Hip pain secondary to SI joints

[Andyman73]

Do I need to get an IMO/IME if my secondary issue falls exactly as the CFR states how the symptoms manifest?

Background, November 2015 I had a C&P for hip pain. X-rays show hip joints are fine. Exam finds that where I'm pointing out the pain and burning is not actually my hips, but SI joint and SI crest area.  However, ROM of my hips is noted as reduced in most, or all directions(flexion, dorsiflexion, abduction and so on.).  Examiner recommends MRI, but won't order it. Says I need to see my PCP to get that ordered.  Long story cut short,  PCP sends me to PT for consult, had 3 sessions, PT stopped due to no improvement and fear of making it worse. Physiologist looks me over, recommends pain injections in SI joints. Went, got it done. Relief lasted a week. Then follow up, anethesiologist offers some other choices that carry a higher risk, like epidurals and such. Back to Physiologist, who sends me to Chiropractor for 6 VA authorized sessions.  Chiro stopped after 5th session, noting short term little relief, but no progress.  This ended in December 2016, a year after the C&P exam took place.  Have a VA acupuncture appointment in a week or two.

I've been trying to do things the right way, more so backwards and upside down, than right up the middle. According to CFR 4.66, covering the SI joints, one of the indicators is painful ROM of the hips. Normally this whole area is bullet proof, with limited exceptions, like severe trauma directly to the area. Also traumatism(fell down stairs at boot camp which is documented in my smr) on top of transitional anatomy(congenital partial lumbarization of S1, of which I have according to numerous VA x-rays) can cause problems with the SI joint region, felt as pain and burning sensations along the SI crests and outer thighs. And painful ROM of the hips.  I have that noted by the PT, my PCP, and the Rehab dept. Physiologist, and from that C&P exam back in November 2015.

Also there is a separate condition covering the burning pain felt along the outer thighs. 

So, this brings us back to my question.  Do I need to get an IMO for this, since I already am SC 40% for low back strain/pain. And I've been going through the VA for treatment and DX for this pain.  The Physiologist noted that this is most likely due to my low back strain, and DJD.  Is this enough or do I need more?

Thanks.

Andy

[pwrslm]

Look at your record.  Why did they send you to all the conservative treatments?  If that shows its caused by your SC back issue, then it should be a done deal.  Check with the ROI, ask for all of the referrals that the PCP or spec's put in sending you to conservative treatment also.

 

[Andyman73]

pwrslm,

I know that they wanted to find out what the root cause of my pain is, and such, and to see if it can be reduced, eased, etc;.  Physical therapy didn't help. Pain injections in the SI joints, didn't help. 5 sessions at the Chiropractor, did not help. Acupuncture appointment coming up in the middle of February.

But no amount of treatment, short of surgery, will undo the damage started by a fall down the stairs back in November 1992. And it certainly won't undo the transitional anatomy/partial lumbarization either.  Or 24 years of limping due to knee problems from that fall.  Or the foot issues that developed a few years after that.

Would be nice to have something go my way, instead of not. My original SC date for my low back is 11/98, and L ankle and knees..as well.  And my feet SC 03/06.

Just gets old, to be told, that no matter what's in your SMR, if no DX, then no nexus, no deal.  

Just called the radiology department to see where my image and report info was.  I was up there on Dec 14th, for bunion x-rays, filed ROI request for all my images and reports. Lady said she overnited them the same day.  I said, well, 4 weeks later and I haven't received them yet.  She took my info and said she will drop a new copy and send it out, again, in today's mail.  Got some IMO appointments lined up and need those images and reports. 

Something's gotta give, just hope it's not me.