### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hi my name is Paul male 27 years of age. i was injured back on march 3 2013. i fell into a storm drain i injured my knee, and hit my back. Once i was on the crutches i seperated my right shoulder on them. I have had three knee surgeries over 10 years ago. No problems after the last acl reconstruction. Now i am having extreme pain in my right leg, mainly knee with shooting pain up and down my leg. I also have my shoulder that is killing me i can barely lift it above my head. I have been treated my an ortho who believed my knee to have rsd and sent me to a pain management specialist. They have done every test known, blood mri xrays bone scan. The pain management doc wants the ortho to do exploratory surgery on my knee. I am worried if i have rsd that will make it worse. How do i handle that. I also had problems about two months after the initial injury with my back hurting. I thought it was matress and after a month of pain it went away. The pain management doc asked if i had any back pain because he wanted to check for injuries that could affect my knee. i told him about the pain and he ordered an mri. After it came back it showed a fractured spine and a hemangioma. When i saw the spine specialist he said that the hamangioma had to be there since birth. My research shows that no one really knows how they happen some believe genetics others trauma to tissue. He also said wc will not cover that because the fracture was due to the hamngioma weakening my back. but he says that it doesnt need to come out. My back has been really hurting for about two weeks and he said hemagiomas do not cause pain, my research again shows that some do. Also wc has not approved my shoulder therapy for three months now and the pain is just as bad and sometimes feels worse. My questions should i seek a second opinion and how to find the right one to help me in my area. My knee pain is terrible if i put weight on my leg it bruises easily and swells up. I am just lost on what i should do. I feel these doctors have just traded me back and forth and just keep putting me on different meds. I am on opana 10mg which does not work all day. Lyrica 150mg, zipsor and flexiril. I am just so tired of being in pain. Please help.

### output:

Hello, I have studied your case. Hemangioma do not give pain, but fracture associated with it may give rise to pain. For these symptoms analgesic and neurotrophic medication can be started. I will advise consulting two specialist knee and spines again for proper opinionative time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Physiotherapy like ultrasound and inferential therapy will give quick relief. I will advise checking your it B12 and it D3 level. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care