Help me get the best out of my GP re. back problems

[aStabbingStrangleways]

I've got an appt on Monday to discuss my ongoing back problems. About ten years ago I fell down some stairs and landed hard in a sitting position, injuring my coccyx in some way that has never been made clear. After a few days of feeling a bit sore, the muscles around my coccyx went into spasm and I spent several days pretty much immobilised.

Since then, I have had episodic recurrences of this problem. The pain and inconvenience ranges from moderate to severe. When it happens, I get bent into a sort of crone-like position and anything involving lifting, bending or sitting becomes difficult to impossible.

Now that I have two small children, this has obviously become more of an issue! Since DD was born three months ago, the problem has flared up again and never really subsided. I now spend most days hobbling about stiffly with horrible sciatic shooting pains through my hips, legs and buttocks. OTC painkillers do not touch it.

I have spoken to GPs in the past about this but all they've ever done is shrug and suggest I see an osteopath. I did do this after the initial injury and it helped enormously, but I can't afford to see one at the moment. One GP did prescribe co-codamol for a particularly bad bout following DS's birth, but I don't want to be on painkillers for the rest of my life unless it's my only management option.

So what do I ask them for on Monday? A referral to physio? Part of my worry is that DD's birth has somehow aggravated the site of the injury (I was induced and she was born very fast) - who, if anyone, would I see for something like this?

Thanks if you've bothered to read this far!

Ask for a referral to an orthopediac consultant. If you got sciatic type pain then that suggests nerve involvement and you should really have an MRI.

Also ask for a referral to the pain clinic. There are much better drugs than co-codamol for back pain. If there is nerve pain then things such as amyltriptelene are better options and the pain team will be better at working out what is best for you.

have a look at the NICE guidelines for back pain
here
these are what your GP should be following

You can try for a referral to a physio, but the wait is likely to be a long one, first off. Second off, they may not be able to do anything for the problem - they're not ideal for things like that, but they might be able to give you some exercises to do that will help.

Your GP may refer you to a Pain Clinic, which will also try and give you coping mechanisms to deal with the pain.

He may also offer you some drugs, of a muscle relaxant/painkiller variety - up to you if you want to take them (if you're not breastfeeding).

Apart from that, I have to agree with the initial recommendation to see an osteopath - even though you say you can't afford it, think about it - one session could make a lot of difference and it's going to cost you what - £40? Sounds like a lot but measure it up against how much pain you're in and for how long - divide the amount by the number of days you've been suffering since your DD was born - unless it absolutely is a choice between eating and having the osteopathy, I'd get the osteopathy done.

I second an MRI, it's the only way that the doctors can really know what is happening. I went private for an MRI scan - £200 but that was several years ago.

You really need an MRI before potentially wasting money on an oestopath. I've nothing against osteopaths and have spent well over 3k on different ones to no avail. The last one was honest with me after about 6 sessions he said that there was nothing he or any other osteopath could do. They can't unslip my discs.

Obviously this may be different for you but if you have an MRI you know what the problem is and whetehr something could be done by an osteopath.

wow, thank you for all your replies :) i think part of my problem is that, because it's not life-threatening or crippling to the point where i cannot cope at all, i have felt like it is/i am not worthy of serious help, which is pretty stupid when you consider that i've spent ten years having recurring pain [twat] so when i've spoken to docs in the past i've tended to downplay it and almost assume there is nothing they can do to help me, which of course gives them the perfect opportunity to do nothing.

Well, I'd stop that for a start! More peoplehours are lost in the workplace through back pain/problems than anything else, I believe - it can be a major problem.

Thanks again. It is reassuring to know that this is something that should be taken seriously

Another tip is to make sure and describe your back pain very accurately, because GPs can only know if you tell them, don't underplay it.

Also, although physio appointments can take ages, if you have a bad episode where you can hardly move you are very likely to get seen quicker, I always have.

I justify the cost of the osteopath to myself by thinking that if our car was as badly broken as I was we'd be spending hundreds on it. I asked myself whether the car was more important than me.

Good point Ghostie. I will prioritise finding the money for treatment once I've been through any available diagnostics, as I agree with Viva that it's worth me actually finding out what is wrong. Having said that, the osteo I saw after the original accident was a bloody miracle worker, but I do think that the problem has intensified due to DD's birth. I didn't used to get such bad sciatic pain before.

Just as well I booked that appointment as I just had a scary almost-dropped-the-baby moment getting up off the sofa

Whatever you do, don't give up - if the osteopath doesn't work (although from the sound of it this may well be the way to go, and worth every penny), try something else, and something else, and something else. A friend of mine had a bad back for very many years - he'd had operations on it, and physio, complete rest didn't work, he was off work and suffering from depression as a result. For him it was acupuncture that did the trick - within 3 months he was able to drive (albeit an automatic) and was back at work part time. This in turn helped his depression, and so on and so forth.

And don't forget you can do some things to help yourself - be very aware of your posture and what movements aggravate your condition. Learn how to lift properly. Lose weight if that's an issue. Do some gentle exercise (swimming is excellent).

I have had coccyx pain for a year .GP is crap .physio was ok.orthopod a patronising so and so
paid for my own MRI which showed a deformity of coccyx which the orthopods is doing nothing about. the pain clinic doc wants to inject it with steroids by palpation to which I have said no.
I have had 6 sessions with a chiropracter and 3 of accupuncture.
Its not as bad as it was but there are days when I can hardly walk.
good luck to you I hope you have better luck than I

I'm off work with a recurring back problem at the moment. For the first time ever I'm taking muscle relaxants along with the painkillers, and the difference is amazing. I'm still in pain, but I'm far more able to walk normally and can put on my socks without crying (like last week).

Best of luck, it's a miserable place to be.

Thanks all, and I am sending lots of back-healing vibes to fellow sufferers.

Today has been particularly crap and has made me determined to give a full description of the pain and how it affects me. Because I am a coper, I've always classed the pain as fairly low-level i.e. I am not screaming in agony and unable to move. Am now starting to accept that it doesn't need to be that extreme to merit proper investigation! Being in pain and having reduced mobility makes me exhausted, depressed and short-tempered, and that is not how I want to parent or to live my life.

Tis a while ago, but I saw a muscularskeletal consultant for my back problems. Liked the fact that he didn't push surgery as the only option for me. MRI def needed to see what's going on.
Pain management really helped me too. Amyitryptaline for nerve pain and exercise.

thank you, this is all very encouraging :) i will report back tomorrow on what happens.

i should probably say that i watched my brother die of bone cancer a few years ago - it was in his spine and he went through a lot of really hardcore surgery as well as chemo and radio, to no avail - so i have a bit of an extra layer of anxiety about living with long term back problems. not because i think an MRI is likely to show the same, it is vanishingly unlikely. just that experiencing sciatic pain and reduced mobility gives me a horrible deja vu feeling nad brings back a lot of bad memories, as well as being crap on a practical level. not sure whether i will mention this tomorrow though as i don't want to be written off as merely anxious.

Good luck tomorrow, as you can see from guidelines ix are not high on the list however family hx and your additional worries are very very justafiable and I woulod recommend you do tell your gp. Patient concern is a reason to do something

hooray, referred for MRI :) gp was very nice and actually listened, asked me lots of questions etc.

all very different from when my brother fell ill - his gp refused to send him for an MRI scan despite a list of ever-worsening symptoms including loss of feeling and incontinence.