who to believe???

[nook]

hello,

about 5 years ago I planted many rose bushes in a day and woke up with horrible pain in my neck, shoulder, arm and back. It never got better. Fast forward over the years to the following:

· C4-C5- disc osteophtyes, mildly narrowing ofcanal and indenting the spinal cord, bilateral facet and uncovertebral degenerativechanges, markedly narrowing the left/moderately narrowing the right neuronalforamen.
· C5-C6-disc osteophtyes , mild to moderatenarrowing of canal and indenting the cord, bilateral facet and uncovertebral degenerativechanges, markedly narrowing neuronal foraminabilaterally. Small right lateral meningocele or perineural cyst.
· C6-C7- focal central disc protrusion, , mild narrowingof canal and indenting the cord, bilateral facet and uncovertebral degenerativechanges, moderately narrowing the left neural formen.
· no underlining cord signal abnormalities
· L4-L5 –disc bulge, moderate degree of stenosis,both congenital and acquired etiology. Marked lateral recess bilaterally. Noherniation noted.
· Osteoporosis (was on foamax one year, spine gotworse.
Bursitis-left shoulder
I have pain in my arms, fingers, legs, back and ribcage and weakness in my arms.. I am slowly becoming disabled. I now have developed burning neuropathic pain in my arms, hands, back and legs. I have been to at least 5 neurosurgeons, none of whom agreed on procedures. 1- just clean osteophytes from back, 2- three cervical fusions, 3- two cerival fusions (c4-c5 and c5-c6) 4- one fusion c5-c6, 5- don't get back surgery (yup-advice from the first neuro to evaluate me at MGH!!).All said surgery is elective, not absolutely necessary.

I have been to the Mayo Clinic in Rochester and had facet shots in my neck and in my lumbar region (I think they may have helped but am not sure, epidural in neck (no help) and a cervical nerve block at c5-c6(most painful proedure and pain lasted three weeks(did not help). I have had physical therapy (no help). I have been to rheumatotogist who said I have fibromyalgia).

My primary care doc said "suck it up", it is all in your head, everyone has DDD at your age (58), go see a pyschiatrist or to a pain clinic.

I feel lost, not sure who to trust, what to do but I can't continue like this. I have become homebound, can't really drive very far due to pain and stiffness.

My question is can surgery help the pain??? I live in MA but am thinking of going back to NYC to a Dr. Elowitz or HSS. Any advice? I am told the burning pain can't be caused by my spinal issues, but from reading the posts here, I think perhaps it is possible. I am terrified of having to get three cervical fusions since the more you fusions, the more chances for problems, so I have heard. Would love to hear from anyone with similar issues and if they had successful surgery outcomes long term. I do not want to go on disability. I want my life back. I only take nortryptilline for the burning pain and 1/2 vicodan when I can no longer deal with the pain but the next day I feel worse after the vicodan, so basically take no pain meds. I can't take NSAIDS, allergy to neurotin.

thanks and sorry for the long winded post.

[nook]

me again. I just reread my post and perhaps seem a bit crazy. I am just in so much pain. I do hope someone will respond. I am so frightened of surgery, know an ADR is not an option (facet joint disease and osteoporosis) and am not sure 2-3 fusions long term provides good results (once done, you can't go back.).
thanks

[laid up doc]

It sounds to me like you need a dr who's in your corner to narrow down where your pain is coming from and address it... TO ME, a pain doc is usually best at this, NOT a surgeon. a surgeon wants to know where to cut and if someone will pay for it. some are better at being PHYSICIANS than others, but few will go through the diagnostic process with you of getting various injections, trying meds/PT methods, etc.

if you're looking at a 3 level fusion... see a pain doc to have a more thorough look at your imaging and symptoms to see if all 3 are symptomatic. MRI's do NOT always correlate with symptoms -- a fact that mars many people's workups and treatment plans.

good luck to you.

[trkdoc714]

Nook,

LUD gives great advice. The pain doc is more interested in finding and treating the source(s) of pain. He's also more intent on finding relief for you through minimally invasive methods.

From a patient's perspective, I think I'd try to find another PCP. He's supposed to be on your side, not dismissing your pain (with documented causes) as simple aging.

Good luck.

Bob

[KanRunMo]

You've gotten some good advice from those who have responded. The primary care doctor should be concerned about where the pain is coming from. However, once the back is diagnosed as the problem, they (at least mine PCP), back off and says to leave it alone. I would suggest talking with an orthopedic surgeon or neurosurgeon who has done artificial disc replacement. They are hard to find in the U.S. There are many people on this forum who have had successful cervical back surgery with ADR or fusion. The percent of success is probably not as high or as common as with knee, hip and shoulder surgery.