First post, advice needed!

[rbrown]

Maria?
If the spasms are being caused by a disc or nerve issue will the Toradol still help? I realize this is difficult to answer. But if it is disc or nerve related and the Toradol helps is it likely that the spasms will just return once the Toradol wears off?

[Maria]

Basically anything you use medicinally is just to break up a cycle of spasms or cover up the pain depending on type of medication.

Sometimes covering up something can be a good thing. As an example I got Epidural steroid injections over a 10 year period because they greatly helped to masque the pain I had from a leaking bulging disc at L5 and L4.

In that period of time the L5 area had an autofusion of the facets which has greatly alleviated pain I used to have at that level and gave me a semblance of stabilization at that level.

I avoided having a fusion surgery at L5 and in fact I avoided having a 3 level global fusion (thanks to ESIs being helpful) and I didn't have a proposed L4 ADR and L5 fusion.

Now whether I would have been better off with the ADR and fusion done I don't know I only know that I am quite certain I am better off NOT having had the 3 level global fusion.

Currently I get Toradol shots when my L4 is acting up and locks my back up ro my cervical spine acts up and my neck locks up badly. It helps very much. For me it's likely the involved disc has leaked a bit of toxic material on the nerve and aggravated things so the muscles start doing their protective guarding action (or spasms).

Toradol is not going cure you by any means but it may give you a break. I'm only suggesting it because back when I used to have horrendous spasms I spent weeks in bed hardly moving because that's what it took to get over the muscle spasms. Now I can get a shot of Toradol and pretty much be back in action right away.

What works for me may not work for you but many people I know get Toradol injections for their back spasms and it helps. If you want to wait until you see a specialist and find out exactly what is going on with your back as best one can tell you I understand that however if you want to get some relief from severe spasms in the interim a Toradol injection can likely help with that although your clinical picture will not be changed whatever that is and the only way you'd know if it would help you is if you get an injection.

I cannot say 100% that it will help you but it's surely worth a try and only then will you know if it helps you.

[rbrown]

Well I haven't had any spasms yesterday or today as of now. I'm being very careful with my movements, always tighten the abs before I move. Doing my PT exercises and walking some. My low back starts to ache pretty fast when I'm upright sitting or standing. I obviously still dont know if this "episode" (4-6 months varying degrees) is muscle or spine related. I hope its muscle and starts to get better with rest and PT. Rest is always ironic because the more I rest the more the muscles atrophy which makes it hard to do PT without my back getting sore and possibly back to spasms. If it is disc or nerve related I suppose it could still "resolve" itself but who knows how long that might take if ever. I'm still waiting on a referral for a second opinion to see a spine specialist.

[Maria]

Sometimes I have a few months without any probs sometimes up to about 6 months re debilitating spasms.

[rbrown]

Found out today the referral I requested for Ortho spine specialist was denied and instead was given a referral to another Nuero surgeon. (Dr. Gregory Withers in Arcadia) who is 66 years young. Not that age is an issue but unlikely that he is doing minimally invasive surgeries or any of the more modern techniques. My primary did say Toradol shot was no problem and I can come in to get it.

[Maria]

Good re the T-shot and re the referral my Orthopedic Spine Surgeon is in his 60's and is doing ADR surgery too. I don't think he was into it as early as some of the younger guys but he got into it because it's been around a while now and is FDA approved. Sometimes some of the older guys pick up the newer techniques as well to stay competitive or may have a younger partner that is doing that type of surgery.

Even with HMOs you have the right to ask for a 2nd surgical opinion. Some will tell you that you do not but that isn't true. If there is no one in the HMO that is within a reasonable distance to you than you can request to see someone of your choice that is and go thru the process of trying to get that authorized. What I don't like about HMOs is that whomever works for them is pretty much ruled by HMO system in terms of how to proceed. I mean almost strictly by logarithm (sp). I'm not saying there aren't good surgeons in some HMOs but they are so bound by procedure according to how the HMO dictates they proceed.

Anyway everything now goes thru Peer Review or Utilization Review or something that takes decisions almost out of the surgeon's hands re insurance companies. It can be a real uphill battle in some circumstances to get a surgery authorized and in others not. I guess we'll see how things go for you and I do hope you will find this referral informative and helpful. Please excuse my HMO bashing. I guess you can tell I'm not a fan of managed care but I do not mean to rain on your parade.

Don't ever let the HMO talk you into seeing someone that is in the same office as a 2nd surgical opinion because you want an unbiased 2nd surgical opinion and that comes from someone that is not in the same office or practice.

[jsewell]

Sorry you are stuck with someone that is older and may not know new techniques, but it can' t hurt to go see him. glad the shot is no problem. i think i would try the shot and get this doctors opinion. You do need to know what is going on and any spine surgeon should be much more help than a primary doc.
judy

[rbrown]

Maria;
My HMO is United Healthcare, I'm currently in the Healthcare Partners network. There isnt an Orthopedic spine surgeon or specialist in the entire network. Does that mean if I appeal the denial to see out of network specialist (Dr Costigan) that they might approve it since there isnt one available at all in "network"?