Weird C&P ROM

[Rivet62]

I had a weird C&P exam yesterday. My range of motion was like 5 to 10 degrees in every direction in the thoracic lumbar ROM measures.  He didn't seem to question that, as he was looking at my back muscles while I was standing doing the forward flexion and backward extension. I was pretty seized up and he called it muscle spasms, which I'm sure it was.  My C&P was for DDD, painful motion, and lower extremity radiculopathy. I'm waiting to see if he'll call it inconclusive as a result of spasms, but I would argue spasms are part of what interferes with work. Of course, I would rather not have to argue it at all.

What struck me as odd about the ROMs is that he had me sit upright on the examining table and he had me bring my elbows to my side and bent, with my forearms parallel with the floor and my fists clenched then he asked me to twist my torso. I could do all that except twist the torso beyond 5 or 10 degrees.

I looked online and saw no one performing that kind of ROM, with elbow bent and to the sides of the body. Has anyone had that kind of ROM for twisting the back?  What is he trying to see with my arms like that?

I told him he was the first ever to actually measure ROM (but he actually only did it on the top of my head in relation to my back) and he said "well there wasn't much to measure," causing me to think he'll call the C&P inconclusive because muscle spasms have interfered maybe. Well, I have a documented work termination as a result of flare-ups...a medical opinion that I cannot return. I have documented emergency room visits as a result of flare-ups at other jobs. I have lots of documentation.

So, my question here is... can the doctor call the C&P inconclusive as a result of muscles spasms interfering?  Or are the muscle spasms confirming the C&P findings that will lead to an increase of service-connected ratings?

If you look at my signature below my comment you can see my existing ratings.  I guess I'm wondering if muscles spasms are radiculopathy.  I was pretty seized up after the 25 mile drive to the C&P and the hard seats they had while I waited.

I laid down in the examining table and did active straight leg raises, and no more than 25 degrees and he said that's positive (for lower back problems I guess). I didn't get the impression that he was trying to play tricks.

He made some negative comments about the VA medical system. He worked for VA decades ago, or maybe it was an internship.  But what he did say is that he was trained decades ago as a cardio thoracic specialist (he has since practiced as a DO- not an MD)... anyway, it caused me to remember the new sprinkling of heart related issues my new primary care doctor has given life to from old diagnoses that haven't warranted any real follow up.

Do you think that the VBA has purposely gotten this man to opine heart problems and not actual back problems??  I have all imaging and radiology reports that show severe DDD, but an anesthesiologist had told me that smoking interferes with healing the discs and that smoking causes more pain. I know a retired MD and that MD calls that bulls*hit. 

It appears my C&P examiner is not trained in spine specialty, even though VES says he's trained in that (maybe by a VA qualification to perform rudimentary ROM exams). He is a general practitioner. That's been his career as a DO... so maybe he's qualified.

Ok wait.. I'm being silly about this.

Saint Lukes hospital in Kansas City says "These include: Pain in the low back Pain, numbness, tingling, or weakness that travels into the buttocks, hip, groin, or leg Muscle spasms"

https://www.saintlukeskc.org/health-library/understanding-lumbar-radiculopathy

I think my C&P is on the right path. 

This caught my eye while I was surfing the net for answers (although it involves a future cervical spine claim I have):

"Nonoperative treatment includes physical therapy involving strengthening, stretching, and potentially traction, as well as nonsteroidal anti-inflammatory drugs, muscle relaxants, and massage. Epidural steroid injections may be helpful but have higher risks of serious complications. In patients with red flag symptoms or persistent symptoms after four to six weeks of treatment, magnetic resonance imaging can identify pathology amenable to epidural steroid injections or surgery.

Ok... I have the two anesthesiologists who have refused to do epidural nerve blocks on my lower spine, but neither one of them will say why. All they've said is they refuse me as a candidate for epidural injections! Why can't they say why?  I have pressed for answers and they're just button-lipped about it. Is there something about these guys? Some kind of inside code that has them all agreeing that mum's the word when they encounter something they don't want to do?

Edited February 19, 2022 by Rivet62
Trying to get this right...

[Mr cue]

20 minutes ago, Rivet62 said:

replace that with 'mindfulness programs'... or some psych-driven pain management to cope with pain

Basically they are telling veterans that weed and CBD work.

But we ain't expecting that an let see if these mood medicine work. Smh.

It all about a dollar you can grow you own pain medicine weed in your backyard.

An I help with other condition.

But somebody got to get pay first smh.

 

 

[Rivet62]

30 minutes ago, Mr cue said:

Basically they are telling veterans that weed and CBD work.

But we ain't expecting that an let see if these mood medicine work. Smh.

It all about a dollar you can grow you own pain medicine weed in your backyard.

An I help with other condition.

But somebody got to get pay first smh.

My ex lives in a very relaxed state and gets seeds from the state, and says it's darned good...like the best gold. 

Me? The only thing that is legal in my state is if the weed has been ground down into an approved capsule from an approved vendor I suppose.

The VA will pay tons of money for less beneficial prescriptions and tons of money to yack about it, but the yacking is nothing more than note taking that can be used to either decrease or deny. I suspect that with every encounter that doctors are claims adjusters. Fortunately for me, the situation is so serious that they can't pretend it's all ok.

Edited February 20, 2022 by Rivet62