Getting to the Bottom of the Problem

In order to alleviate pain, you first have to be able to identify the source of the pain. How many times will I see a new patient who has been living in chronic pain that has not gotten proper diagnosis or is being treated for their pain with no firm diagnosis. In many of these cases the diagnosis reads: degenerative arthritis because that is all the doctors can find. Case in point: I recently saw a patient who’s been having severe, chronic, low back, hip, and buttocks pain for seven years without a proper diagnosis. She saw many doctors, had MRI’S, epidurals, and shots in her hip without any relief and without a specific reason, other than degenerative disc disease and osteoarthritis.

So, what did I do? First thing…Listen! What did I learn? That none of the other doctors had gotten to the bottom of her problem. There is no way she could have the pain she was having with the diagnosis she was given. So what did I do? I had her get a new MRI-STAT. This revealed an annular tear, which is a disc problem that was missed on the first MRI.

This is definitely the main reason for her low back pain. I immediately sent her for an epidural and started traction. The two best treatments for this condition. The buttocks pain, she kept pointing to the bottom of the buttocks and saying, “This is my worst pain!” Was anyone listening? 99 out of 100 times when someone points to this area, it is the same problem. I sent her for a piriformis injection. Pain abated almost immediately.

So, here we are 2 months later and 90 % of her pain has been resolved and I am hopeful that I’ll make it 100%. The annular tear is a very difficult condition to treat. So, why did she have to be miserable for so many years? First, no proper diagnosis. You can’t fix the problem until you know what the problem is. Second, if you don’t treat these conditions every day, you’re just going to accept the first diagnosis, not realizing that due to the patients severity and chronicity of pain, there was something else going on.