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I am 27 yrs old and have chronic lower back pain. Recently, it was discovered that I was born with a tilted pelvis, which caused the left joint that connects my spine to my pelvis (think its the sacroylliac joint?) to be improperly formed. This caused the same joint on the right side to overcompensate for the lack of the left joint, and now the joint is severely worn. Sorry for the lack of medical terminology - im still not 100% understanding of my diagnosis because it was very recently that my doctors figured it out.
Currently, my medications are Etodolac 2x day and Percocet 5/325 1-2 pills 2-3 times a day, depending on how bad the pain is. My work consists of sitting for long periods of time in meetings or on the computer, and sitting is one of the biggest triggers of pain for me. Laying on my back or side also causes me a lot of pain, so I have to sleep lying on my stomach with a pillow under my stomach.
I left my appointment today feeling very discouraged and fustrated. I took my medications as usual today, so I had taken the Etodolac and Percocet about 2.5 hours before my appointment - no one told me otherwise. When the doctor saw me, he was surprised that I wasnt in a lot of pain - I would say a 4/10 opposed to a 9/10 when I am not taking any medication. I would like to think that ive began to tolerate the pain more now than i used to, simply from being used to it, so a 4/10 isnt as bad as it used to be for me - its pretty tolerable. I told him that I had taken my medications, and they work pretty well for me, so im not im much pain. He suggested that maybe I come back another time and plan to go without medication for the day and make a later appointment so the pain is at its worse. I was surpsied that no one suggested that when the appointment was made, or that the doctor isnt used to seeing patients that are currently taking medications.
The second thing was the doctor I saw (im guessing thats what he was) seemed to disagree with my diagnosis, but didnt have an alternate explanation for what he thought the cause of my pain could be. He claimed to have reviewed my MRI report and x-rays, but he also commented when I arrived that I was early (whoops - 10 min) and it took him quite some time to come in to see me, so who knows if he was doing a quick reivew at the time. The radiologist that read the xray works at the same hopsital, and my primary care had a few conversations with the radiologist regarding his findings so that he could fully understand the diagnosis. I thought it was somewhat lazy that the doctor at the clinic didnt think to consult with the radiologist to see why they came to different conclusions.
In the end, I left with an appointment for next week where I need to arrive in pain, and I had no answers to what my next steps are or if I could benefit from any cortisone injections as my primary care had sent me there for.
Has anyone else had similar experiences with pain clinics? Are they really capable to giving a proper diagnosis, or are they there to treat the diagnosis you came to see them with?
I agree with Cheree that the doctor at the pain management clinic may have wanted to examine you unmedicated so he could see how far you could move until the pain would make you stop. That is really the best way for him to tell where to inject you to fix your pain. If you aren't in pain when you see him how can he figure out the best place to put the injection that your pcp sent you there in hopes of getting. When I worked in the ER, surgeons hated it if we medicated patients with abdominal pain before they examined them, it really hinders making a good exam if the patient has had too much medicine.
His main job is not to make a diagnosis, but to treat your pain so you can best function in life. If I wanted to be certain of a diagnosis with back pain, I would go from my pcp to a neurologist or orthopedic doctor who specializes in the spine.
Take care, Annette
I am so sorry that you are going through all of this. I hate to say it, but I am so confused about pain management clinics. I have never known what they were exactly. I saw on the news that many have been sited in FL. because of a few doctors stepping beyond their boundaries, which makes it hard on everyone. Pain is a horrible thing to deal with hour to hour, day to day, 24.7. I like others wish there was a "quick fix," but I know my body and also try and watch out for me and I get other opinions.
I have chronic severe pain and fatigue (fibromyalgia and chronic fatigue syndrome), along with some spinal injury, etc. I am usually on the fibromyalgia board because this is my main problem - all over pain.
I have always wondered when you have an appt. with your doctor, do you take your meds so that they are working "well" for you when you arrive; then he/she see that you look like you are feeling well! If you do not take them, I would probably have to be taken in on a stretcher and screaming! There is really not much of a "happy
medium" for me. So, if you see me here sometimes, it is because I need some answers too and, so far, I have not gotten too many.
Hang in there and I hope things get better with you!
Ann

If you need to go to another doctor and he wants to do the same MRI, you will at least have this written information in had and there is no questioning what is on paper. You also have a right to your x-ray films and any reports; you just have to sign for them.
If you do not watch our for yourself, believe me nobody else will. It does take time on the phone and when you are in pain, it is very hard, but they know this also. A lot of times you cannot seem to reach the correct office or particular office in the hospital where the x-rays are stored. But, the physician should have a copy of the report.
When I had pneumonia fro 6 months ( I could read how severe it was from the report sitting right here in front of my face along with the x-rays), but it is lengthy and technical.
Anyway, I was so ill and almost died. My doctor was personable, but he got tired of seeing me. I could not help it if I had pneumonia, but no antibiotic was working for me. I guess he was frustrated too.
One day I went in and MORE x-rays. HE looked at them and said, "GREAT, no more pneumonia!" I thought - GREAT! "Why do I feel so bad and why is this pain still with me?"
As soon as I got home, the doctor's office called, along with the Radiologist and said to get back to the office. The DOCTOR is not "trained" and it is not HIS field to read those x-rays. So, he did not see that the pneumonia was still there. THE RADIOLOGIST caught it.
I gave that doctor another chance and went back to him, yet having MORE x-rays done and MORE antibiotics pumped into me. NEEDLESS to say, I DID NOT GET BETTER From this doctor. HE was killing me.
So, I finally had the sense to change doctors! YAY! I stayed with him because he was nice, amiable and we had a good rapport. Well, that means a lot, but not everything.
If you have someone to help you that would be great in handling this situation.
I wish you much luck!
AnnMy initial visit was with the doctor and the physiotherapist but the program I'm in is a team approach. I wasn't told to stop taking my meds before the appointment, but I'm sure that it helps the doctors understand your true pain level and limitations when you are unmedicated.
My team helped to confirm several things that were going on for me, and also diagnosed that I have permanent muscle damage in the pelvic area, which I didn't know about. There are also issues with muscles surrounding my hips/glutes and possibly some SI joint problems as well. None of these things were really clear before going to the clinic, so yes, pain management centres can definitely help clarify a diagnosis, or discover other problems. The thing is, it doesn't always happen in one appointment or even several...it can take time. If the doctor you saw disagrees with the radiologist, then he has an obligation to explain why, but he may be reserving that until seeing you again unmedicated.
Once they've had time to really check you out, it may be beneficial for you to be seen by other specialists, such as physiotherapists, kinesiologists, etc. Cortisone injections are good to a point, but not for all problems and often in limited use. You don't want that to be your first line of treatment if there are other options.
I think it's important to remember that just like individual doctors, there are good clinics and bad clinics. I don't think you can make a decision based on one appointment, so I would encourage you to have patience, hang in there, go to the next appointment and ask questions. Make a list if you need to...it's your body and you have a right to know what's going on, but you also have to allow the doctors ample time to make their diagnosis.
I am now scheduled for several appointments with regular physio, pelvic-specific physio, the kinesiologist, dietitian, and my doctor (to work on finding the right combo of sleep and pain meds). I have a nerve block scheduled in July as well. In addition to this, I have several group appointments to help with self management, exercise, and sleep...a secondary team approach to teach me new skills to cope.
I've accepted that I will always have pain, but I'm encouraged by the many options out there to help me live with it. I am not my pain, and I will not be defined by it. I am still in control.
Best of luck to you!! Pam
Good Luck!!!
Rick
I have my first apt next week with a Pain Management Clinc and not sure what to expect. I guess what you went thru might be what I should expect.
I don'tknow why I'm being sent to this place? I got hurt on the job, so the Nurse for Workman comp called me to tell me that I was going. OK
I've been doing physical threapy for several months, thought they would send me to a "real" doctor, not pain management. I have pain, I have pills for pain, but don't take those pills unless I'm not working or I can't work/ I live with pain everyday like most of you I read/
I don't need to know that I should try shots but I don't want them.....I have read here and other places and decided I don't want shots! I get physical threapy so what do they have is different? I know I have L5 S1 bluging disk, I know I hurt my knee but nothing is broken/ I know that my hip never stops hurting, but under the "workman comp" they will not be looking at my back, hip or foot or ankle. Only the part I said hurt right when I had the accident..........ops I didn't know you better write everything down because it can come back and bit you! In other words only in those first few hours that all I felt was my leg hurting and knee/ So that is all the workman comp is interested in!!!! So since I have learn about those bluging disk they won't go there! So why go to pain management? I learn thru my threapy that my lower back is causing most of my pain.
So what I guess is these doctors or whatever they are, are going to turn off my case and that is it! So yeah like you jessdes what in the Hell am I going for? Why do come early 10min like you did? Only to be put down? Why do everything they want? Well I wish you well Jessdes.......... Hope you do feel better soon. Ruth
Have you seen an orthopedic doctor yet? Did he suggest surgery of any kind for your knee?
A pain management doctor is a "real" doctor. They are real doctors who have additional training and certification for pain management. You say you are in pain everyday, go hear what he has to say. Maybe he will have something to offer, and if you don't want to do anything he suggests you don't have to. There are also other kinds of medicines to take for pain besides the traditional pain pills.
If you wish to, you can always go to your own doctor and ask for a second opinion. Maybe he has something to offer you.
Take care, Annette
p.s .my pain is 4/10 and that's not so bad
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