Anchie, I am so sorry that you are so uncomfortable and having such a hard time sorting out how to get the best help for your back pain. There are so many lovely responses here, and it’s clear from them that there are numerous potential causes for low back pain such as you have described. (Arthritic changes, disc problems, muscle imbalances and tightness IT band, sacroiliac joint syndrome). Do you have any Physical Medicine and Rehab. Specialists? Maybe it would also be called Sports Medicine. I believe they are best equipped to sort out this sort of problem because they have excellent functional knowledge of the human body along with pain management training that crosses between exercises/physical rehabilitation and medical interventions including procedures and medications. If you go to an orthopedic surgeon, they know surgery, and you will most likely end up getting a procedure like the infusions. If you go to an osteopath, they may miss something like a sacroiliac syndrome on the opposite side causing paradoxical symptoms, or perhaps functional or actual leg length discrepancy, or piriformis syndrome, etc. The nice thing about some PMR specialists is that they can refer you to an orthopedic person if needed, or to a good physical therapist, a neurologist or to a more specialized pain management specialist if they feel their training is inadequate.
It is clear that you do not trust your orthopedic doctor. I think your instinct is correct but more on that later. Did you get a clear diagnosis from him/her? Did he give you the reasons for his treatment strategy? How about from the other doctor? If you have a clear diagnosis, and understanding of their recommendations, you can probably do a bit or research and see what the standard of care should be for treatment interventions and also look at the outcomes for those interventions. Can your doctors give you the Cochrane data or equivalent to support their interventions? There is a fairly decent evidence base regarding back pain.
Why didn’t you go to the physical therapist suggested by your orthopedic specialist? My guess is that you already know the relationship with him is compromised and you have no intention of continuing treatment with him. Most doctors have a group of professionals they refer to regularly for a specific reason. The person has a specific skill set that would be helpful, or the person is a good communicator with the doctor, etc. In your case, your doctor has already hinted that you are failing to follow his treatment plan, and if you go to a different physical therapist this also goes against his recommendation. Now, if you complain to him that you are not feeling better, he will simply say it is because you failed to follow his instructions. You can not hold your doctor accountable for his failure to help you. His belief is that you failed to follow his plan. He then never feels badly about his treatment approach and can go on thinking that the failure was with you. He can and will go on treating people the same way——without changing his approach. His excellent reputation remains intact. There’s some faulty logic here.....right?! He’s blaming you for not feeling comfortable with his treatment approach, but did he offer an explanation for it other than it’s what he recommended and you wanted his advice? Unless he can go back and rescue things by explaining himself, he’s clearly not the sort of doctor you prefer. He sounds paternalistic and like he expects you to accept what he advises just because he has credentials and experience. That’s fine for some people, but I don’t think it is for you. He hasn’t attended to the interpersonal relationship between you, or shown any respect for your remarkable intelligence.
