Getting a Second Opinion: When You Need a New Orthopedic Surgeon

Back and neck problems are often complex and can be difficult to diagnose and treat. A lot of neck and back issues are misdiagnosed in the first place, and even with an accurate diagnosis, identifying the best treatment is a concern. Some doctors may recommend a treatment with serious and permanent consequences when an alternative treatment may be better suited to your needs.

If you’re concerned about what your doctor has told you, it may be wise to get a second opinion. Talking to an expert orthopedic surgeon can give you peace of mind, a better understanding, and a more confident treatment plan.

Reasons to Get a Second Opinion

There are two main reasons that a patient may want to get a second opinion from an orthopedic surgeon: first, to confirm the initial diagnosis, and second, to determine the best treatment to alleviate the problem, provide symptom relief, and prevent future issues.

Confirming Your Diagnosis

It is not uncommon for orthopedic problems to be misdiagnosed, especially if your primary care doctor is not a spine surgeon. Some of the most commonly misdiagnosed back and neck problems include:

  • Herniated or Bulging Lumbar Discs: A bulging or herniated lumbar disc is a common back problem that may be mistaken for other issues. Because it pushes on the nerves, it can cause pain, burning, numbness, and weakness in the back, buttocks, legs, or all of the above. In some cases, a herniated disc causes little or no back pain, making it more difficult to diagnose.
  • Bulging or Herniated Cervical Discs: A cervical disc herniation is frequently misdiagnosed because symptoms may be felt in the upper back, arms, or hands. Symptoms may include pain, burning, numbness, or weakness, and even neurological issues such as difficulty walking. Many individuals, especially when neck pain is not a significant symptom, do not even realize that they could have a herniated cervical disc.
  • Slipped Disc: A slipped disc puts pressure on the nerves or spinal cord, which over time can lead to other problems. This condition is often misdiagnosed, especially in females (for whom this condition is incredibly common).
  • Sciatica: Compression or irritation of the sciatic nerve can cause pain, numbness, and tingling in the legs. Identifying the source of the compression can be difficult, and it is only with a correct diagnosis that the right treatment can be administered.
  • SI Joint Pain: The SI joint, which connects the lower spine and pelvis, is often missed as the source of low back pain. One study found that SI joint pain was missed in half of failed lumbar fusions.
  • Lumbar Spinal Stenosis: This narrowing of the spinal canal in the back region can cause a wide range of symptoms, such as low back pain, numbness, or tingling in one or both legs. It is often mistaken for arthritis in the hips, and over time it can cause permanent numbness, weakness, incontinence, balance problems, and even paralysis.
  • Cervical Spinal Stenosis: This narrowing of the spinal canal in the neck region is commonly misdiagnosed as carpal tunnel syndrome or peripheral neuropathy. Because it can lead to cervical myelopathy, which may result in irreversible paralysis and severe loss of function, an accurate diagnosis is critical.
  • Cervical Myelopathy: This condition is when cervical stenosis has progressed, and spinal cord cells are dying. Symptoms include issues with the hands and arms, dexterity, and balance, with or without neck pain itself. It is often misdiagnosed as peripheral neuropathy or carpal tunnel syndrome, and it is one of the most commonly missed diagnoses among our patients.

Misdiagnosing any of these back or neck problems can lead to serious problems. If you are concerned about a diagnosis that you have received, a second opinion can give you peace of mind.

Getting a second opinion can confirm whether you have been correctly diagnosed. If a second surgeon confirms the initial diagnosis, you can feel more assurance moving forward with your treatment plan. But if the second surgeon indicates that the initial diagnosis was incorrect, it will lead toward getting a more accurate diagnosis. You will also know that the initially recommended treatment may not provide relief, because your doctor needs to have a correct diagnosis to recommend the right treatment for your needs.

Getting the Best Treatment Recommendations

The other reason to get a second opinion is to determine the best treatment. If you have concerns about the treatment recommended by your initial doctor, you may want to speak to a spine surgeon. A spine surgeon can confirm the diagnosis and indicate whether the initially recommended treatment is the best option. If it is not, or if there is an alternative treatment option, the spine surgeon can recommend a treatment that may be better for you.

For example, your initial doctor may recommend you get spinal fusion surgery for a herniated lumbar disc. However, in many cases, a bulging disc can be replaced by an artificial disc through lumbar disc replacement surgery. This procedure preserves full range of movement and reduces wear and tear on the adjacent lumbar discs after surgery. Although still a major surgery, disc replacement has a shorter recovery than fusion surgery and is often preferred by patients. Dr. Pehler has performed many artificial disc replacements and may recommend it to you as treatment for a bulging lumbar disc.

Another example is treatment for a cervical disc herniation. Some doctors may recommend you get neck surgery, which can be a scary proposition for the patient. However, if there is no accompanying compression of the nerves or spinal column, it may be possible to avoid or at least postpone neck surgery for a long while. Dr. Pehler has experience with conservative treatments such as physical therapy, medication, and/or spinal injections, which may provide sufficient symptom relief and save you from having to undergo surgery.

If you are considering a second opinion, these are some things to keep in mind:

  • Make sure to find a board-certified orthopedic spine surgeon.
  • Request your medical records from your initial doctor or surgeon so that you can share them with your new spine surgeon.
  • Ask your second surgeon for a detailed explanation of the diagnosis, what treatment options are available to you, and whether surgery will be necessary.

Getting a second opinion is the best way to make sure that you’re receiving the best possible care. If you suspect that there may be another option besides surgery, or if you have doubts about the accuracy of your initial diagnosis, reach out to a board-certified orthopedic spine surgeon for a second expert opinion.

Dr. Stephen Pehler is a board-certified orthopedic spine surgeon with extensive experience helping patients like you get an accurate diagnosis with a proper treatment plan. To book an appointment with Dr. Pehler, call 303-695-6060 or complete our online contact form today.