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

[dav_marine72]

Chris,

Your going to need nexus letters like someone stated earlier. I was in the Corps 91-95. I broke my right foot in boot camp due to pes cavus and my left in Marine Combat Training due to pes cavus. I only had one entry in my service medical records for back pain. I had pain more than that but I'm sure you know in the Corps you suck it up. After I got out my back went south in 97. I tried everything but ended up having a failed L3-4 and L4-5 discectomy. At that point I knew I needed to go after the VA for my back or I could be screwed.

I went back to my surgeon but any MD will do. I told him I had back pain alot in the Corps from humping a pack around for 4 years but said nothing. He wrote a letter stating since there was no MRI prior to me going into the Marines and by 2000 I had herniated discs at L3-4, L4-5, and L5-S1 via an MRI there was certainly a chance my back was damaged in the Corps. Then I went to a Podiatrist and had him write a letter stating that because of my Pes Cavus my feet didn't take the shock from all the running and hiking in the USMC and it was possible my feet caused my back to be destroyed.

I had already had service connections for my feet because of the factures. I had a spine exam at the VA and the examiner concluded that my back should be service connected directly and that he would have service connected secondary to my feet also. I bring the feet up because of your ankle pain, etc.

My feet after I got out went from moderate Pes Cavus, mild equinis to severe Pes Cavus, severe equinis with 0 dorsflexion, tarsal tunnel bilateral and arthitis bilateral. I also have severely diminshed achilles reflexes bilaterally.

So as long as you can get letters you'll probably get service connected for the back due to either killing yourself in the Corps or you foot which then killed your back. Once you get connection for the back the scatica will be considered in your neurological rating as will be the foot drop.

You need them to say it's possible either scenrio happened in the Corps though. Then you can go after any other secondaries if you have any. I think back if I didn't fight them how screwed I would be. I had a 2nd L3-S1 fusion done over a year ago and have been unable to work ever since and I am rated for TDIU.

[81150 CAFB]

Had my appointment with the neurologist and he gave my a really decent nexus letter with his explanation of why the emg/ncs was normal and I still have nerve damage. He basically stated that my nerve damaged was caused by my previous compression from all of the previous ruptures at the L4-5 level and that even though the compression is gone the nerve is still damaged and he is treating as permanent. He said that the ncs/emg was normal because there was no more compression on the nerve. He then had his diagnosis of moderate to severe sciatic neuritis. He basically told me it is like a loose wire and my muscles and nerves still function below the knee (ncs/emg was from knee down-do they ever do buttock and thigh ?) but I have the nerve root damage from all of the previous compression and corresponding chronic pain. The only reason he said he did the test and a myleogram was to rule out compression.

Does this make sense to anyone? I would think any nerve damage would show up, but he didn't seem to think so. I have to take his word for it and use his letter that he signed explaining this. I just wish there was an objective way to identify nerve damage when the emg/ncs states otherwise...the way I look at it is my nerve is damaged beyond repair at the l4-5 canal and is giving me horrible referred pain in my sciatic nerve in my butt that effects my hip and knee and sometimes when it gets really bad it goes down my left leg below the knee with symptoms of pain/numbness/dull feeling and tingling that is random. I asked him how he knew I wasn't lying about my pain and disability and he told me because of my medical history (failed back surgery syndrome etc...) and experiance in dealing with nerve problems all the time. I just hope the VA will look at my records and use the letter from a very qualified neurologist to rate me properly, but that seems unlikely.

Please let me know if you ever had radicular pain and was tested (emg/ncs) that came back normal. If you online the data shows about 30-40% of the tests are incorrect.

I also started seeing a pain management specialist (neurologist/anasthesiologist) and will get his opinion on the issue and see if he can help.

[Michellee]

Ain't that the truth! I had similiar experience years ago with VA pain clinic. They even tried acupunture when I was told they VA doesnt do that, yes they do. Our Va had a acupunture doc. He stuck that needle btwn my left thumb and index finger and I still didnt get any relief. What a crock of @##$%

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.

[kryptos]

I got 40 Percent for each leg they called it neuropathy-paralysis of the sciatica nerve, i also have L3 L4 L5 Fracture Compression, they just did a EMG and then rated me 40 percent righ tleg 40 percent left leg and i get 60 percent for my back.