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What type of Doctor would be best for upper back pain?

Started by juliek75 on 06/17/2010 7:22pm

I am an RN and I know that in itself has a lot to do with my back problems, but I've always had a weak back. I am a 34 year old that feels like I'm living in a 84 year old's body. Lately the past 3 years I've got this horrible back pain in my upper back, it radiates more to the left, but by the end of the day it covers the whole upper back sometimes radiating around the ribs and chest. Now just this past week my lower back decided it felt left out and decided to start hurting too! I've switched MD's three times and got referred to an orthopedic doctor, they did x-rays which show very mild scoliosis and kyphosis, supposedly not enough to be causing so much pain. Also showed degenerative changes. I tried physical therapy and it didn't really help, because of my job I can't take anything strong and the Motrin and mild muscle relaxer, Skelaxen don't really do much at all for relief. I feel like the doctors don't understand just how much pain I am really in, or they think I'm making it up, it seems like everytime I have an appointment it ends up falling on a "good back day" when the pain is only about 4/10, where days like today it is definately a 9/10. At work I push through it because I must, but it affects my homelife, I don't have any ambition to do anything because it will cause pain. This was a very longwinded post but I guess basically I just want to know which type of doctor would be best for my type of pain. Or if anyone can make any recommendations for a good one in Pennsylvania or I'm even desperate enough at this point to travel further if I can find the doctor who will finally listen to me.

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My own experience with back and neck pain is extensive from both the patient and practitioner side, and my advice would be to either 1) look for a medical school with both a good reputation (plenty of metro areas have ratings based on extensive patient reports--Pittsburgh may; PA is large and surrounded by states with cities full of amazing practitioners, so I am not sure which direction you need to travel to hit the nearest metropolis) and also a SPINE CENTER--"orthopedist" is quite vague--some fix broken limbs, some are podiatric orthopedists but not called podiatrists, and some are what you would want, a SPINE SPECIALIST. ... The other option is 2) a PAIN CENTER as •Most pain treated IS back pain, •Many double as spine centers, and •Most start with MRIs of the back to find damage and the majority I have been to (as I have moved, otherwise I would never stray from the loved MDs I have been treated by!) have dozens of treatment options and are very client-centered...

This site has a profile for Hari Gabriel in Pittsburgh-Gabriel Pain and Spine center (something to that effect) the center name, and it *seems* like Dr Gabriel is very educationally like my own long term pain doc: mine was an anesthesiologist that **check as this is important in my opinion!!** went BACK to school to obtain licensure as a pain specialist, required in some states but NOT ALL. Dr Gabriel is an anesthesiologist with a pain/spine center, so he may very well have gone back to reschool... As so many procedures (I had radiofrequency nerve ablation performed and suddenly BOOM I was so much more mobile and active! Nerve blocks are also great for some...) and therapies (TENS units, traction therapies oriented at reducing degeneration of discs and vertebrae, intrathecal delivery of very low doses of medicines, etc) ... You want a doc who knows about it ALL. Some people even get relief with simple injections every few weeks or even months for some; those would keep you narcotic free...

Has Ultram been considered? If not, it is a SUPER medicine with few side effects, though for me the extended release made me drowsy--the regular never had any negative effects by contrast, though it can lower seizure threahholds--nothing is 100% risk free, of course.

I have found that the range of physical therapy effectiveness is ridiculously wide... from waste of time or even more debilitating than helpful to a perfect compliment to the doctor's therapies. Depending on whether there is arthritis present, common with spinal pain, especially in women, you will want a non-NSAID inflammation treatment. You may want to seriously consider also being evaluated by a rheumatologist if arthritis or fibromyalgia (or lupus or arthropothies like ankylosing spondylitis) descriptions match your experience enough to even consider a bit of bloodwork and potential genetic screening if the facility is advanced enough (I mention this in part as these autoimmune conditions go untreated quite often, are misdiagnosed SO MUCH, and evolve and get worse without treatment most often; some DO go into remission, though).

I hope this is of help; closest great options I can think of are in Nprth Carolina; I am certain someone is closer! Take care!

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This is very interesting because you have just described my pain exactly. I've been dealing with it for 5 years now but it is getting worse. I went to a chiropractor for the first time 1 year ago and have been seeing him ever since. It helps but is not nearly enough. I've joined the YMCA to exercise and strengthen my core. This too doesn't help. I find myself planning activities etc. around my upper back pain. I'm not sure who to make a doctor's appt. with, so I've done nothing in that department yet. I need to do something though because I am 41 years old and cannot keep living like this. Please keep posted of any relief you find because I am lost too.

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