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Accused deputy killer Michael Paul Astorga will have to come up with another way to get a second opinion on his aching back.

Barely a month after he appeared in an Albuquerque courtroom complaining of filthy food and foul treatment at the Penitentiary of New Mexico, Astorga, 31, was back Thursday to grouse about what his attorney called treatment tantamount to medical malpractice.

Defense attorney Gary Mitchell said that even after agreements were made last month to improve his client's care while waiting for trial, doctors refused to perform diagnostic tests such as an MRI or CT scan to determine what was causing Astorga's chronic back pain.

"I think I know exactly what's going on here," Mitchell told state District Judge Neil Candelaria. "They don't want to pay for it."

But Department of Corrections medical director Stephen Vaughn testified that such tests were not warranted and that Astorga had refused the physical therapy and nonsteroidal anti-inflammatory medication he had been prescribed.

An X-ray of Astorga's back in August found no particular issue, Vaughn said.

Mitchell countered that Astorga refused the treatment because he first wants to know what's wrong with his back.

"We're not asking for the world," Mitchell said.

The judge denied Astorga's motion for medical treatment, saying the Department of Corrections appeared to be providing reasonable care and that Astorga was refusing care.

Astorga has said his back was injured during his arrest in Ciudad Juarez, Mexico, where he was captured there after an intense manhunt following the March 2006 shooting death of Bernalillo County sheriff's Deputy James McGrane Jr.

The deputy was shot during a traffic stop in Tijeras. Detectives believe Astorga shot McGrane because he was wanted for the previous homicide of a family friend.

Astorga is being held in Level 6, the maximum security unit at the state penitentiary near Santa Fe, for safety reasons until he goes to trial.

Astorga, dressed in maroon shirt and tie, offered smiles to family members - particularly his toddler son, who made a rare appearance in court until the little boy had to be taken out of the courtroom for repeatedly uttering "Dada" too loudly.

Astorga's wife, Marcella Poolaw Astorga, was pregnant with their son at the time of the shooting.