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Daniel Sheibley, MD
Daniel Sheibley, MD, Doctor
Category: Medical
Satisfied Customers: 1734
Experience:  MD Grad Jefferson Medical College 2009. Internal Med intern 2010 & Radiology residency 2011. Husband & father of two.
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My back hurts everytime I sit down. Lower left side. Its generaly

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My back hurts everytime I sit down. Lower left side. It's generaly O.K. while I stand or sit but starts to get sore towards the end of the day. Been like this since December 17th.
Not a sharp pain and no numbness. - dull achy pain. X-ray was normal.
Submitted: 2 years ago.
Category: Medical
Expert:  Daniel Sheibley, MD replied 2 years ago.

Daniel Sheibley, MD :

Hello

Daniel Sheibley, MD :

Have you had any recent trauma?

Daniel Sheibley, MD :

Any prior musculoskeletal problems?

Customer:

Not to my knowlege. I work in "catering" and lift heavy items.

Daniel Sheibley, MD :

In a primary care setting the work up of new-onset of back pain in the "average patient" should start with antiinflammatories, physical therapy and an x-ray. If these have been sufficiently tried then a further workup is warranted.

Customer:

Did all of the above. Pain seems to be getting worse. Especially when I sit down.

Customer:

I had an MRI on Thursday but it won't be read until Monday.

Daniel Sheibley, MD :

The next step in a workup would include an MRI of your lumbar spine. This would show if 1) there are any bony defect such as a misalignment (anterolisthesis, retrolisthesis or pars defect, 2) if there are any problems with the intervertebral discs such a s a bulge, protrusion, or sequestration into the spinal canal or one of the neural foramamina (where the spinal nerve roots exit) any variety of the intervertebral disc problems can cause impingement or displacement of the many nervous system components throughought the spine.

Daniel Sheibley, MD :

Good.

Daniel Sheibley, MD :

The results of that MRI are going to guide treatment further. If it simply is a low-grade (1-4 out of 4) listhesis (antero or retro otherwise described as vertebrae that have slid forward or backward on another) then the recommendation would be to continue physical therapy and symptomatic management.

Daniel Sheibley, MD :

low grade would be like a 1 possibly 2 out of 4

Customer:

We are moving so I've been packing up boxes all day. I have to work tomorrow - big job. How much motrin can I take?

Daniel Sheibley, MD :

any sort of instability or severe disc protrusion would warrant consideration of a surgical option. Considering this is a relatively new (yes 2 months does feel like quite a while though) problem most orthopedic surgeons would want to wait and see how you do before turning the page and considering a relatively invasive back surgery.

Daniel Sheibley, MD :

The recommended dose of motrin over the counter is 200mg. You would have to see a physician 1-on-1 to be prescribed or directed to any other pain medication at a different dose.

Customer:

Really don't want surgery. I will try anything before that. I'll say my prayers and hope that it can be fixed with P.T.

Daniel Sheibley, MD :

It is not advisable to take more than the recommended dose on any medication. Motrin specifically is excreted by your kidneys and overdoing it can hurt your kidneys

Daniel Sheibley, MD :

Physical therapy is not a quick fix, but rather takes a bit of time

Daniel Sheibley, MD :

Especially when there is inflammation in an area it takes time for that inflammation to go down before the true healing can occur

Daniel Sheibley, MD :

Your MRI will show in great detail what your next step should be.

Customer:

Thank you.

Daniel Sheibley, MD :

Alignment of your vertebrae, any slipped/malpositioned disks and/or nerve/spinal cord impingement or abutting (having a disk touch or deform a portion of a nerve)

Daniel Sheibley, MD :

There are orthopedic surgeons who subspecialize in spine just like some focus on knees or ankles

Customer:

It seems to help when I contract my stomach muscles. Or,maybe it is just taking my mind off of it.

Daniel Sheibley, MD :

Are you going to see one who personally focuses on spine or is generalized

Daniel Sheibley, MD :

There are back braces you can use to help stabilize your core

Customer:

I don't know of anyone in the Seattle area.

Daniel Sheibley, MD :

A call to a university hospital is usually the best bet for finding such an orthopedic surgeon who focuses on a specific region of the body

Daniel Sheibley, MD :

It is quite common in the area where I live for orthopedic surgeons in a larger practice (multiple surgeons) to each have a focus. So literally a large practice has a foot guy, a knee guy, a hip guy etc.

Customer:

Actually, I had a brain tumor removed 10 years ago (benign). I could see if that neurosurgeon is still in practice.

Customer:

would you recommend ice or heat at this point?

Daniel Sheibley, MD :

That may be good for continuity of care, however I would wait until the orthopedic surgeon sees you because if this will be a medically managed issue for the time being you could do well under an orthopedic surgeon's care and if it escalates into a spinal surgery you could opt to go to the neurosurgeon if they do that type of surgery.

Daniel Sheibley, MD :

It is good you got an MRI given your neurologic history.

Daniel Sheibley, MD :

MRI is the ideal imaging modality for the central nervous system

Daniel Sheibley, MD :

Either one literally. Decide based upon which makes you feel the best.

Daniel Sheibley, MD :

Aleve is usally a better antiinflammatory as it doesn't need to be dosed as frequently

Daniel Sheibley, MD :

thus you won't have peaks and valleys to your pain control

Customer:

Aleve does nothing for me. Actually, when I took high doses of Motrin, it worked the best. I also drink over 64oz. of water a day.

Daniel Sheibley, MD :

I can not recommend high doses of Motrin as I haven't physically examined you or taken a physical

Daniel Sheibley, MD :

I can only tell you the recommended dose and risks of taking excess

Daniel Sheibley, MD :

I hope you understand that

Customer:

Thank you for your advise. I realize that. My GP actually said I could take the higher dose for a short period of time.

Daniel Sheibley, MD :

I can not speak to whether or not you should follow or change your GP's prescribing advice.

Daniel Sheibley, MD :

But if a physician did prescribe you something you have every right to follow their recommendation as they fully examined you and know of your other medical problems and history

Daniel Sheibley, MD :

If you found this helpful or informative, please remember to click the "Accept"

Customer:

Thank you. Yes, it was helpful to know that I should really see a back specialist.

Daniel Sheibley, MD, Doctor
Category: Medical
Satisfied Customers: 1734
Experience: MD Grad Jefferson Medical College 2009. Internal Med intern 2010 & Radiology residency 2011. Husband & father of two.
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