I have updated my profile to include shoulder pain issues, all of which is self explanatory. I do not have a problem with my existing regular GP except that when it comes to pain control she has very dark blinkers on. Accordingly, this afternoon I phoned surgery and asked for an appointment on the basis of wanting a second opinion with a more senior GP ( at my existing practice ) and got a strange response. Like, " why do you want to do this" ? I then explained that I was unhappy with existing treatment and to a degree my existing diagnosis. My pain levels were increasing and extending to my right arm and right hand. I was then told that the matter would be referred to her line manager and they would phone me back.
So, does anyone know ( at GP/Surgery level ) if there are set protocols/practices/procedures involved when asking for a second opinion. I would have thought this request would be my entitlement.
Many thanks guys and gals.
John
Written by
BenHall1
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Many thanks indeed for your outline. It has helped me in being objective in my 'shoulder journey'. Your advice pretty much covers my existing mindset and all I have to do now is logically, update an existing shoulder pain profile for ease of reference for whoever I may end up seeing. At this time of writing I've not heard back from our 'Appointments Reception' people.
There is just one thing though ... at the time of writing all decisions are being made by my GP practice are based on X-Rays dated = 12/12/2018 for Rt. Shoulder and 25/09/2020 for the Lft Shoulder. I feel these are out of date .... what is your view ? if I may ask.
Y'know ... I cannot put on a shirt or jacket without either having my wife assist me or, without performing some freak show antics that enable me to slip my left arm into my left sleeve in order to minimise pain.
It is now 01.15 am and I am up and around the house having been woken with pain 😱😱.
Thanks again. I'll let you know outcomes in due course.
First of all, GP surgeries have to put every patient, whether they ring up, use an online form or go in person, through triage. It might be that the receptionist was just asking the questions she has to ask, not that she was being obstructive. Additionally, older patient are assigned a specific named GP and are supposed to see that GP only, because the evidence shows that this improves outcomes. However, sometimes a GP can overlook things and a second opinion is needed. This will be why she has to discuss it with her line manager.
As for x-rays, GPs are not supposed to request x-rays if they think that it is only osteoarthritis. So you might have a difficulty getting an up dated x-ray.
Have you seen a physiotherapist? In most areas you can self refer via an online form. And some GP surgeries have physios now too. It might be a good idea to see a physio because not only because they might have some exercises that will help, but also they can either request x-rays themselves if they are advanced practice physios, or they will ask your GP to request them.
Also, and sorry to bring up your age, there should be some community resources available too. In many areas it is called the frailty service, although they have realised the word frailty is not liked by patients so some enlightened areas have renamed it. You should have a care navigator in your surgery, sometimes also called a social prescriber, that can point you in the right direction for that.
This information is based on England, but you haven't said where in the UK you are, so apologies if there is a different path in which ever country you live in.
Its just a total disaster I'm afraid. My GP referred me to MSK Interface Service ( an hours drive away from home in Cornwall ), they referred me for Physio, I ended up back at my Surgery this time to the Surgery Physio who then referred me for X-Rays ! Got it ! Meanwhile I have been having Physio since April 2024. I have achieved nothing from Physio other than improved range of movement. The shoulder pain is continuous - its just a question of degree, day by day.
Nobody has considered referring me for a CT Scan or MRI which will also be the subject of the 2nd Opinion.
Next, I might be 80 but am pretty fit, physically and mentally. Especially mentally. In fact I stopped work driving buses on 5 July 2024 ... that means every year I have had to have a medical for DVLA to renew my PCV licence. Then I have had to jump through more hoops for my employer. That said I still have my valid PCV licence and I am seriously considering renewing it in the new year and take yet another damn medical. Just to prove a point. I am certainly not frail, physically or mentally. Frankly from what I've seen driving around I wouldn't licence half those I've seen driving mobility scooters. Not unless they were subject to the same medical standards and driving standards as I am. And some I've seen are so obese they'd automatically fail a medical anyway, so they'd be off the road.
Depending where we go with my request for a 2nd opinion with a senior Dr/GP in my existing surgery I am at the point of referring my Surgery to the Care Quality Commission for investigation. Similarly, as my Surgery is a private company they may well end up being referred to Cornwall Trading Standards for investigation. Don't you luv it when a mob of NHS employees hide behind the Companies Act.
If my vet treated my cat in this way they'd be deregistered by now !
No offence taken at your advice on age/frailty by the way, I'm just explaining.
Perhaps I should have explained better what medical people think of as frailty. It doesn't mean what patients think it means. What it means from a medical point of view is that if a person gets ill or has an accident then it will take them longer to recover than others. So my son who is in his 20s and is disabled is classed as frail, because if he gets a virus it lays him down lower and takes him longer to recover, not because day to day he is frail.
So someone in their 80s, if they get a broken bone, or get flu, they are likely to take longer to recover than someone in their 20s, regardless as how they are day to day.
I had a lovely very active friend in her 80s and I said if the frailty nurse rings her up please accept the visit, ignore that it is called the frailty service. I told her all about what they had to offer, because I was involved through my Patient Participation Group with setting up the frailty service. She said she would give it a try. But she contacted me and said when they did ring up she refused because she didn't think she was frail. A few years later they contacted her again and she did accept this time, and she let me know that once she realised what the service was really about, she wished she had said yes to it sooner.
So if you have the opportunity to talk to someone from the frailty service, don't dismiss it because you are currently healthy, take them up on it so you can stay healthy for longer! In fact in some areas it is now called a Wellbeing Service.
Hi, with similar symptoms, neck pain and pain radiating down my arm to my hand and certain fingers, my GP referred me to a local specialist Integrated Pain and Spine and Spinal Service. I was assessed by a specialist physiotherapist and they ordered an MRI. They found I have spiny bone growths (osteophytes) which press on the top of my spine. I was referred back to my GP for pain medication - it didn't need surgical intervention. I also have a squashed lumbar disc and my GP prescribes co-codamol and nortyptaline. At our GP surgery you can choose which GP you want to see. It sounds like they have sent you down the complaints process.
Age is not a barrier to receiving proper medical care. Keep a note of all conversations, appointments, treatment - or lack of it. Hope you get the help you need.
Thank you very much for your comments - most encouraging, as have been those from others who have kindly commented. I am wondering if your "specialist physiotherapist" would answer the description of a "neuro physiotherapist" as described by CDreamer on here a few days ago ? I have already started to form the opinion that I'm gonna have to "kick ass" to get what I believe I'm entitled to. Just polishin' my mountain boots at the moment 😱
What both worries me and makes me angry is all medical actions emanating from my useless surgery at the moment are based on X-Rays of between 4 and 6 years old.
I am wondering about nortyptaline, must check it out as I've been tried ( experimented with ) on both Gabapentin and Amitriptyline both of which at different times/dates in the last year or so have given me diahorrea and so I've just reported it to my GP and gone back to CoCodomol 30/500.
Thanks strongmouse ... I have a session with my GP on 6 Dec and will report back.
The specialist physiotherapist I saw was able to exam my hand and find out which nerves were effecting them and causing the pain in my arm and hand. He had a good idea which cervical nerves were involved - C3 -C4 marked, and C5-C6 mild. He was very knowledgeable and I went on a Pain Management Course afterwards which has helped.
Sorry your GP has been unhelpful, going forward I hope he takes your concerns more seriously and you can get the investigations and treatment you need. I mentioned my quality of life to a doctor as it is important to keep our health as good as possible, and to be independent for as long as we can.
Thanks for that ...... strikes even more of a chord with me. I've just looked at my Cervical spine X-Ray report dated December 2018 and guess what ............ and I quote ................. " there are moderate spondylotic changes with the loss of intervertebral disc space, endplate and facet jointsclerosis at C3/C4 and from C5 to C7. Vertebral alignment and body heights are maintained. "
So that goes some way to explaining some things for me/ to me. More than my GP has done. Appointments are all by remote control and phone these days with the GP deciding who he/she will call in for an appointment. Anyway, I do have an appointment for 6 Dec ............ hey it's gonna be firework night !
I think you do amazing , the age thing is very much wrong in my eyes, I have so much respect for anyone who lives life not putting age as a marker . We all deserve the same respect and care regardless of our age. I think you are doing amazing, don’t beat yourself up, have some compassion for yourself. The whole medical system is under strain . The people in it are amazing .
I have suffered over twenty years in chronic and acute pain , for me the journey continues, however, remember fight in flight response does not help mine or you’re wellbeing.
It’s a frustrating feeling, we know , look at how well you are doing , just give yourself a lot of credit. Xxxx
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