Proving Back Pain, Rate Increase

[jenni2005]

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

[rpowell01]

Jenni can you do me a favor and lay down in the best on your stomach and bend your lumbar spine backwards. If you have increased pain in your buttocks then you most likely have DJD which is seen most on Xrays and CT Scans. MRIs have a harder time seeing this and this COULD be the reason why you are having the sciatica issues. I wish I could get a referrel to Orthopedics, I only was able get as far at Pain Management and all these did was put me on Oxycodone. Some VA MDs are very helpful but I blame it more on the facility because some facilities you can get the best care and some others you can't.

 

EDIT** I also want to say that MOST of the time the sciatica causes pain ALL the way down the leg or it starts in the buttocks and skips down into the feet or toes. MOST of the time whenever you see it just being in the buttocks then its muscle related or the joint to the left and right of the lumbar spine, it feels like a big muscle. This is just from what I read but again if the nerves are not being pinched a lot then it could be just in the buttocks.

 

Your situation sounds just like mine did from 1996-2010, muscles tighten up and you get pain down your buttocks. See if you can get an EMG because this will tell you a majority of the time if its a pinched nerve or muscles.

 

Get back with me on bending your lumbar area backwards by laying down in bed. If it hurts then this is most likely DJD instead of DDD which are two different things but the VA considers them the same, Osteoarthritis, which there is no cure or fix. Trust me I know, I've been dealing with the progression from normal DJD to now moderate to severe. Also get a CT Scan on your whole spine it will tell a lot about the facet joints.

Edited August 15, 2015 by rpowell01

[pwrslm]

Be careful with hyperextension of the lower spine.  That's where you lay on your stomach and bend backwards.  I was sent to Phys Therapy, and this is what they had me do.  I'm not s young un', 55, but the caution is valid at any age.

When they had me do this extension exercise, they used an excert from McKenzie self help books.  Lay on stomach, keep pelvis to the floor, so you don't do it like normal pushups, then you push up and lock your elbows straight.  The effect is like a sit up, but your hips stay as close the floor/on the floor.

 

Problems I had could have been prevented with a simple x ray, they would have seen if I had facet or disc space problems and they would have known that I should not be doing any type of hyperextension exercise at all, but they didn't do that.  My VA PCP didn't want to take the time to properly diagnose this, so she referred me to Phys Therapy for evaluation.   That's where they started me on extension exercises.

When I did this over a period of 2 weeks, I started getting tingling down my left leg.  After 4 weeks, the tingling turned to twitching, that ran from inside/above my left knee to my toes (my toes would be twitching so much that it would keep me awake at night).  After 8 weeks, muscle weakness started to set in.  At 10 weeks, I stopped exercise and walked in to see an MD because of sciatic pain in both legs set in, the muscle weakness turned into foot drop.  After I stopped, the condition kept advancing, and by 16 weeks I could not walk more than 1/2 block without muscle exhaustion in both legs, and had to use a prosthetic (AFO) so I would not trip over my toes when my left leg swung forward.

An xray would have revealed that I had a collapsed disc between L5 and S1, and this led to a deformity and sever arthritis in my facet joints. The result was that I had 3 more disc's that had been forced out to the rear, and the facets caused foramina stenosis that was causing damage to the nerves at 3 levels.  6 months after this happened I got an EMG (ouch, needles jammed deep into many muscles) that said this was a chronic condition (more than 90 days).  I'm not sure if the damage will be reversed, nor are the 3 surgeons I have spoken to.

 

So, the moral of the story is, get a proper medical evaluation before you do anything about your low back pain.  It might be as simple as a sore muscle or strained tendon, but if it is a herniated disc, or you are older and could have additional complications to deal with (facet joint issues like I did), its best to be safe, with both eyes wide open, than to go in blind and injure yourself far worse. 

Edited August 15, 2015 by pwrslm

[iceturkee]

don't know if this will help. i had my first emg in 1992, along with my first lumbar spine mri. the mri showed i had a bulging disc and the emg confirmed radiculopathy. i don't remember when my last emg was. but i had an mri in may 2014, which showed 5 herniated discs, both foraminal and spinal stenosis, a grade one slippage of vertebrae, abnormallordatic curve, 2 torn discs and arthritis. i can braely walk from my living room to my bedroom without pain in my right lower extremity which shoots down my right leg. i start limping real bad and must sit for a few minutes before attempting to walk again.

[Tomahawk]

You may want to ask for a pain management consult as well.  I had some steroid injections 2 or 3 times that didn't do shit for me.  But after that they did something called radio frequency ablation.  And that was a godsend for a few months the first time.  The last 3 times I did it was with very limited success.  But according to my doc the vast majority he performs the RFA on gets 1-2 years of relief from it.  Its a great alternative to surgery.  As mentioned earlier in this thread deciding to have surgery on your back is a big deal.  I have spoken to people who feel like a million bucks after, and others who have been worse.  Being I am only 37 I am holding out as long as possible before doing it so that I'm not having surgery every few years.

Fortunately I work for a small company with understanding owners.  If I can't get out of bed I just shoot them a text message letting them know that day is a bad one.  They always respond the same telling me to get some rest and come in when I feel better.  Anywhere else I think I would have been fired numerous times.  Missing 15-20 days a year because you cant get out of bed would get old for most place.

 

Personally if I were you I would go ahead and file for the increase.  And then just continue seeking treatment.  With the speed the ROs work at you may very well be 18 months into new treatments documenting the increased findings before they even look at your claim.