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    Seeking direction on battle with bulging discs
    bdiskman posted:
    I'm really hoping someone here can give some advice on which direction to go next in my battle with bulging discs. Four years ago I was diagnosed with two bulging discs in my cervical spine (4th and 5th vertebrate) and possible bulging discs in my lumbar region (unsure since I only had an MRI of my cervical and mid back). This initial diagnoses was made by a very reputable orthopaedic sports medicine doctor. I went through supervised physical therapy ffor a few months and continued on my own, with mild success. 18 months later I got a second opinion from another orthopaedic doctor at a spine center. He felt that my pain was probably more from joint disc strain rather than bulging discs. So I went through another round of supervised physical therapy with a different physical therapist and have continued on my own with mild success. In all honestly, my physical therapy has not always been consistent and I could do a much better job at it.

    Recently, I took a new desk job which has worsened my pain. I am having a very mild, yet persistent tingling/numbness in my right arm which in the past I would only feel on rare occassions for less than a day. I feel like perhaps I should get a 3rd opinion, but I'm confused as to which type of doctor to see. Instead of another orthopaedic doctor, should I try a nuerosurgeon or other?

    I've read online that ignored pain in arms or legs can lead to permanent nerve damage. I have no idea if this is true, but I'd rather not take the risk. So my second question is, am I better off getting extremely serious and consistent at the physical therapy for 6 weeks before getting a 3rd opinion, or am I risking nerve damage not seeing a professional first?

    Thank you for any guidance on this.
    bj1208 responded:
    hi and welcome to the support group -

    NO I would stop the physical therapy - what you need to do is get another opinion from either an Orthopedic Spine Specialist or Neurosurgeon Spine Specialist - or get a couple of opinions -

    yes being left untreated can cause permanent nerve damage but you must be examined to be able to identify if this is the cause.

    you should also see a pain management doctor - a PHYSIATRIST is a good pain management clinic - here's link -

    they can also refer you to good spine specialist - this should not go untreated - please make appts as soon as you can -

    please keep us posted - take care - Joy
    bdiskman replied to bj1208's response:
    Thanks Joy, what I'm confused about is whether or not to see an ortho or a NS. I got the impression that NS's were for more serious cases where people are in severe pain. My pain is more mild to moderate. Everyone seems to have a different opinion on which type of doctor to see.
    bj1208 replied to bdiskman's response:
    hi again - it doesn't matter which doctor - they are both great - an NS did my surgery and am now seeing OS (just my preference) -but it's always good to get a couple of opinions on what they say - this way you know exactly what you are dealing with -

    hope this helps - take care - Joy
    bdiskman replied to bj1208's response:
    Joy, if I'm interested in a non-surgical approach, will a NS/Neurologist provide non-surgical advice/approach, or are they mainly looking at everything from a surgical approach? Thanks
    dianer01 replied to bdiskman's response:

    I have too been through back surgery and did work with a neurosurgeon and if the NS believes the best approach is not surgery, he/she will tell you so. The level of training is what gives the neuro or ortho the ability to read mri's and interpret other studies. Neither Neuro or Ortho is likely to refer you to chiropractic.

    Hope this helps.
    painloopy replied to bj1208's response:
    I don't agree that you should stop physical therapy. Most NS or OS doctors will send you for this before anything else. I've had 4 back surgeries and if someone had just told me to keep up with the therapy - I could have avoided a ton of pain and suffering later. but we are all different I do think second and third opinions are important also. Physical therapy is NOT a fix all so going for 6 weeks will not make it all go away - it is something you will need keep on doing and a way of keeping your body strong to make up for this musculoskeletal issue. I also think that you should keep a diary at work for when you have the numbness and tingling to take to the doctor so it can clue them in as to what position you may be in when it happens most. I don't think you should see a chiropractor as first choice but neurologist or orthopeadic doctors (in my experience) have looked generally at the same things. You should look into a pain management doctor as well - they often all work in unison anyway so your NS or OS doctor should be able to refer you to one that works with them - communication will be important there.
    bj1208 replied to painloopy's response:
    what I told this person is to stop it until another opinion (or a couple) can be done to make sure there is nothing major wrong - doing physical therapy without current MRI/CT Scan/X-ray etc., can make certain problems worse -

    I was sent for physical therapy for almost 2 years - all it did was make my pains worse - and i had had several MRI's and CT Scans - and a doctor that was not back/neck certified - I not only had a bulging disc but it was splintered so the physical therapy was pressing those splinters into my S1 nerve roots on both sides -

    a complete examination needs to be done - and if the OS or NS (must be a spine specialist!!) deems that physical therapy needs to be done they can write the proper RX outlining what the patient needs -

    most good physical therapists will ask to see MRI's, CT Scans etc., BEFORE treating and will also ask if there is a written script of what needs to be done -

    this is the reason I stated to stop the physical therapy UNTIL A FULL PROPER DIAGNOSIS CAN BE DONE -

    I have nothing against physical therapists or chiropractors - but I do believe that a full diagnosis and written script from a spine specialist is needed.

    hope this explains it a little better - Joy
    painloopy replied to bj1208's response:
    Thanks Joy - it does explain a little better what you meant. I agree it is best to figure out what is causing the situation and physical therapy can do harm if you don't know what the condition is in the first place. That way the therapist knows how to adjust the routines to what you need. I just know so many folks who don't give PT a chance to work then end up getting surgery and only end up worse off then they were before (and back in PT anyway) because they thought the PT was supposed to fix the problem - which it is not the case. It's a preventative - not a cure. But it also can be dangerous if you go in blind. So many folks are looking for the quick fix these days.

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