Trauma Surgeon Questions Trauma Surgeon

PCP refusing to listen?

About 6 or 7 years ago, I slipped and fell causing some bruising at the back of my left thigh to the buttock. Ever since then the pain comes and goes every 2 to 3 months. For the past year, the pain seems to have intensified to where I'm not even able to walk or stand for very long. I feel like I may be damaged some nerves during that fall. I've gone to my PCP a few times requesting for him to send me out for some imaging but every time I mention it, he automatically claims that there's nothing wrong with me and it's just only my diabetes that is causing me pain. What should I do to get some actual care and see what's been causing me pain all these years?

Female | 64 years old
Complaint duration: 6+ years
Medications: Ace, Metformin
Conditions: High blood pressure and type 2 diabetes

10 Answers

I would recommend finding a Naturopath doctor. Set up a consultation.
Start Acupuncture with Moxibustion. You would need a lumbosacral MRI. Consult with a Telehealth physician. Consult Functional Medicine.
I can see that this can be frustrating as you are in pain. Since you are a Diabetic I assume you have an Endocrinologist? I would have them refer you out to an orthopedic or neurosurgeon, or order an MRI. This would give some reassurance hopefully to see if the problem is stemming from your lower back, since you stated you had a fall.
Since you had a slip for accident, and your symptoms have been ongoing for several months now it would be most reasonable to have some imaging done of your lumbar spine. The lumbar spine is the lower part of your back which can easily cause your symptoms that you’re feeling because of pinched nerves, or maybe inflammation of a disc. It is not unreasonable to considering some type of imaging consisting of low back x-rays or possibly a lumbar MRI. What complicates your condition is your diabetic neuropathy. Yes go to a primary care provider, orthopedist or a chiropractor to determine the cause of your symptoms. I believe this should be done sooner rather than later!!!!
The injury is more likely from the slip more so than the fall. The pelvis is three bones held together with an amazingly dense series of ligaments. There are ZERO muscles that move the pelvis. This makes it vulnerable to sprains. The primary mechanism of the sprain is the slip...with or without the fall. Find a chiropractor who specializes in the SOT (sacro-occipital technique) method.
Your problem needs a proper history and examination to understand the mechanism of injury, then and only then a course of treatment can be developed. A Chiropractor, an orthopedist, or a DPT is well versed to find the cause of your pain and find a cure.
If you have an HMO plan, PCP needs to make a referral to a neurologist or neurosurgeon. If your insurance is a PPO then you can make your own appointment for answers. Sorry about your PCP.

I recommend that you have an Electrodiagnosis examination as soon as possible to determine what is causing your pain and where the lesion is. I do Electrodiagnosis medicine at my Clinic. Most plans do not require a referral from your PCP.
I’m sorry to learn that you’ve been suffering for so many years. Although diabetic neuropathy is common, the onset of your pain has likely been caused by falling and sustaining injury to your lumbar spine (lower back), left hip joint or both.

Unfortunately, the family practitioner (PCP), although knowledgable in diagnosing and treating chronic health conditions, are not typically trained in disorders of the neuro musculoskeletal system.

The injuries that are acquired by accidental slip and falls, automobile accidents, athletic (sports injuries), etc., are best diagnosed and treated by orthopedic specialists, doctors of osteopathy, neurologists and/or chiropractors.

You can ask for a referral to any one of the specialists mentioned above. I recommend a thorough musculoskeletal examination of the lumbar spine and left hip joint followed by xrays of both areas. An MRI scan of the lumbar spine and possibly the left hip may also be necessary to rule out lumbar disc herniation and/or lumbosacral and left hip internal derangement.

Following a proper diagnosis, there are options including physical therapy, chiropractic, acupuncture, pain management and/or surgery, as a last resort, to reduce your pain and discomfort.
Given the trauma and recurring pain, a simple set of X-rays may shed some light on the issue or at a minimum rule out a few. As a chiropractor, NMS(neuromuscular-skeletal) issues are all I am concerned about. Find a good chiropractor. And chiropractic is NOT all about manipulation.