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DrThomasMd
DrThomasMd, Board Certified MD
Category: Neurology
Satisfied Customers: 54471
Experience:  Internal medicine doctor, diagnose and treat neurology patients, many years
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I have an diagnosed leg pain. I have seen a GP, 2 rheumatologists,

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I have an diagnosed leg pain. I have seen a GP, 2 rheumatologists, and 2 neurologists. I have undergone several rounds of blood tests (including multiple autoimmune), 2 MRIs of my upper, middle, and lower back, 2 of the tests where the neurologist sticks needles in your muscles, an ultrasound, and PT. The MRI showed a slight bulging disk in my neck for which I attended PT and nothing changed. The pain has not gone away in over a year and a half and in that time I have tried muscle relaxers, and different one-a-days, but the only thing that seems to work is tramodol (50 mg 4-6 times a day). Some times the pain is in my hands, but always in my legs. None of the tests in the past 18 months show anything abnormal. The doctors seem to be out of ideas.
Submitted: 5 months ago.
Category: Neurology
Expert:  DrThomasMd replied 5 months ago.
Hello
Do you have the summary of the lower spine MRI ?
Customer: replied 5 months ago.

I don't have it with me. However, I was told that the only abnormality of all of the MRIs was the slight bulge in my neck which was treated with PT, but never affected my legs. Neither one of the neurologists discussed any issues (no matter how slight) with the rest of my back.

Expert:  DrThomasMd replied 5 months ago.
It is very common to overlook findings that can cause leg pain.

Let me ask you, you have not seen a structural medicine specialist?
Customer: replied 5 months ago.

No, I have not. I have never even heard of a structural medicine specialist. What do you think they can do for me?

Expert:  DrThomasMd replied 5 months ago.
They are called, physical medicine and rehabilitation doctors [the specialty is PM&R] or physiatrists.

They can do a whole body structural exam and see if there is a structural problem for your leg pain, which probably IS a problem in the lower spine, not spotted by the other doctors.

They will use a variety of manual medicine techniques to correct this once you have a diagnosis.

They are now plentiful and should be easy to find.

Just google "physical medicine and rehabilitation doctors, and your city/state".
Use reply to let me know if you have further questions.
Please do not forget a positive rating.

Customer: replied 5 months ago.

So you think that 2 MRIs, 2 summaries, 2 neurologists, and a physical trainer missed something in my lower back? It seems like a lot would have to happen in order for it to be overlooked.


 


 

Expert:  DrThomasMd replied 5 months ago.
I am sorry you rated poor service, and still have questions, which I am glad to answer for you.....


But you have rated me negative with JA and seen to it that they do not pay me....

In fact neurologists miss this problem all of the time....I have over a 90% success rate with such patients, and most of them have had this problem missed.


I have also given you labs which apparently have not been done, which will rule out the other possibilities.


I see no reason for a poor service from you....your question sat elsewhere and when no one would take it I was alerted. Since then, I have responded to you promptly.


Please click a positive rating to reverse your bad rating, then let me know what other questions you have, and what has not been answered for you.
Customer: replied 5 months ago.

"I have also given you labs which apparently have not been done, which will rule out the other possibilities."


 


Which labs would you recommend? They aren't listed in any of the above answers.


 


"I have over a 90% success rate with such patients, and most of them have had this problem missed."


 


Does this refer to other patients with undiagnosed leg pain? How many patients do you think you have had this success rate with?


 


Thanks,


April

Expert:  DrThomasMd replied 5 months ago.
Yes.
Usually a lack of diagnoses is due to one of several reasons.
a. The correct testing has not been done.
b. The correct specialty has not been consulted.
c. The patient has not followed up with the correct specialty.


Often undiagnosed leg pain requires a structural diagnosis.

In fact, there are plenty of findings on your MRI to account for the leg pain. The MRI is s static picture, and does not show what happens in the spine when you walk or bend over. The PM&R doctor can assess this hands on and do further testing if needed.


Please do not forget a positive rating.

Customer: replied 5 months ago.

"I have over a 90% success rate with such patients, and most of them have had this problem missed."


 


Does this refer to other patients you've had with undiagnosed leg pain? How many patients do you think you have had this success rate with?

Expert:  DrThomasMd replied 5 months ago.
Yes.
In almost all cases it was patients with similar MRI findings that had been ignored.

I send them to a PM&R doctor with over a 90% success rate.


Please do not forget a positive rating.
DrThomasMd, Board Certified MD
Category: Neurology
Satisfied Customers: 54471
Experience: Internal medicine doctor, diagnose and treat neurology patients, many years
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