/ Medical Matters - Second Opinion

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FesteringSore - on 04 Jul 2017
Five weeks ago Mrs. F. fell on the stairs and hurt her back. To keep it brief she has had long term arthritis in her shoulders but since the fall she has had excruciating chronic pain in her lower back. She had an x-ray which indicated no damage. She has taken pain killers but they do not always agree with her and in any case seem yo make no difference.

I honestly think this may be an instance of the GP not being able to identify a problem so has resorted to the universal panacea of "take a couple of paracetamol". She has even been to an osteopath. She feels as if the GP is trying to fob her off.

How does one get to see an orthopaedic consultant - privately if necessary? She shouldn't have to live with constant back pain and it's getting us both down.

Can anyone help PLEASE?
captain paranoia - on 04 Jul 2017
In reply to FesteringSore:

Go for a second opinion. X-rays do not always reveal fractures, or they may be missed on the assessment. The GP may not be associating the chronic pain with an accident, and may just be thinking 'oh, another bad back...'

Go back to the GP and remind them this is due to a fall, the painkillers are not helping, and request more detailed imaging; CT or MRI. Point out how much the pain is affecting both your lives, and your long-term health. The GP should at least be able to give their explanation for why the pain is not receding after five weeks; bruising ought to be recovering by now. GPs expect you to keep going back if things don't improve, so you have to play the game; they won't pro-actively follow up appointments to make sure things are getting better.

I know someone who fell and hurt their back, went to A&E, and the doctors didn't take an x-ray because their assessment of the injury (by mobility) suggested to them no fracture. Five years of pain later, an orthopaedic consultant went very pale when he heard the answer to the question "and what did the A&E x-ray show...?". It turned out that there was an unresolved fracture, compounded by osteoporosis that a proper interpretation of patient history should have alerted the A&E doctors to... The resulting poor posture to compensate for the pain probably contributed to the need for a hip replacement. All for the cost of an x-ray...
Post edited at 18:19
ian caton on 04 Jul 2017
In reply to FesteringSore:
Go see GP and ask for physio ànd or referral to consultant. Gets you in the queue.

Go see a private physio before seeing gp. Show's you are serious.

Either gp or private physio can refer you to private consultant.

Do research on web to find out which consultant you want to see. Look at their cv's etc.

Think about getting private MRI separately. £199 or so. In house can be £600 plus. But specifying exactly what MRI will need help from physio or other.

But: consultants think knife !!!

Do listen to what they all have to say.

Senior specialist NHS physio's are often very good.
Post edited at 18:23
Dave the Rave on 04 Jul 2017
In reply to FesteringSore:

Forget physio at this stage.
She has had a traumatic injury to her back which as yet is undiagnosed as 'not' a fracture.
Call your local private hospital and get orthopaedic assessment and MRI.
Don't expect much change from £750.
Andrew Lodge - on 04 Jul 2017
In reply to Dave the Rave:

Agree with Daves comments above.
ian caton on 04 Jul 2017
In reply to Andrew Lodge:

But you need refering by gp or physio, you can't just phone up and go.

Least ways, no where I have been.
Dave the Rave on 04 Jul 2017
In reply to ian caton:
> But you need refering by gp or physio, you can't just phone up and go.

> Least ways, no where I have been.

Hi Ian. You can phone up and have a consultation privately in England and Wales. On the Nhs you need referral.

We had to do this for my wife's back pain. A £400 pound MRI FOUND 90/c occlusion of the spinal canal by a sequestrated disc. This could have left her without bladder/bowel function if left untreated.
Festering:- if your wife has any problems with her bladder or bowel or any saddle anaesthesia( numbness down below and around her anus)then it's a medical emergency.
Post edited at 20:09
ian caton on 04 Jul 2017
In reply to Dave the Rave:

Not here you can't.
Dave the Rave on 04 Jul 2017
In reply to ian caton:

> Not here you can't.

Where are you and which private hospitals did you try?
Dave the Rave on 04 Jul 2017
alx on 04 Jul 2017
In reply to Dave the Rave:

I read the OP and immediately thought of my father whom after a fall onto his back suffered a slipped disc. Almost same intractable pain described. The docs wrote him off for months as having a bad back and prescribed him exercises and attendance at a back clinic. Second opinion, MRI, followed by a couple of cortisone injections had him back to normal - as normal as normal can be for a 70yr old.
Climbing Pieman on 04 Jul 2017
In reply to FesteringSore:
Others have covered things, but worth repeating what Dave the rave said - if bowel or bladder are affected, and/or numbness is present in the groin then this is an NHS emergency and she should go to A&E urgently. Google cauda equina syndrome for full range of symptoms.

Otherwise, from long term experience of spinal problems myself, pain itself does not make the NHS act quick, so she needs to know what is wrong and private maybe the way to go , if waiting list times are as long as thy have been for me a couple of times.
Bellie on 04 Jul 2017
In reply to captain paranoia:
I once badly broke my wrist. The nurse ruled out a break due to mobility, but humoured me with an x-ray, even though I knew I'd broken it. Turned out it was quite broken, and the nurse wandered around waving the x ray to others saying this guy has full mobility in (insert medical name for actual bone here) and I should not have been able to move it.

Very recently a friend's Mum had a fall. GP ruled out anything amiss despite her protests. More pain and GP physio did a bit of work on her leg. More pain, and they basically claimed she was putting the crying on to get attention (as you do!) More pain, and an ambulance was called. Paramedic did basic examination and said - I'm not surprised you are in pain - You have been walking round with a broken leg for a fortnight.

So if Mrs Festering Sore is in pain. Don't just accept their word for things. However much we put them on pedestals - they can be wrong.

- responding/adding to the Cap'n's missed diagnosis stories.
Post edited at 23:51
FesteringSore - on 05 Jul 2017
In reply to All:
Many thanks for all the replies. I'm looking at various options at the moment so please forgive the brief, non-individual reply
Nbrain - on 05 Jul 2017
In reply to FesteringSore:

Really sorry to hear this story about your wife.

I think most of the problems are the communication between the GP and yourselves.

Although the X-ray is normal this doesn't mean there isn't any damage just that there are no broken bones. There may well be soft tissue injury that can take a long time to heal.

If I were you I would be a little wary at going privately at this stage. The NHS is excellent at managing acute injuries and my experience of private consultations for back surgery is entirely positive.

You need to have a conversation with the GP asking about the likelihood of underlying injury and the value of further imaging. The aim of the game is to exclude any injury that you could make worse by exercise really.

Unfortunately the mainstay of treatment is likely going to be physiotherapy and analgesia and it may take a long time to improve.

Although getting an MRI might give you a diagnosis it won't necessarily change the road to rehab.
Tom Cox - on 05 Jul 2017
In reply to Bellie:

Just giving my thoughts from the other side of the fence on this. Sounds like a terrible case of a lazy GP not assessing these injuries properly and not adequately addressing patient concerns. However I would urge everyone here not to taint all doctors with the same brush; most do a fantastic job and really do care for their patients. Just because you don't agree with their opinion it doesn't necessarily mean they're fobbing you off!
ceri - on 05 Jul 2017
In reply to FesteringSore:

When my GP didn't refer me for a long standing poorly knee I sent her a letter complaining that I had been denied suitable treatment. Less than a week later I had my referral letter for a scan which showed I needed surgery. Push harder, if you are not comfortable doing it in person send a letter.
ian caton on 05 Jul 2017
In reply to Dave the Rave:

Fair enough. Calderdale. But our local private place wants to know whose refering all the same.

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