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Sciatic Nerve Pain!


81150 CAFB

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I am currently 4 months post op from L4-L5 fusion. I had a diskectomy performed on this same level in August 2009 and when in the Air Force in 1989. I am in the process of filing my claim (I have all of my records and 4 doctors letters). My question is regarding the section covering sthe sciatic nerve. It appears that the rating does not cover pain, just numbness, loss of use etc... I am still having severve sciatic pain in my left buttock, even after the surguries and the doc said that it might be stuck in some pain loop and it may be permanent. I have been on lyrica for about 2+ months with not much success. I am also having severe pain in my hip that goes to my knee and then if I do something I shouldn't it goes down my lateral leg to ankle and toes. Is there any rating for sciatic pain? I occasionally get some tingling in my foot and I do have deep nerve sensation loss (can feel light touch but not if you jab into my calf), but no paralysis. The sciatic nerve rating is so subjective...I just don't know what to expect.

I am applying for sciatica and I guess/hope that they will evaluate and rate properly based on my severe pain and limits.

Please respond if you can help.

81150

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  • HadIt.com Elder

Welcome to Hadfit and I hope that you find relief from the pain. I don't know about the ratings but if your operation was on something service connected you should get 100% for a period of time and than reevaluated.

Good Luck

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I am currently 4 months post op from L4-L5 fusion. I had a diskectomy performed on this same level in August 2009 and when in the Air Force in 1989. I am in the process of filing my claim (I have all of my records and 4 doctors letters). My question is regarding the section covering sthe sciatic nerve. It appears that the rating does not cover pain, just numbness, loss of use etc... I am still having severve sciatic pain in my left buttock, even after the surguries and the doc said that it might be stuck in some pain loop and it may be permanent. I have been on lyrica for about 2+ months with not much success. I am also having severe pain in my hip that goes to my knee and then if I do something I shouldn't it goes down my lateral leg to ankle and toes. Is there any rating for sciatic pain? I occasionally get some tingling in my foot and I do have deep nerve sensation loss (can feel light touch but not if you jab into my calf), but no paralysis. The sciatic nerve rating is so subjective...I just don't know what to expect.

I am applying for sciatica and I guess/hope that they will evaluate and rate properly based on my severe pain and limits.

Please respond if you can help.

81150

Actually it is not all subjective. Nerve conduction studies and EMG's are excellent tests to help diagnose nerve damage and corroberate what the patient says. The pain you are experiencing may or may not improve, it is most likely due to nerve damage and only time will tell if it gets better. But, if if gets worse report it immediately. One thing though, it could also be caused by nerve impengement in which case you need to complain to your neurologist or whoever is treating you for this condition. The pain from nerve impingement if treated early enough can resolve or improve, but if left untreated will certainly become permanent. See your doctor soon, ASAP.

JMO,

Bergie

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My neurosurgeon is done with me (surgey looks fine). I have accupuncture set up this week. Saw a chrio...he would not touch me. In my cliam should I just list 4.124a - 8520 Sciatic Nerve and list as bilateral and let them work it out?

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Thanks for the response Bergie. I am very concerned about the nerve issues. I am trying to line up a neurologist to get to the bottom of my problems. I just hate the thought of another myleogram and the possibilty of an s1 problem. It seems never ending! What do you mean by impingment...additional compression at another level (since I've had the fusion)? I am also concerned about scar tissue since the fusion op report noted (3 months after discectomy) that he removed a massive amount of scar tissue from around the nerve. I don't know if you can do anything about this. The hip and butt pain (and back pain) seems worse now then before my discectomy.

81150

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This is something for your future reference and may be of use to you. I too have exactly sciatica produced from a large protusion at the L5 pinching/pushing the S1 to the forward facet. They granted me 20% at the DRO level but gave full grant for "Lumbar strain with radiating pain in buttocks and down legs", which as I understand it from my readings here is VA speak for limiting the rating potential to 40%.

I do not know exactly how or when I will resolve this but I just wanted you to be aware of that possibility when they respond.

Good luck to you on your claim and more importantly I hope your pain resolves itself or at least subsides.

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Possible bad news...saw neurologist this week and the did emg and ncs. The results were fine. He said that it means that he doesn't think there is compression on the nerve, but to be sure I have a myleogram set for tomorrow. He said that the nerve pain that I am feeling is probably from a damaged nerve that may be permanent. I asked him about the pain/numbness/dull feelings in my legs and he said that it is from my damaged nerve...like a loose wire. All he said the can do is manage with meds and injections. How do you rate for a damaged nerve? I will look at the regs..thought I saw several other listings under sciatic (Neuralgia...). I almost hope they find some compression rather than permanent damage.

Edited by 81150 CAFB
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From one 81150 to another, Since you live in Texas make sure to have the TVC represent you and do not go through this without their help. It is a good organization and helped me to %100 over the last 4 years. This is the best state in my opinion to win your case.

Dizzy.

PS. Cold War Vet "83 to "91

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Not to get off-topic, but what is "TVC" and how does one contact them?

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I have sciatic nerve issues but do not have anything in my smr related to this, only an ankle/ knee issure. I'm on a couple of nerve pain meds, Primary doc is referring me to a specialist. I was an infantryman humping 90lbs through mountains and stuff. how do i go about getting this issue service connected?

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  • HadIt.com Elder

TVC is Texas Veterans Service I think. They work for State and help Veterans as Service Officers. No matter what Service Officer you pick yhou still have to make sure your claim is advanced properly.

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I am currently 4 months post op from L4-L5 fusion. I had a diskectomy performed on this same level in August 2009 and when in the Air Force in 1989. I am in the process of filing my claim (I have all of my records and 4 doctors letters). My question is regarding the section covering sthe sciatic nerve. It appears that the rating does not cover pain, just numbness, loss of use etc... I am still having severve sciatic pain in my left buttock, even after the surguries and the doc said that it might be stuck in some pain loop and it may be permanent. I have been on lyrica for about 2+ months with not much success. I am also having severe pain in my hip that goes to my knee and then if I do something I shouldn't it goes down my lateral leg to ankle and toes. Is there any rating for sciatic pain? I occasionally get some tingling in my foot and I do have deep nerve sensation loss (can feel light touch but not if you jab into my calf), but no paralysis. The sciatic nerve rating is so subjective...I just don't know what to expect.

I am applying for sciatica and I guess/hope that they will evaluate and rate properly based on my severe pain and limits.

Please respond if you can help.

81150

I too had a L4-L5 fusion in 1996 as a result from injury. The pain never really improved and after much testing and drugs, injections it was determined that there was damage to the covering on the left ganglion nerve root that occured when the disc first herniated. This results in activity related leg pain radiating down my left leg into my foot. The more walking and standing or sitting I do the more pain I'm in. I was rated a total of 40% back to 2004. Then as of Aug 2009 they increased me to 60% due to IVDS episodes. I then filled in Dec for TDIU since I hadn't work since 2000 and was granted TDIU back to Aug 09 as of March 2010. They should, assuming you are service connected for this problem, rate you for limited range of motion, radiating pain, unusual scaring, and possibly a few other items if they exist.

Make sure you have good representation and good luck.

Blackbird

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I have sciatic nerve issues but do not have anything in my smr related to this, only an ankle/ knee issure. I'm on a couple of nerve pain meds, Primary doc is referring me to a specialist. I was an infantryman humping 90lbs through mountains and stuff. how do i go about getting this issue service connected?

My suggestion to you is to get a reputable Independent Medical Opinion from a local group of Spinal Neurologists who have a member dedicated to rendering opinions that your back problems are related to your service via repetitive heavy lifting vs say a sedintary work record. Most metro areas will have groups like these. Finding that group will be your largest hurdle but perseverance is your ally. If you follow through with this you can use "would a resonable person believe my back problems came from sitting in a chair lifting reports and files or humping 90 lbs for days at a time for years?".

How I did it. Also if you do get an IMO be sure they note they reviewed your SMR and make all your MRI etc available to them. Make it easy for them.

Good luck.

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Got the results of my myleogram yesterday...no compression. It now becomes a nerve damage managment issue. He then said it would go to pain managment. He upped my Lyrica dosage and gave me a prescription for Ultram Er (300 mg) for pain. I asked him about helping me with my VA filing regarding this issue and he said he would. My main question is how do you rate "radiculitis"? The pain is constant in the back and hit the buttock and fires of whenever down the leg. The doc siad that the damage is done and the pain can vary depending on what you do...great. I am pretty sure this is a permanent damage issue...but how do you rate whenthere is no compression but the nerve is damaged/inflammed but it doesnt travel constantly down leg? The emg/ncs below the knee were fine showing no damage...so I am stuck with a damaged nerve at the root theat stabs me in the but and causes a mess of pain and random radicular feelings down the leg to foot. Not very clear cut in the code. I was planning on having the neuro look at the codes with me at the next appointment and see what he wold rate me as. Very confusing since I don't have the true Sciatica(?)

81150

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radiculitis is not in the spine repository here at hadit,at least that I could find, and seems to be used interchangeably with radiculopathy.

Definition

Lumbar radiculitis is an umbrella term for a painful condition occuring along the root of any of the nerves extending from the lower (also known as lumbar) region of the spine. The pain may result from the lumbar nerve being either pinched, inflammed, irritated, or not working properly because of a lack of proper blood supply. While the symptoms experienced by each individual may vary widely depending on which nerves are affected, unrelenting pain is a common denominator in all lumbar radiculitis cases.

So it seems the neurologist is using a catchall term since he can't nail down the cause without an image of physical change and I am guessing from a blood screen.

The great thing and the most positive thing you have going for you is that he told you he would help with the filing of your claim. May I suggest that you get a list of VA Diagnostic codes aligned with the diagnosis and try to get him to commit to one or more as appropriate. I would print a form that leaves a blank for diagnosis and code then include a statement that he reviewed your SMR's and any VA records you have. I would leave an area where he can express his opinion as to why he believes there is a medical nexus between your current diagnosis and your service. He could certainly use his own forms but those areas need to be covered.

That is admittedly a lot to ask for but that is very tough scenario, that does not mean you can't win, only that you will have to work harder to get the neurologist to diagnose and commit.

I am sure many are rooting for you!

PS if there is such a thing as true Siatica it would commonly be demonstrated by a herniated disc at the L5/L4 level with the herniation pushing or pinching the S1 nerve, and also narrowing of the sciatic nerve pathway, ie a physical orgin. This in no way means this is the only way to get pain from the sciatic nerve.

Edited by cannoncocker
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Got the results of my myleogram yesterday...no compression. It now becomes a nerve damage managment issue. He then said it would go to pain managment. He upped my Lyrica dosage and gave me a prescription for Ultram Er (300 mg) for pain. I asked him about helping me with my VA filing regarding this issue and he said he would. My main question is how do you rate "radiculitis"? The pain is constant in the back and hit the buttock and fires of whenever down the leg. The doc siad that the damage is done and the pain can vary depending on what you do...great. I am pretty sure this is a permanent damage issue...but how do you rate whenthere is no compression but the nerve is damaged/inflammed but it doesnt travel constantly down leg? The emg/ncs below the knee were fine showing no damage...so I am stuck with a damaged nerve at the root theat stabs me in the but and causes a mess of pain and random radicular feelings down the leg to foot. Not very clear cut in the code. I was planning on having the neuro look at the codes with me at the next appointment and see what he wold rate me as. Very confusing since I don't have the true Sciatica(?)

81150

Post your last MRI. I would like to see it, delete any personal information.

J

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  • HadIt.com Elder

If you expect real help from VA pain clinic forget it. They have cookie cutter approach to pain. I went today and they again decided to take me off the opiates they have had me on for five years. Great, now I guess I can just bite on a stick when it hurts. They said all my problems are due to bad posture.....right. If you have serious pain you need a real pain doctor who sees you as a human being.

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If you expect real help from VA pain clinic forget it. They have cookie cutter approach to pain. I went today and they again decided to take me off the opiates they have had me on for five years. Great, now I guess I can just bite on a stick when it hurts. They said all my problems are due to bad posture.....right. If you have serious pain you need a real pain doctor who sees you as a human being.

Too true! I am on 5mg Hydrocodone and they act as if it were a morphine drip on a hanger. I wouldn't even consider asking for an increase. I'd rather endure.

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  • HadIt.com Elder

Cannoncocker

I was with my wife when I saw the pain doctor. I was in a wheelchair due to an operation on my foot. The doctor must have asked me five times if I ever used illegal drugs. He told me I could not even have a beer on New Year's Eve. No question in my mind that I must have "drug addict or drug dealer" written all across my forehead. I guess they never heard of nerve pain or phantom pain which is very real to the person who suffers it. Pain is subjective. I want my pain to be treated, but the VA just refuses. I am supposed to drive 20 miles and half an hour just getting to the hospital from the remote parking to get an hour of PT. I have already been there and it did not work.

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Looking at the codes and ratings I think I would be rated under neuritis. I will try to get the doc to see what he thinks since the pain is constant and hopefully get him to rate it specifically as severe/moderatly severe or what ever he thinks. I just don't know how the VA would rate it...based on his diagnosis? You can't really test a damaged nerve, it is pretty subjective and I am sure they would look at the ncs/emg that was fine but doesn't mean anthing for nerve damage at the root that causes constant pain-not the loss of use.

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  • HadIt.com Elder

American society and medical profession have a schizophrenic attitute toward pain. There is this moral judgement that is laid on you if you have pain that is not due to broken bone or bloody gash. On the other hand the VA, for instance, wants to treat your pain....yeah,right! If the VA can't see the actual result of some loss of use they tend to give low ratings for pain. I am SC'ed for chronic nerve pain. I get 10% for that but it is the real cause of many of my problems.

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