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visit with neuro/ chiro

AnonymousUserAAnonymousUser Posts: 49,002
Hi, I've had sciatica for 11 mos. No insurance, so I waited for it to go away on its own, finally went to a clinic for uninsured 2 mos ago. Xrays done, report said DDD and arthritis (I'm 46, no previous problems). MRI said broad-based disc protrusion L4-L5 (herniated disc?) with effacement of L5 nerve root. Nurse at clinic said "see a spine specialist." Meanwhile, I qualified for a state insurance pool for people who are denied insurance (which I now was)- but I have to wait 6 mos. before I can get treatment for 'pre-existing condition.' I decided to pay out of pocket and brought MRI to a neurosurgeon, driving 70 miles for the appt. Paid $134 and he spent all of 7-8 minutes with me. No exam, told me my MRI (done at my local hosp.) was "crap." Asked if I could walk on heels and toes; I took a few steps and he said, "The nerve is functioning well; you just have irritation." He never asked what level of pain I have or what activities bother me. He said I don't want surgery- it's very expensive and unnecessary- said some people get injections but they may only last a few weeks and people are shocked when they get the bill. He advised me to look into buying an inversion table (I hung upside down years ago and hated it- couldn't stand the feeling of blood rushing to my head). Also told me to see a chiropractor. I wasn't able to ask any questions, like is there any risk of rupturing a herniated disc, etc. He mentioned that the radiculopathy will go away on its own- might hang around for 2 yrs. I thought there is a risk of permanent nerve damage if this continues. ? I feel I was ripped off- $134 to get a recommendation to a chiro (after the clinic told me NOT to see a chiro for herniated disc) and can't afford to pay the same amt. for second/third opinions-- remember, I have a 6-month wait til insurance will kick in for this. So I am seeing a chiro this week for the first time in my life. Nervous, scared, confused and could use some input. I don't even know the size of the protrusion; I keep seeing descriptions of herniations in measurements of mm. My report doesn't show this, and the neuro didn't order any more tests.


  • I had the injections from the pain management Dr. and my sciatica is better after 3 shots. I found physio didn't help me except learning some excercises I can do on my own.Everyone has different reactions to accupuncture. All I know is I was told no to surgery and to try conservative treatments first. I'm going for a second opinion Jan.22 to ortho. I may choice surgery if it's offered. I would try anything rather than have surgery now. Your GP can order an EMG to test for nerve damage I think before going to chiro. I went to chiro but not for adjustments only for TENS and some excercises. You shouldn't be forced to go to chiro. I hope things work out for you and are you able to get social assistance? Take care. Hope things work out. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I agree with what Charry said,that you shouldn't be forced to go to a chiropractor.In fact,that is a personal decision and not many Drs would give that advise.

    If you do decide to see a chiro,please don't let them adjust your spine.There are other things that they might be able to do besides manual manipulation..and keep in mind this is only my opinion,but it is an educated opinion.There is a possibility that having your spine manipulated by anyone less than a specailist could cause you more harm than good.

    Were you referred to this neurosurgeon by the clinic,or did you choose him? The only thing he said that I agree with is the "I don't want surgery" part...but then again,who does.Surgery is a last resort for most spine problems,unless they are a medical emergency,Drs like to try all conservative treatments first.

    I think he was being honest with you about the injections.They are very expensive,and he would know that you have no insurance.Believe it or not,that is USUALLY the first thing that most (not all-but most) Drs look at before anything else.(Your ins. info is on the first page of your chart)Even before they look to see why they are treating you.IMO,that is probably why he dismissed you so casually.I'm not trying to be rude,only realistic..he knew that you could not afford to be treated.It's the sad truth.

    The good news is that there are good DRs that will treat you,but probably not until your coverage kicks in.Until then,is your pain manageable? I have arthritis,ddd,and numerous other problems.Nerve damage doesn't ALways happen,but I cannot give any advice on that because I'm not medically trained or have any knowledge in that area whatsoever.I do know that you should keep close tabs on your symptoms and report ANY changes to your Dr ASAP.

    If all you can afford now is the clinic then by all means utilize their medical expertise.That way you will have some background(charts-tests resuls)to take with you when your coverage does come through and you will be better prepared.

    Look at it this way.You have already been waiting 11 months,that has to be frustrating but,at least now you've had x-rays & and MRI.Now that you know you have DDD and arthritis,among other problems-nothing has really changed other than you have a better idea where you stand.But do watch closely for other symptoms.Keeping a 'symptom diary' can help you keep track of things until you can see another spine specailist.

    Good Luck and keep us posted.
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  • Charry, there is no "social assistance." If one doesn't qualify for Medicaid, there is only indigent funding- it only covers diagnostics and hospitalization. So they covered the MRI but I have to pay the radiologist and for any treatment I get.
    Robin, I can't go back to the low-income/uninsured clinic. They are unable to treat me; they don't have anyone who deals with spine conditions and don't have physical therapy. They are mainly there for everyday stuff, all they were able to do was x-rays in house and order an MRI.
    As far as responding to my not having insurance (yet), the doctor was pretty rude. He didn't ask if I'd have a way of getting money for treatment. I could ask friends and/or family for all he knows. He never even gave me the chance to know what options are availble. He said he has a herniated disc and would go to a chiropractor himself. He told me that traction might work. I'm not even sure what that is and I'm a bit apprehensive.
    I feel like I'm pretty much on my own-- no explanation of the extent of the herniation or possibility of additional or permanent damage, no advice on what to avoid. I have no one to show me proper stretches or exercises for this condition, since I have no access to physical therapy. I suppose I can make one appt. with PT to get the advice, but I won't be able to afford more than one visit.
    I have done some stretching in the past few days, on my own. I still have pain in the lower leg- worst at night, and pressure and mild pain above the tailbone. I am able to walk and even tried a 2-mile run on Sunday (the neuro didn't tell me I couldn't do it). Aside from having burning in the toes of my left foot after the run, I didn't feel any worse than usual.

  • It has always been hard for me-the not knowing.I don't know much,and don't want to lead you down a path that could cause you harm,but I do know that arthritis does not like to move..but it is important to do at least gentle movements to keep the area from locking up.The more I move my neck the less stiff and sore it is,but every day just starting is really painful.

    I would suggest that until a Dr tells you what is best to be cautious,but don't completely stop moving.Ease into every day with the pain & no abrupt/forceful movements.The only reason I'm offering this much advice is because I can see that you are not one to stop being active.You ran 2 miles yesterday so that tells me a lot(lol).

    I'm glad that you are able to run-that's awesome..I miss running,but it's been years for me.Getting 'in the zone' caused a lot of damage to my feet,but it was sure fun.

    If you look at the top of this page and mouse over 'conditions' you will see a section on herniated discs-there you can follow many links which may pertain to your problems and help ease your mind and answer your questions.Right now you may not appreciate me saying this,but later when your insurance kicks in,you will be better prepared and know what questions to ask when you finally do get to see that specailist.You'll be way more advanced than many of us were when we went in blind,with no knowledge.

    I guess May is when the Ins. comes through?
  • I honestly don't know when my 6-month wait will end. I was told I would have coverage beginning Dec. 1; it's now Dec. 8 and I have yet to see the policy and card in my mailbox. I assume it will be 6 months from the date they issue the policy. In the meantime, at least I'll be covered if something else comes up. Immediately after Christmas last year I began feeling very poorly; 3 months later, I underwent an abdominal hysterectomy which I'm still paying for. This has not been a good year!
    I've been reading much online, especially excerpts from runners who had problems with herniated discs. I had to stop running last Dec. when I had pelvic and abdominal pain, after having plans to run a half-marathon early 2008. I can see where inactivity has not helped. I am stretching better now that I've had a little exercise. I still have pain from the left buttock down the side of the leg but who knows when/if that will ever go away.
    Will let you know how the chiro goes.
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  • I'm sorry about the obstacles you are facing. Perhaps you can go back to the low income clinic where they can give you medications until your insurance kicks in. Pain medicine like Vicodin is fairly cheap. They can give you a generic muscle relaxer and generic Neurontin to help with the sciatica. Go to Walmart to have those filled at $4.00 or at a discount. There should be a community clinic that charges only on your ability to pay. You need a have a clinic because going to the ER for care won't work. They will also tell you to go to a clinic because they won't keep giving pain killers. I hope you find someone to treat you and eventually things will work out for you. Don't give up. Take care

    PS Don't go near a chiro. You have a complex problem and they might make you worse. That specialist was blowing you off because you are uninsured. Believe me, I've been there.
  • meydey,
    Well- now that I'm insured, I'm not eligible to go back to that clinic. I have insurance; even though it doesn't apply to the back problem until June 1, I can't go to a clinic for the uninsured anymore. The irony!
    Meanwhile, I did go to the chiro. We looked at the MRI of my spine and the disc appears to be bulging. The MRI report says "broad-based protrusion" but no one ever explained what that meant (not even the guy I paid $134). Incidentally, one of my dogs has a bulging disc- diagnosed at age 8 mos. He's had 2 myeolgrams and is now 13 and runs around fine. He used to have spasms and would be on the floor, unable to move for about 10 minutes. He'd get up and his back legs would be wobbly but he would be fully recovered after that. He is m inspiration. I figure if he can fun around like nothing is wrong, I will again, too.
    The chiro advised me not to try running until we get this taken care of. I felt worse last night after my first treatment but not as bad as usual this morning. I do have some discomfort/mild pain now in the lumbar/sacral area just above the tailbone, kind of nagging. I have another appointment on Friday and will probably go weekly until I begin feeling better.
    The nurse at the clinic had prescribed Vidoin, which I took at night so I could get comfortable enough to sleep. I don't have a refill and don't take it now unless it's unbearable. If I really needed any more drugs, wouldn't the neurosurgeon have prescribed something?
  • The neurosurgeon can prescribe you medicines according to what your symptoms are. For the back pain he may give you Vicodin . Medicines like Neurontin, Cymbalta, or Lyrica are very useful for nerve pain. Muscle relaxers are added in for spasms and the combination of the three types of medicines are effective in dealing with your pain.
  • He probably didn't/won't prescribe until he sees if you are going to remain a patient.The way I understood your initial post it sounded as though it were the first time you had seem him,without ins.,and paying cash for the visit he may have assumed that either,A.You wouldn't be coming back until you had insurance,or B.You were only there to get medication(no disrepect is meant here-this is simply the way a lot of Drs think).Most Drs won't prescribe scheduled drugs to anyone they haven't taken on as a regular patient.

    I doubt if he would have treated your pain because he mentioned that your MRI "was crap" and he didn't even ask you what level of pain you were having.
    "The nerve is functioning well; you just have irritation." He never asked what level of pain I have or what activities bother me
    That's crazy that you have to wait even longer to treat your 'pre-existing' conditions.I can understand if you needed surgery or something equally expensive,but it seems to me that not treating your spine issues for another 6 months could end up costing more in the long run?These ins. companies should look more closely & at individual problems before writing them off so thoughtlessly.Maybe you should call them and talk to them about the possiblities of prevention and how caring for your spine now could possibly save them money later.If they already have you on their plan it wouldn't hurt to try ..I wouldn't think? I doubt it would do any good,but you may end up talking to someone who has a bit of compassion.
  • In response to considering talking to the insurance company about eliminating the 6-month wait, this is not an option. It's the LAW-- EVERY insurance company requires a 6-month wait for ALL pre-existing conditions. This includes diabetes and cancer. I didn't believe they would make people with potentially fatal illnesses wait, but I found out that yes they do. I am working with a legislator in my state about getting the law changed. I encourage others to check the laws in their state. Even if you have insurance and aren't worried about your own condition being covered, consider others who are suffering and even dying as a result of these inhumane laws.
    And no, I will not be going back to that neurosurgeon. If he couldn't give me the time of day during the first appointment, he has lost my business for good- even if I eventually require surgery and he is the best surgeon in the world. I will take my business elsewhere.
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