6 Topics to Help You Talk With Your Spine Surgeon

SpineUniverse spoke with Lali Sekhon, MD, PhD, FACS to obtain his advice about preparing for and getting the most from an appointment or consultation with a spine surgeon.

“I know that patients don’t have the knowledge bank that I do,” says Dr. Sekhon. “But each patient has a story to tell, and I want to hear that story.”  When “writing” your story, it helps to include the classic narrative elements of how, what, where and when—and be as specific as possible.

6 Topics to Cover in “Your Story”
Use the six topics below to help you “write” your story then review the lists below dealing with symptoms specific to neck (cervical spine) or back (lumbar spine) pain. One caution: Your story shouldn’t be a novel. “Keep it to a paragraph,” advises Dr. Sekhon.

1) How did the pain start? Explain what you were doing and if the pain came on suddenly or gradually.

2) How long have you had the pain (months, days, years)?

3) Where is the pain? You might say something like, “It starts in my back and then travels down my left leg. Or, the pain “starts at the base of my neck and then spreads to my right shoulder and down my right arm.”

4) Describe the pain using words like burning, tingling, stinging, stabbing, dull, sharp or achy. Explain if the pain is constant, intermittent or even cyclical.

5) When is the pain better? Worse? What alleviates or aggravates the pain? Is it better in the morning and worse at night? Is it better when you stand or sit? Does walking help or make it worse?

6) How is the pain affecting your daily life?

Talking Points About Cervical Pain (Neck Pain)

• Does extension of the neck give you any symptoms? (Extension means to bend backward)
• Are you more unsteady on your feet?
• Have you fallen or noticed a loss of balance?
• Have you noticed any weakness in your extremities? (Extremities are your arms, legs)
• Can you use a knife and fork? Pick up a pen?
• Have you noticed any change in coordination?
• Have you noticed loss of muscle bulk?
• Have you noticed a recent weight loss?
• Are you having fevers or night sweats?
• Are you experiencing any bladder or bowel problems?
• Are you experiencing numbness in the crotch area or difficulty passing urine?

Talking Points About Lumbar Pain (Back or Low Back Pain)

• What symptoms or pain do you experience when walking, lying, sitting or standing?
• Is the pain better when you’re sitting down? Worse when you’re standing?
• Is the pain better or worse in the morning? At night?
• Is the pain better with activity?
• Do you wake up with stiffness in the lower back?
• What parts of the body does the pain travel to (inside/outside of legs, one leg or both legs)?
• Have you fallen or noticed a loss of balance?
• Have you noticed any weakness in your legs?
• Have you noticed any change in coordination?
• Have you noticed loss of muscle bulk?
• Have you noticed a recent weight loss?
• Are you having fevers or night sweats?
• Are you experiencing any bladder or bowel problems?
• Are you experiencing numbness in the crotch area or difficulty passing urine?

Bottom Line: Faith and Trust
Depending on your responses, physical exam and any diagnostic tests, you and your doctor will discuss treatment options. “It’s important to remember that medicine is both a science and an art,” says Dr. Sekhon. Doctors within the same specialty have different approaches to the same problem. “And at the end of the consultation what the patient has to decide is: Am I going to put my trust and faith in that doctor?” he adds.

Ultimately, you have to be comfortable with your doctor. But if the doctor seems distracted or can only see you for five minutes, “find another doctor,” says Dr. Sekhon emphatically.