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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Medical
Satisfied Customers: 7405
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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What can I do if i'm in so much pain I cannot even get out

Customer Question

what can I do if i'm in so much pain I cannot even get out of bed and get dressed, but my doctor says keep taking my pain meds and there is nothing he can do?
JA: What medications do you take daily? Are you allergic to any medications?
Customer: no med allergies. vicatin, muscle relaxers, neproxin sodium, claritin
JA: Anything else in your medical history you think the doctor should know?
Customer: back injury 20 years ago and pain and function has been getting worse since and now even chiropractic is having no relief
Submitted: 1 month ago.
Category: Medical
Expert:  Dr. Muneeb Ali replied 1 month ago.

Hi,

Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Can i ask have you had a MRI done? if so what did it show? Does the pain radiate down into the legs? Have you undergone any other treatments apart from painkillers like injections in the back? PRP injections? Anything else?

Customer: replied 1 month ago.
I had an MRI 10 yrs ago and they said there was some deterioration in t12. I got in pretty bad shape a few years ago and went to physical therapy for a while but soon after, the pain and other syptoms returned. Just in the last month, the pain has gotten much worse and now is radiating down my left leg, to the point I cannot go to work or do anything. I went to my primary care physician and he said physiologically, there is nothing wrong with me and nothing he can do. Years ago I did a consult with the pain clinic and they said there is nothing needed at that time.
Expert:  Dr. Muneeb Ali replied 1 month ago.

Thank you for the additional information, actually the first thing that needs to be done here is a MRI of the spine again. A MRI done 10 years ago will NOT give us enough information to determine what interventions can be done to manage the pain right now. your doctors statement that nothing is required right now is not 100% correct and infact he should be either ordering a MRI or referring you to a neurosurgeon or orthopedic surgeon to determine the severity of the problem. Secondly, i think since the pain is radiating down into the leg that means that either spinal cord or the nerve roots arising from the cord are being compressed, this would be confirmed not only on the MRI but also on a NCS/EMG test. Now once we have determined the extent of the problem there are several treatment optiosn APART from the physiotherapy and the painkillers which can be considered. Some of them include,

Nutritional supplements for the bone, joints & discs like Glucosamine, Chondroitin, MSM etc

Traditional/herbal medicines like Devil’s claw Secondary Root, or Limbrel (Flavocoxid), or Noni concentrate, or Nettle Root extract, or S adenosyl methionine etc

Following are some additional measures to help with severe pain;

Diathermy therapy

Ultrasound therapy

Laser therapy (Cold laser therapy or Low Level Laser Therapy)

Interferential therapy - a type electrotherapy

TENS (Transcutaneous Electrical Nerve Stimulation) – another type of electrotherapy

COOLIEF Cooled Radiofrequency treatment

Calmare Scrambler Pain therapy (medical device)

Iontophoresis

Lumbar traction therapy

SMT (Spinal Manipulative therapy)

IDD therapy (Intervertebral Differential Dynamics Therapy)

Special forms of spinal injection treatments - PRP (platelet Rich Plasma) spinal injection, Prolotherapy spinal injections, Etanarcept spinal injections, Botox spinal injections etc

Chiropractor spinal manipulations

Osteopathic spinal manipulations

Acupuncture etc

I would suggest that you have the MRI repeated and then the NCS/EMG test and follow that up with a orthopedic or neurosurgeon consult as it is possible that if the above treatments are not applicable in your case then surgery can be done.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

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Customer: replied 1 month ago.
what do I do next if he refuses to do anything. I was just there a week ago and he did nothing.
Expert:  Dr. Muneeb Ali replied 1 month ago.

Ask him for a referral and if he still refuses then seek a second opinion from a doctor in your area, yourself. Without any repeat imaging, how can he say that nothing can be done? we need to know how severe the problem actually is before saying this and ask your doctor specifically about each one of teh above options as well.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/

Customer: replied 1 month ago.
I went to the chiropractor and he adjusted me, but for the first time in 20 years, he requested that I go home and apply heat and come back in 3 hours to try manipulation again. He said that the sacrum was so bad and the muscles were so tight that he wasn't getting it. I did what he said and went back and he basically said I need medical help. I then went to Urgent Care after my doctors office said they could not see me this week. Urgent care said they could not help me and instructed me to DOUBLE up on the medication amount for now to get the pain under control. THAT is the LAST thing I want to do, but I can't stay in bed forever. Another try with the "medical professionals" with the same results. More meds and no results. i'm so tired of treating the symptoms while ignoring the cause.
Expert:  Dr. Muneeb Ali replied 1 month ago.

I fail to understand as to why your doctors are not ordering a MRI here, a MRI 10 years ago is not the basis for completely giving up. In the last ten years there have been many advancements in the management of back pain . Pain radiating down your leg is CLEARLY an indication of nerve compression and this DOES need a MRI and NCS. I completely agree with you that painkillers are not the solution, they are a stop gap measure at best. Can you seek a second opinion from an orthopedic surgeon or neurosurgeon in your area? or does your insurance require a referral from your primary physician? if you dont need a referral then go see an orthopedic surgeon yourself.

I agree that they seem to be ignoring the underlying cause and simply trying to mask the symptoms with painkillers, that may help in the short term but you do need full evaluation and further testing to see if there is a viable solution for your problem from the options that i listed above.

Customer: replied 1 month ago.
A referral has to be ordered by the primary care physician, otherwise the insurance company pays nothing, and if the referral is outside the network, I have to pay half, even if a referral is given. That said, if I cannot get back to work soon, I wont have any insurance anyway if I don't have a job anymore.
Expert:  Dr. Muneeb Ali replied 1 month ago.

I can understand the extreme difficulty you are in, try convincing your primary care physician again, explain to him that the pain is now radiating down the leg and it is worsening every day. Painkillers are not working anymore, if he still does not relent for a referral, then unfortunately you may have to go yourself and pay the extra cost. But i still dont understand why the PCP is not willing for referral, his treatment is obviously not working and any doctor whose patient is not improving would seek a second opinion, in the patients best interest.

Customer: replied 1 month ago.
I'm tired of the pain, the mediations, and feeling like I'm being swept under the rug. That's why I'm opening up to whoever will listen for advice and/or action. I'm having some legal consultations as well. Maybe they will be able to help when they hear my story and the results that I've had.
Expert:  Dr. Muneeb Ali replied 1 month ago.

That is a good idea, you should not be in so much pain. At the very least they should investigate the cause of the pain, just saying that nothing can be done without looking into the problem is not right.