is medically trained he took more courses than most doctors do and he at least cares about me and ran what the drs refused to do. now I am suffering and I am feeling like I just want to disappear.
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rocckyd
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Joined : May 2012
Posts : 1115
Posted 1/5/2018 9:02 AM (GMT -7)
I’m so sorry that you are stuck in this situation.

Unfortunately, regardless of courses, a chiropractor doesn’t have the same weight as a Dr. It royally sucks, but it’s the way it is. With the current climate towards pain management, you do have to jump through hoops. One such hoop would be an mri. An X-ray just doesn’t show enough information.

Do you think your PCP would refer you to a spine specialist? Granted, he’d order more testing, but at least he would know what to look for.
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worriedgirl
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Joined : Apr 2009
Posts : 1221
Posted 1/5/2018 1:22 PM (GMT -7)
He would but I asked for something to be done a month ago. No one listened. He tried what he thought, the er doc did crap but I dont want to waste money on tests to be told the same thing also. The chiropractor is the only one who took the time to run the tests. He is not out for the money because he treats my husband and doesnt charge him full price. He cut almost 400 off my treatment because he has treated my household. I may have to go to the specialist but i dont see why i couldn't go in to see him, show him my xrays and just get a little stronger. Im not asking for pain pills just a relaxer to help long enough for the treatments to work. I have been told i will see some results in 3 weeks. If at halfway point and not better then i will get referred to a specialist for extra help
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skeye
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Joined : Mar 2008
Posts : 3089
Posted 1/5/2018 3:54 PM (GMT -7)
Worriedgirl,

I know you are angry and frustrated, but as it was explained to me by multiple doctors (including more than one PCP, an ortho, and 2 neurosurgeons) when I had an acute crisis with my back a year ago, because 90% or more of people with acute back and/or radicular pain will get better on their own/with conservative treatment within 2-3 mo, it is standard practice to wait at least a month before sending a patient for imaging (the only exception being if there is severe or progressive neurologic compromise or trauma that made them suspicious of an acute fracture). Your doctor may be more willing to send you for imaging now that more time has passed. And like roccky said, even your chiro is the world's best interpreter of xrays, xrays only provide a very limited amount of information/a very small piece of the puzzle, and usually an MRI is required to make an accurate diagnosis and treatment recommendations (guaranteed if you see a specialist, the first thing they will want will be an MRI).

I know even one day or one week feels like an eternity when you are in crisis, but the odds are in your favor that you will get better. And it is promising that you have already noticed some mild improvement. As for the muscle relaxer and the concerns about your blood sugar, the best way to address it would to be to sit down and have a conversation with you doctor (i.e. make an appointment). Your doctor still may or may not be willing to increase or change your muscle relaxer if you talk to him/her face to face, but you are more likely to have a better outcome with an in person meeting than a phone message. Do know, however, that some muscle relaxers are just as tightly regulated as opioids, and this could be partly why your doctor is reluctant to increase the dose.

Post Edited (skeye) : 1/5/2018 4:06:55 PM (GMT-7)

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worriedgirl
Veteran Member
Joined : Apr 2009
Posts : 1221
Posted 1/5/2018 9:06 PM (GMT -7)
i understand it is just frustrating because a month can cause a whole lot of damage especially to a persons life. I know my body better than any doctor and I knew a month ago that something was wrong. I should have forced the er doctor to run tests but no telling if they would have caught it. now I am suffering but I have no room to complain because so is others. I am just a big crybaby and I am not used to pain. now I have to adjust to having back issues the rest of my life and pain and I am trying to process it and being a big baby. I don't like pain and I just want my normal life back. I was in so much pain today I could barely sleep. I am hoping my treatments work or I will have to see a specialist. I may end up breaking down and going to one anyways. I just like to see how the cheapest way works first as I already have a ton of dr bills already. I swear if its not one thing its another. I just want to give up.
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skeye
Veteran Member
Joined : Mar 2008
Posts : 3089
Posted 1/6/2018 12:16 AM (GMT -7)
Yes, you know your body. But even if they had done testing right away, what would have changed? The answer is probably nothing, because conservative therapy (time, rest, treatment of acute inflammation) is always going to be the first line of treatment unless there is an emergent indication for surgery. Either way, healing takes time. There really are no quick fixes.

I also wouldn't jump to the conclusion that you will be this way the rest of your life. Yes, now that you are aware that you have back issues, you may have to be more careful from now on, but this DDD and arthritis did not just develop suddenly overnight. Both diseases are chronic processes, and have been going on for a while, you just were not aware (as is the case with many people with these conditions) until something set you off and caused this acute flair up. Yes, it may take a while (weeks to months), but the odds are in your favor that you will recover from this flair up, and once you do, things will probably go back to more or less the way they were.

I know it is hard when you are in so much pain, but rather than catastrophizing and thinking worst case scenario, make short term goals and look at day to day or week to week progress, instead -- you've already said that things are a bit better, which is great! Hang on to the positives, and don't worry about the long term, or you will just stress yourself out and tense up even further, which will only increase your pain and delay your recovery. Believe me, I know things like this can be life altering (I won't bore or scare you with my own sop story), but it is honestly the minority of people who don't recover from these types of episodes. You will get there, it just takes time and lots of baby steps.

Post Edited (skeye) : 1/6/2018 12:29:01 AM (GMT-7)

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rocckyd
Veteran Member
Joined : May 2012
Posts : 1115
Posted 1/7/2018 2:33 PM (GMT -7)
Don't give up-That's not allowed smile

Other than waiting for a tax refund to deposit into your account, few things are slower than waiting for your body to heal. Add the stress of not knowing the degree of healing that will occur, and life is miserable.

Also,remember that this site is made up of people in the minority-those that did not get better. Whether surgery, illness, injury, or just bad luck is the reason for pain, for most that pain is acute and it will improve.

If your pain persists, you will need to have Drs dig deeper to find out the problem. I know you are worried about $, but instead of spending smaller amounts of money on tests and your current treatment(chiro), a more expensive test/scan might yield results that would save you time, money, and hopefully shape a treatment plan.

And PUHLEEZE don't minimize your pain, call yourself a baby, or downplay your situation. Pain is mean and scary regardless of what and why.

Let us know how you are doing.
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worriedgirl
Veteran Member
Joined : Apr 2009
Posts : 1221
Posted 1/7/2018 8:08 PM (GMT -7)
rocckyd thank you for your kind words. I have been feeling sorry for myself this last week and that is totally not me. I am going to go see a specialist just so I have 2 people on my side. just my chiro is the only one that took the time to find the problem. I know some say don't trust them but he has helped my family out more than anyone and he is not all about the money he actually cares about us. trust me I know when they care and don't care and he does. but I guess the more I have in my corner the better. I just hate shelling out money on tests when they will come back to say the same thing I have been told but if that helps me get to manage this pain I will
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mrsm123
Veteran Member
Joined : Dec 2007
Posts : 1239
Posted 1/8/2018 9:25 AM (GMT -7)
Worriedgirl,
We ALL get being frustrated and being in pain. We ALSO all get wanting answers and a fix right away.
I just want to caution you about a couple of things. You seem to be giving tremendous weight to what your chiropractor said about your Xrays and spine.
From many years of experience dealing with chiropractors, spine surgeons, MRIs and CT scans, please don't put all your faith into just xrays and what your chiropractor said.
Xrays can look at the alignment of the spine, the height of the spaces between the discs, but they can not see nerve or spinal cord impingement. They also can not determine disc degeneration or how minimal, moderate or severe it might be.
Some disc degeneration is perfectly normal, especially as we get older. Almost everyone over the age of 21 or so will show signs of disc degeneration if we were to do MRIs on the population. It is when the normal wear and tear of being upright, walking, working cause MORE degeneration than is normal for our age that it might be a concern. That can only be seen by MRI since the discs are gelataneous/water to see how badly discs are drying out.
Normally, the discs do dry out some, very, very slowly over decades.
In order to see whether or not there are nerves pinched or the spinal cord is being effected, there would need to be an MRI done. Those things can't be seen on Xray, no matter how good a chiropractor is.
Skye is right, typically, when it comes to back pain, doctors first recommend, some rest, anti inflammatory meds, and possibly a muscle relaxer. All muscle relaxers work, milligram strength has nothing to do with weight, or effectiveness. Some muscle relaxers may be more helpful than others to each of us, but don't get stuck thinking that milligram dosage means one is better than another. Higher milligrams don't necessarily mean more EFFECTIVE.
Don't be surprised if you are sent for physical therapy before any referrals to see a spine surgeon.
Normally, they go with the least invasive, graduated treatment steps first, as most sudden back pain disappears as quickly as it appeared, even sciatica typically resolves on its own, given time.
I wish you the best. We all understand how hard this can be.

Post Edited (mrsm123) : 1/8/2018 9:36:09 AM (GMT-7)

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worriedgirl
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Joined : Apr 2009
Posts : 1221
Posted 1/8/2018 9:49 PM (GMT -7)
I am because he is the only one who took the time to care and yes I am planning on seeing a specialist to make sure all the appropriate tests are. he offered to have me go for a mri but he says it will state exactly what he knows. but I am planning on getting a specialist and get what I need done so that I have others helping me out.

today the pain isn't so bad since my adjustment but tomorrow is when I will really feel the pain im guessing. I can feel the pressure building up. I am just trying to adjust. ive tried the muscle relaxers, rest, and anti inflammatory meds and it is not working. I do NOT want surgery I just want relief. I have worked to hard to get to where I am at to keep going like this and letting it ruin my career and everything ive worked hard for.
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(Seashell)
Veteran Member
Joined : Dec 2012
Posts : 1080
Posted 1/8/2018 10:19 PM (GMT -7)
Worriedgirl:
I am going to comment on your use of chiropractic care, aware that you see your chiropractor as the only person who is helping you.

I offer a correlary and differing view. Chiropractic care may be further harming your back.

Chiropractic “adjustments” work on the principle of applied manual forces that disrupt the integrity of the lamina interface. Adjustments disrupt the natural sealed vacuum of the joint space. With every spinal manipulation (i.e. “adjustment”) harm is done to the vertebral joint space. The joint vacuum is broken. The alignment of the lamina are challenged. The result: Micro-trauma, cumulative, that accelerated the normal wear and tear of the vertebrae. Osteoarthritis is accelerated.

Your osteoarthritis and pain are not going to benefit from continued chiropractic manipulation.

Seek a qualified orthopedist or neurosurgeon. Try a round of physical therapy for abdominal core strengthening and flexibility. A large percentage of back issues are due to poor muscular tone and deconditionong due to a largely sedentary life style. An uptick in targeted physical
Conditioning and flexibility can go a long way toward improving quality of life for individuals with lumbar back pain.

Be cautious of an overly zealous reliance of chiropractic care.
Karen
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worriedgirl
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Joined : Apr 2009
Posts : 1221
Posted 1/8/2018 11:14 PM (GMT -7)
I will seek a specialist and go ahead and talk to them about what they feel is the best course of action. I know it seems like I am ignoring advice but I am not. I needed some answers and got them from someone who has helped my family greatly. I know some of the treatment he is using is actually used from the spine specialist to like the decompression so I know that is on the right track. I will call my doctor and go ahead and let him refer me to a specialist.

I am listening I promise I am just trying to process everything and figure out steps I need to take. I will contact my dr for a referral and go from there.
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straydog
Forum Moderator
Joined : Feb 2003
Posts : 18323
Posted 1/9/2018 5:13 AM (GMT -7)
Worriedgirl, just a little food for thought with your situation. You have been overwhelmed by this entire situation, stressed to the max. This is normal, however, take things one day at a time. Don't go down the path of the "what ifs", you will drive yourself batty doing that & it certainly will not help your situation at all. Do a google search for mindfullness, it helps people a lot. Very easy to learn.

Every person is different with pain, how they react to it, how much they can tolerate & that sort of thing. No two people are alike in that arena. You have seen some improvement which is a plus. So knowing you have improved some that should tell you something. Has the chiro told you how long he thinks he will need to treat you? Usually they will treat 6 weeks & then see where the person is at after that. You want all of this gone like now, boy didn't we all, lol. It just does not happen that way.

Something I learned years ago is the mind is very much connected with the body. Last fall I was going through a bad rough patch. I was having a very difficult time getting out of bed & trying to walk. It was bad enough all I could do was groan to myself. In my mind I was thinking great another lousy day ahead of me. Usually I do have some trouble moving around when I first get up, but once I am up moving around it gets a little better. With that thought of oh great another lousy day, I was setting myself up to have a bad day before it even started. I had to remember to change my thinking because I was setting myself up to not have a good day. Our thoughts & attitude are everything. Distraction is also a great tool to help with pain.

Take care.
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mrsm123
Veteran Member
Joined : Dec 2007
Posts : 1239
Posted 1/9/2018 6:45 AM (GMT -7)
Worried,
I started down the spinal road after a motorcycle/deer accident that made me a human projectile, 100 feet in the air, then another 60-75 feet on my spine, knees, shoulders on the highway.
Needless to say, most of the trauma damage was to my spine. I went the chiro route, and thankfully, for 15 years it worked, gentle heat, massage, very seldom minimal adjustments.
As the years went by, the flare ups became more debilitating, lasted longer. I returned to the same chiro, each time, and after a few months, things would ease...until during one flare, I went in to see the chiro..for some unknown reason, he did an 'adjustment and the pain was unlike anything I had ever felt. I tried to stand and my legs instantly buckled under me and I was a heap on the floor.
The muscles in my legs spasmed, twitched and just wouldn't work. The very next morning I was in a surgeons office, scheduled for my first spine surgery in less than 2 weeks after a new MRI showed the chiro managed to cause a slipped vertebra to displace even further.
The decompression machine applies force to your spine, just as the adjustments do.
If I were you, I would be extremely cautious about using that machine, or allowing adjustments of your spine until you have at least had an MRI and can be sure that there is little chance of something like what happened to me occurring to you.
A TENS unit might be helpful. There are reusable ones available in pharmacies you apply that are over the counter.
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