Everything but surgery - what to do

Moustache6

Moustache6

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My Doc has tried everything short of surgery for my lower back.
The MRI show right L2-3 disc extrusion; moderate and chronic disc degeneration at L3-4 without stenosis; mild degenerative change L4-5 and L5-S1 with mild left L4-5 neural foramen stnosis. I have had physical therapy, traction, acupuncture, and have a TENS machine that I use daily. I have 2-4 episodes a year where my back looks like I have scoliosis and it is extremely painful to even move for days at a time. Every time I sit in the car for more than 45 minutes my back is sore for the next couple of days.
From the experience of everyone with similar issues is there a course of action that has been helpful. To date the docs have only been able to temporarily relieve symptoms. The pain keeps coming back.

I am currently rated at 10% for Lumbosacral or Cervical Strain. Is my rating where it should be... I know that there are flexion requirements, but don't they take into consideration all of the information I listed above?

Thanks
 
Moustache6 said:
My Doc has tried everything short of surgery for my lower back.
The MRI show right L2-3 disc extrusion; moderate and chronic disc degeneration at L3-4 without stenosis; mild degenerative change L4-5 and L5-S1 with mild left L4-5 neural foramen stnosis. I have had physical therapy, traction, acupuncture, and have a TENS machine that I use daily. I have 2-4 episodes a year where my back looks like I have scoliosis and it is extremely painful to even move for days at a time. Every time I sit in the car for more than 45 minutes my back is sore for the next couple of days.
From the experience of everyone with similar issues is there a course of action that has been helpful. To date the docs have only been able to temporarily relieve symptoms. The pain keeps coming back.

I am currently rated at 10% for Lumbosacral or Cervical Strain. Is my rating where it should be... I know that there are flexion requirements, but don't they take into consideration all of the information I listed above?

Thanks
Click to expand...

Indeed and it depends; if all medical evidence shows symptomatology for a DoVA 10% rating via the "General Rating Formula for Diseases and Injuries of the Spine" as annotated within the VASRD then maybe.

Otherwise, the medical evidence will need to show symptomatology supportive of a higher rating as annotated within the VASRD as such..."With or without symptoms such as pain (whther or not it radiates), stiffness, or aching in the area of the spine affected by residuals of injury or disease."

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Moustache6 said:
My Doc has tried everything short of surgery for my lower back.
The MRI show right L2-3 disc extrusion; moderate and chronic disc degeneration at L3-4 without stenosis; mild degenerative change L4-5 and L5-S1 with mild left L4-5 neural foramen stnosis. I have had physical therapy, traction, acupuncture, and have a TENS machine that I use daily. I have 2-4 episodes a year where my back looks like I have scoliosis and it is extremely painful to even move for days at a time. Every time I sit in the car for more than 45 minutes my back is sore for the next couple of days.
From the experience of everyone with similar issues is there a course of action that has been helpful. To date the docs have only been able to temporarily relieve symptoms. The pain keeps coming back.

I am currently rated at 10% for Lumbosacral or Cervical Strain. Is my rating where it should be... I know that there are flexion requirements, but don't they take into consideration all of the information I listed above?

Thanks
Click to expand...

I have been fighting my back for 7 years now. Have almost identical symptoms, and followed the exact same treatment path, and then had surgery. In my case, surgery was very beneficial as far as relieving my right leg sciatica. I still have pain in my leg, but it is nowhere near the hell I was in when the nerve was pinched. What the surgery did not do is help my back pain. If anything it made it a bit worse. I had laminectomy/disectomy of the L4/L5.

My next step is to have fusion which is a 50/50 for helping my pain. The thought behind fusion, is it imobilizes the bad vertebrae, which generate the pain during movement. The problem is it also creates additional strain on the free moving vertebrae above and below the fusion. So down the road I would very likely have additional disc problems at the new locations.

What works for me right now, is pain medication. I have been on it long term (3 years), and it does not make things completely better, but it does well enough to help me function. It's a tough road though, as you run a risk of getting addicted to opiates if you can't control the pills. I have been on the same dose for 3 years, and don't run into any problems with running out, or over using, but everybody is not built that way. I take 5/325 vicoden. They have tried different things over the years. The worst experience being the pain patch. Those are very strong and seriously messed me up.

For your other question, no they don't take that other stuff into consideration for ratings. It is very rare to see a rating coming from anything but ROM. What is funny about that to me, is the amount of pain you would be in to hit 0-30 degrees and get 40%. I am pretty messed up, and I am 50-60 degrees. I can only imagine 15 degrees, and how aweful it would be.

Joe
 
ranger2992 said:
For your other question, no they don't take that other stuff into consideration for ratings. It is very rare to see a rating coming from anything but ROM. What is funny about that to me, is the amount of pain you would be in to hit 0-30 degrees and get 40%. I am pretty messed up, and I am 50-60 degrees. I can only imagine 15 degrees, and how aweful it would be.

Joe
Click to expand...

Indeed, well stated, Joe; I have been dealing with my LBP medical condition for over 10 years now! ;)

In retrospect, I had an ALIF L4-5 lumbar disc fusion surgery in 2011 while on Active Duty and since I am in constant ROM daily pain while the non-narcotic prescription medication only allows some relief to implement activities of daily living (ADL). That said, it's my decision not to start a medical regime with narcotic pain medication for my lumbar condition.

To that extent, after the submittal of a VARR request, the DRO at the DoVA D-RAS agreed that my PEB referred lumbar spine medical condition was worse from a new medical examination due to an automobile accident as a pedestrian to include two other automobile accidents.

As based upon the new medical evidence for my lumbar condition's symptomatology, I was awarded an increased DoVA proposed rating from 20% to 40% as it should be albeit ADL performance is a contact daily challenge for sure!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer."

Best Wishes!
 
Last edited:
Moustache6 said:
My Doc has tried everything short of surgery for my lower back.
The MRI show right L2-3 disc extrusion; moderate and chronic disc degeneration at L3-4 without stenosis; mild degenerative change L4-5 and L5-S1 with mild left L4-5 neural foramen stnosis. I have had physical therapy, traction, acupuncture, and have a TENS machine that I use daily. I have 2-4 episodes a year where my back looks like I have scoliosis and it is extremely painful to even move for days at a time. Every time I sit in the car for more than 45 minutes my back is sore for the next couple of days.
From the experience of everyone with similar issues is there a course of action that has been helpful. To date the docs have only been able to temporarily relieve symptoms. The pain keeps coming back.

I am currently rated at 10% for Lumbosacral or Cervical Strain. Is my rating where it should be... I know that there are flexion requirements, but don't they take into consideration all of the information I listed above?

Thanks
Click to expand...

A little late on a response here, but what were you ROM numbers? From reading your post, it looks very similar to what I have. You are not always in pain but when you are, it incapacitates you completely? How does that have an affect when going to your exam for possible percentages?
 
There is a rating criteria for prescribed bed rest. If you can get a doc to say yup, no moving for you for x days and can establish a trend for that it may be possible to get a rating for something besides rom.

Hard though, if you can't move, how can you get a doc to see the problem. May take an ambulance for an ER trip to get started down that path. ROM is considerably easier to test and support.
 
scoutCC said:
There is a rating criteria for prescribed bed rest. If you can get a doc to say yup, no moving for you for x days and can establish a trend for that it may be possible to get a rating for something besides rom.

Hard though, if you can't move, how can you get a doc to see the problem. May take an ambulance for an ER trip to get started down that path. ROM is considerably easier to test and support.
Click to expand...

During my C&P exams, even though the C&P Doc did NOT use a goniometer (he "eye-balled" me), I did however, personally hand him several MRI results from the radiology Doctors on my lower back taken over a three year period.

I ended up with a 40% DoD/VA rating (unfit) for lower back and that was based primarily upon the C&P Doctor's "eye-balling" and the ROM degrees he put down on his VA paperwork.

nwlivewire
 
ZC1988 - the ROM numbers were as follows:
Forward flexion ends - 70
Painful motion begins - 60
Extension ends - 25
Painful motion begins - 20
The remaining numbers are all listed as 30 or greater
Post test flexion ends - 70
Post test extension ends - 25

What % does this point toward? Do they use the flexion numbers or the painful motion numbers?
 
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