Sciatic Nerve Pain!

[81150 CAFB]

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

[81150 CAFB]

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

[cannoncocker]

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 May 5, 2010 by cannoncocker

[jbasser]

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

[john999]

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.

[cannoncocker]

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.

[john999]

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.