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Proving Back Pain, Rate Increase

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jenni2005

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Hello all,

I'm rated 10% for lumbar sprain. I generally have two different types of back pain, middle to lower when I'm sleeping and sciatica including down the legs when moving around. Couple questions... I'm rated at 10%, should these two pains be considered two different claims? Also, my pain toward the middle of my back down to my hips usually only effects me while I'm sleeping, laying down position. This hurts me so much, it's as if my back is frozen and i can hardly move. It takes quite a bit for me to be able to even get out of bed, thus missing work occasionally. I've been in contact with the VA a lot lately because of this and they are only offering a muscle relaxer, no explanation to what the actual issue is. Muscle relaxer is fine, if it works because I can't be impaired to do my job. Anyways, if I want to see about getting a rating increase, how the heck do I prove I have this problem, not being able to move, ridiculous pain ect. They only measure how you're feeling at the appointment after being awake for hours, being stretched out. Any info would be greatly appreciated!

Thanks

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Well I have 20% for Lower Back issues, and 10% for nerve damage and tingling of the R Side. To be honest only thing that proves all these issues is MRIs and X Rays. I have had a lot over the last two years, and I am unable to tack pain meds due to Crohns Disease and 2 blood transfusions. I did not even put in a claim for the 10% Nerve damage, the VA caught it after the MRIs and awarded without me asking. You need to ask your VA Back Dr to request MRIs and X Rays. Good luck

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Well I have 20% for Lower Back issues, and 10% for nerve damage and tingling of the R Side. To be honest only thing that proves all these issues is MRIs and X Rays. I have had a lot over the last two years, and I am unable to tack pain meds due to Crohn's Disease and 2 blood transfusions. I did not even put in a claim for the 10% Nerve damage, the VA caught it after the MRIs and awarded without me asking. You need to ask your VA Back Dr to request MRIs and X Rays. Good luck

Try getting an EMG's to check on the radicular symptoms, CAT scans, myleograms, disco grams and imaging with dyes can be very helpful. JMO

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Lumbar strain is a general catch all for a problem. Under strict medical standards, its a tissue injury, affecting muscle and tendons/ligaments. In reality, it normally ends up being something else, but they classify it as a strain because that does not need X Ray or MRI, and unless there are more symptoms, its the easiest to treat, they give you a few pills, send you home, and that's it.

In LBP (low back pain) there are steps that all physicians should follow. First is med's, they do that because 80% of all back pain resolves on its own within weeks of onset. Generally, those are real back strains.

Second is physical therapy after 4-6 weeks without improvement, this is designed to strengthen the core, increase flexibility, and hopefully straighten the spine (chiro). Sometimes they want to give you shots into the spine (be careful with this). These first two are considered conservative treatment.

The third is surgery, and that you need to take careful consideration of because once they do it, historically, you will be back. Half of all back surgery patients are back in surgery within a few years.

A 10% rating on spine verifies you have pain on motion. They can verify that you have had this pain over an extended period of time without any improvement. It is time to go to your PCP and ask him/her directly for an X Ray and an MRI. You are going to need that to begin the documentation to establish an increase, as well as, adding on the nerve disorder (your sciatica) as a secondary condition.

Edited by pwrslm
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Adding on to pwrslm's post, if you do consider getting epidural pain block injections into your spine, please be aware that there is no guarantee that they will work. I have had moderate relief, but they wear off eventually.

Adding on to ARNG11's post, EMG's are not perfect. Different results are possible while laying down vs. sitting vs. standing. The effect of gravity matters. When you are vertical, additional weight can add extra stress on the nerves. Some docs are just in a hurry to get you out the door instead of doing a full assessment.

When you sleep, try sleeping on your side with a pillow between your knees. It can take the pressure off the nerve, depending on where it is impinging.

Research pain on motion (i.e. Delucca). For lower extremities, they are supposed to rate based on when pain begins, not how far your leg can be moved (i.e. torture). The catch here is that some docs are vague and note things like 'pain on motion'. Pain at ROM where motion begins tends to be rated at just 10%.

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Thank you everyone for great responses! So far, my "general" "doc" (the PA I originally saw to get into the health care portion) and I have been talking quite a bit about all this. She is changing my medications again, this time to a muscle relaxer, cyclobenzaprine. I'm also supposed to get hooked up with a PT. I've heard horrible stories about having surgery, especially back surgery, done with the VA. It's a shame that vets have some of the "worst" care, but it is what it is. I can't imagine PT working, as I've done some on my own for years, but I'll go to make them happy. If by chance this all works, then great. But if not, looks like asking for radiation and such will be done. I think I need to request an actual doctor specifically for my back and sciatic nerve. Thanks again, first time posting and was pleased!

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