Pain Management

[JudyW]

I had ADR at L4-5 and have spondylosis at L5-S1. I also had two surgeries on my right shoulder for a labral tear. During those recoveries from the shoulder surgeries I put too much strain on me left shoulder. So long story short. I need a pain management doctor that can handle my back and shoulders AND they have to accept workers comp. If anyone knows someone really good in Orange County or Riverside California, please let me know.
Thanks

[Toebin]

Hi Judy,

I too am from So Cal (LA County) and have had some difficult pain management issues.. I've gone through a few certified "pain management" type doctors and have yet to find one that was willing to listen and work with me. BUT.. just to give you something to think about..

I've been seeing an arthritis specialist for the past couple of years and she has done wonders with not only my pain but several other problems related to underlying medical issues. She's not only a good listener but I find doctors in her field usually deal with a lot of strange and unique problems and tend to listen to their patients symptoms more..

Maybe I just dealt with bad pain management docs, but they all seemed to have their cookbooks out and if you didn't fit into that recipe you were sort of out of luck.

Best of Luck as I know finding the right doc can be difficult.

[ZorroSF]

so you have spondy and L5S1 and ADR at L4L5? which came first? is L5S1 a result from ADR at L4L5?

I suggest you search google for all the pain management doctors in your area and just contacting them all to find out who accepts your insurance then ask for 3 references.

[JudyW]

Not sure which came first. When I had my very first MRI it showed the degenerative disc at L4-5 and the spondylosis at L5-S1. During the process of getting injections, discogram etc and seeing all the other CT scans, xrays, MRI's, we saw the beginning of degeneration of the disc at L5-S1. Don't know if that was always there and the first tech didn't see it or it progressed as time went on.

[Harrison]

Judy, this may not help much, but I myself as a layman continue to be amazed as to how complex a given diagnosis can be. For example, just looking at your L5-S1 situation, take a look at these definitions for spondylosis below.

Any way, have you made any progress finding a doctor?

Zorro, good idea about the three references.

____________________________________________

Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. In this condition the interfacetal joints are not involved. ...
www.wikipedia.org/wiki/Spondylosis

A degenerative disease in which the vertebral joints of the spine become stiff and then fused
www.wiktionary.org/wiki/spondylosis

A degenerative process of the spine that causes a narrowing of the spinal canal and produces compression of the spinal cord and nerve roots. This can lead to stiffness and eventually fixation of the joint.
CPRNJ - Resources, Medical Glossary

degenerative processes that affect the intervertebral disc.
creightonhospital.staywellsolutionsonline.com/Library/Encyclopedia/85,P01158
Arthritis of the spine.
Scoliosis – FREE Scoliosis information | Encyclopedia.com: Find Scoliosis research

Abnormal immobility and fixation of vertebral joints.
Glossary of Botanical & Medical Terms - Planet Botanic Canada

Non-inflammatory degenerative (wear and tear) disease of the spinal column as we get older, such as degenerative disc disease
Patient Resources - Glossary

bone spurs along the margin of the disc
Palm Beach Spine Glossary

[Eskimo]

Originally Posted by Harrison

Judy, this may not help much, but I myself as a layman continue to be amazed as to how complex a given diagnosis can be. For example, just looking at your L5-S1 situation, take a look at these definitions for spondylosis below.

Any way, have you made any progress finding a doctor?

Zorro, good idea about the three references.

____________________________________________

Spondylosis is a term referring to degenerative osteoarthritis of the joints between the centra of the spinal vertebrae and/or neural foraminae. In this condition the interfacetal joints are not involved. ...
www.wikipedia.org/wiki/Spondylosis

A degenerative disease in which the vertebral joints of the spine become stiff and then fused
www.wiktionary.org/wiki/spondylosis

A degenerative process of the spine that causes a narrowing of the spinal canal and produces compression of the spinal cord and nerve roots. This can lead to stiffness and eventually fixation of the joint.
CPRNJ - Resources, Medical Glossary

degenerative processes that affect the intervertebral disc.
creightonhospital.staywellsolutionsonline.com/Library/Encyclopedia/85,P01158
Arthritis of the spine.
Scoliosis – FREE Scoliosis information | Encyclopedia.com: Find Scoliosis research

Abnormal immobility and fixation of vertebral joints.
Glossary of Botanical & Medical Terms - Planet Botanic Canada

Non-inflammatory degenerative (wear and tear) disease of the spinal column as we get older, such as degenerative disc disease
Patient Resources - Glossary

bone spurs along the margin of the disc
Palm Beach Spine Glossary

Harrison, unfortunately doctor's often use terminology that isn't at all very specific. Furthermore, two doctors will often use the same word in a slightly different way from one another. Often enough two doctor's use slightly different wording to describe a patient's problem even though if you sat both down they would agree that they agree with one another. This makes things confusing for patient's who go see a few different doctors for the same problem.

In terms of spine problems, spondylosis is a very non-specific term but generally implies a degenerative condition of the spinal joints and/or discs. OTOH, spondylolysis and spondylolisthesis are very specific terms referring to a very specific type of abnormality usually seen on x-rays. I would say most doctors don't use the term spondylosis much anymore and the doctor who used them term may be very old or have been educated elsewhere.

As for the OP's question, the only way to resolve the issue definitively would be to go back and look at the two sets of images. Sometimes your family physician (or whoever is managing the problem) can ask the last radiologist to directly compare the two films for evidence of progression between the two films.

[Toebin]

Judy,

Kind of along the same lines as what Zorro said.. I know in the hospital I used to work at if someone called for a recommendation to a doctor we would give out 3 names of local physicians in the area. They can't recommend any particular MD but they can give you names to research... might be something that will at least give you some contact names...