SI Joint Struggles/Potential MEB

A

AverageLT

PEB Forum Regular Member
Registered Member
History: I've been in the Army for just over 4 years. I'm an active duty officer. I began experiencing low back pain over 1.5 years ago. I, like most, chose to just ignore it for the first 9 months. I initially went in to a provider on glorious Ft. Jackson in July of 2020. They referred me to chiro (inside the Army health clinic), who I still see regularly. Chiro then referred me to PT, who I worked with for around 2-3 months before they felt as if they could not help me. Saw my PCM and he referred me to pain management. Got an injection into my L5-S1, no relief. Gave up. Pain got worse. Got an injection into both my SI joints. Saw some amazing improvement in ROM, pain very slightly improved. Sadly, the relief only lasted approximately 5 days. Went back to PCM, he said "yeah, sounds like SI joint dysfunction. I have it too. Learn to live with it." (He's like 50 so I'm sure he's fine with it). He gave me an ortho referral and told me to consistently take high dose Meloxicam for 30 days. Ortho mentioned I may not have many options outside of fusion surgery if anti-inflammatories aren't providing relief. X-rays have come back relatively normal minus very slight narrowing in the L5-S1 joint space...which realistically points to loose ligaments in the SI joint area (I am "double jointed" and have hyperflexibility in every joint in my body).

Question: I've begun doing a significant amount of research on VA ratings and MEB for SI joint issues, because I physically cannot handle feeling like this any longer. Has anyone been through this process? My commander mentioned initiating an MEB a few weeks ago....as I very clearly cannot perform my job duties, particularly rucking, running, standing for long periods, and deadlifting on the ACFT (basic training XO). I struggle to find a significant amount of information on how percentages are assessed for SI joint disfunction, especially with imaging not showing much. It would be entirely bases on incapacitating episodes and ROM. I'm very seriously considering fusion of both joints because I can't handle barely being able to put my boots on in the morning at 28 years old. I am a very active persona and compete in bikini competitions, and am a certified personal trainer. This has been one of the biggest "hits" to my current way of life, and hobbies. I don't want to continue to sacrifice my health for a condition that is continually worsening. My fear is dropping a packet and getting out because I am fed up with the pain, and then living with a condition that was absolutely caused by military service. Or missing out on a surgery that could help.
 
I am currently going through a MEB for sacroiliitis as well as another condition. I can tell you the ratings once I receive them. I have also attempted the same “treatment” options as you among others if you need other options.
 
Jsnyder81 said:
I am currently going through a MEB for sacroiliitis as well as another condition. I can tell you the ratings once I receive them. I have also attempted the same “treatment” options as you among others if you need other options.
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I would truly appreciate that. I’m being told I will not be considered a fusion candidate until I try nerve ablation. Which from my understanding, most likely won’t have a good prognosis if the nerve block provided such temporary relief. My other fear, is that the nerve block works for 6 months, I drop a REFRAD packet, and the pain picks back up once I’m already out of the Army. It’s just a bit of a discouraging thing that I feel such pain, but imaging can’t substantiate this severe of pain. It’s a bit of a mind f**k.
 
I had great success with oblation. But everyone's medical situation is different. I had three injection first, with little relief.
 
A little update, my PCM diagnosed me with Ehlers-Danlos Syndrome today, the hyper mobility type. I’m super unclear on what treatments are even a good option at this point.
 
AverageLT said:
A little update, my PCM diagnosed me with Ehlers-Danlos Syndrome today, the hyper mobility type. I’m super unclear on what treatments are even a good option at this point.
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Hey there! I actually got diag'd with EDS not too long ago and it initiated a MEB for me.

My biggest issue is sublex / dislocations. Sadly there is not much we can really do with regards to "treatments". I have however had double wrist surgery to help with the constant sublexing. The left wrist surgery (took place 6 months prior to the right) was the first time they attempted anything of the sort to correct this...resulting in a failure. They then learned from this and modified their approach for the right, making the sublexing basically stop...at the expense of limited mobility. Long story short, they strung the wrist bones together like a beaded necklace....partial fusion.

I'd be happy to talk with you about the diagnosis and going forward and what I have experienced. We both walk a fine line egarding not enough exercise and toomuch….both leading to potential issues.
 
AverageLT said:
History: I've been in the Army for just over 4 years. I'm an active duty officer. I began experiencing low back pain over 1.5 years ago. I, like most, chose to just ignore it for the first 9 months. I initially went in to a provider on glorious Ft. Jackson in July of 2020. They referred me to chiro (inside the Army health clinic), who I still see regularly. Chiro then referred me to PT, who I worked with for around 2-3 months before they felt as if they could not help me. Saw my PCM and he referred me to pain management. Got an injection into my L5-S1, no relief. Gave up. Pain got worse. Got an injection into both my SI joints. Saw some amazing improvement in ROM, pain very slightly improved. Sadly, the relief only lasted approximately 5 days. Went back to PCM, he said "yeah, sounds like SI joint dysfunction. I have it too. Learn to live with it." (He's like 50 so I'm sure he's fine with it). He gave me an ortho referral and told me to consistently take high dose Meloxicam for 30 days. Ortho mentioned I may not have many options outside of fusion surgery if anti-inflammatories aren't providing relief. X-rays have come back relatively normal minus very slight narrowing in the L5-S1 joint space...which realistically points to loose ligaments in the SI joint area (I am "double jointed" and have hyperflexibility in every joint in my body).

Question: I've begun doing a significant amount of research on VA ratings and MEB for SI joint issues, because I physically cannot handle feeling like this any longer. Has anyone been through this process? My commander mentioned initiating an MEB a few weeks ago....as I very clearly cannot perform my job duties, particularly rucking, running, standing for long periods, and deadlifting on the ACFT (basic training XO). I struggle to find a significant amount of information on how percentages are assessed for SI joint disfunction, especially with imaging not showing much. It would be entirely bases on incapacitating episodes and ROM. I'm very seriously considering fusion of both joints because I can't handle barely being able to put my boots on in the morning at 28 years old. I am a very active persona and compete in bikini competitions, and am a certified personal trainer. This has been one of the biggest "hits" to my current way of life, and hobbies. I don't want to continue to sacrifice my health for a condition that is continually worsening. My fear is dropping a packet and getting out because I am fed up with the pain, and then living with a condition that was absolutely caused by military service. Or missing out on a surgery that could help.
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By no means am I suggesting your PCM is wrong. They have way more information. But I highly recommend an MRI if you haven’t had one. Your entire process, diagnosis, and subsequent ratings can be affected. Also suggest a CT Scan before going to C&P exams
 
ajw219 said:
Hey there! I actually got diag'd with EDS not too long ago and it initiated a MEB for me.

My biggest issue is sublex / dislocations. Sadly there is not much we can really do with regards to "treatments". I have however had double wrist surgery to help with the constant sublexing. The left wrist surgery (took place 6 months prior to the right) was the first time they attempted anything of the sort to correct this...resulting in a failure. They then learned from this and modified their approach for the right, making the sublexing basically stop...at the expense of limited mobility. Long story short, they strung the wrist bones together like a beaded necklace....partial fusion.

I'd be happy to talk with you about the diagnosis and going forward and what I have experienced. We both walk a fine line egarding not enough exercise and toomuch….both leading to potential issues.
Click to expand...
I would greatly appreciate that. I’m 2.5 months post Left SI fusion, and 1.5 months out from the Right fusion. I printed the regs for retention and brought them to my PCM. She stated that she would not initiate an MEB until I’m one year post op….from the SECOND surgery. Im struggling with seeing how someone with EDS is medically retainable. Ultimately, I don’t feel like my health is being taken seriously. I’ve had to ask to see an Ortho, Rhuem, and been denied to see a geneticist. I can legitimately feel my joints deteriorating but my PCM won’t talk about an MEB right now. Im QUITE frustrated.
 
Ehlers Danlos syndrome can only be diagnosed through genetic testing. On the other hand, hypermobility spectrum disorder can be diagnosed through range of motion tests. I would push for a genetic test if I were you.
 
That’s not true for hEDS. It cannot be confirmed via genetic testing. It has very specific diagnostic criteria
Coffeeaddixt said:
Ehlers Danlos syndrome can only be diagnosed through genetic testing. On the other hand, hypermobility spectrum disorder can be diagnosed through range of motion tests. I would push for a genetic test if I were you.
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Coffeeaddixt said:
Ehlers Danlos syndrome can only be diagnosed through genetic testing. On the other hand, hypermobility spectrum disorder can be diagnosed through range of motion tests. I would push for a genetic test if I were you.
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I’ve attached the diagnostic criteria here. All other types of EDS can be confirmed with genetic testing. However, hEDS cannot be. That being said, I’d feel much better ruling out the other forms. I do have autoimmune hives and valve regurgitation (both diagnosed) which all “fit” within the EDS diagnosis.
www.ehlers-danlos.com

hEDS Diagnostic Checklist - The Ehlers Danlos Society

www.ehlers-danlos.com www.ehlers-danlos.com
 
I have bilateral sacroillitus if your having pains like numbing in thighs and butt or hurts to sit it could also be sciatica which he said the “sciatic notch” could be getting abutted due to the inflammation I was initially rated by va at 10% for each side and was considered unfit due to it. I also got 20% for range of motion for back which is also rated under SI. I later was upgrade for sciatica to 20% bilateral due to greater symptoms but maybe have an mri to confirm if you having sharp or shooting pains, numbness or muscle fatigue
 
AverageLT said:
History: I've been in the Army for just over 4 years. I'm an active duty officer. I began experiencing low back pain over 1.5 years ago. I, like most, chose to just ignore it for the first 9 months. I initially went in to a provider on glorious Ft. Jackson in July of 2020. They referred me to chiro (inside the Army health clinic), who I still see regularly. Chiro then referred me to PT, who I worked with for around 2-3 months before they felt as if they could not help me. Saw my PCM and he referred me to pain management. Got an injection into my L5-S1, no relief. Gave up. Pain got worse. Got an injection into both my SI joints. Saw some amazing improvement in ROM, pain very slightly improved. Sadly, the relief only lasted approximately 5 days. Went back to PCM, he said "yeah, sounds like SI joint dysfunction. I have it too. Learn to live with it." (He's like 50 so I'm sure he's fine with it). He gave me an ortho referral and told me to consistently take high dose Meloxicam for 30 days. Ortho mentioned I may not have many options outside of fusion surgery if anti-inflammatories aren't providing relief. X-rays have come back relatively normal minus very slight narrowing in the L5-S1 joint space...which realistically points to loose ligaments in the SI joint area (I am "double jointed" and have hyperflexibility in every joint in my body).

Question: I've begun doing a significant amount of research on VA ratings and MEB for SI joint issues, because I physically cannot handle feeling like this any longer. Has anyone been through this process? My commander mentioned initiating an MEB a few weeks ago....as I very clearly cannot perform my job duties, particularly rucking, running, standing for long periods, and deadlifting on the ACFT (basic training XO). I struggle to find a significant amount of information on how percentages are assessed for SI joint disfunction, especially with imaging not showing much. It would be entirely bases on incapacitating episodes and ROM. I'm very seriously considering fusion of both joints because I can't handle barely being able to put my boots on in the morning at 28 years old. I am a very active persona and compete in bikini competitions, and am a certified personal trainer. This has been one of the biggest "hits" to my current way of life, and hobbies. I don't want to continue to sacrifice my health for a condition that is continually worsening. My fear is dropping a packet and getting out because I am fed up with the pain, and then living with a condition that was absolutely caused by military service. Or missing out on a surgery that could help.
Click to expand...


I experienced the exact same situation as you minus the hyperflxibility. Chronic hip and back pain. Went from Chiro, to PT, to constant injections(TFESI with RF has helped the most with mobility). The Pain in constant and the spasms are fully incapacitating. Code 37 6 January. I'm currently waiting to have a full MEB initiated(package is at AFPC). I will try to remember to keep you informed on what happens on my end!
 
Hello all,
Here kind of in the same boat. 18 year and 7 months as AD Army, and I just got diagnosed with SI joint sclerosis and atrophy bony bridging. I already had a Spinal fusion back in 2021 and Ive been dealing with that since then. I am currently in PT for "Tennis Elbow" forearm tendonitis, and all kinda of Sh.. in my right shoulder after surgery and now my SI diagnosed. It seems that my route will be an MEB from what I have searched on the internet and what I have read here above. from yall experience, what should I realisticlly expect to be the otcome?
 
BrokenIvan said:
Hello all,
Here kind of in the same boat. 18 year and 7 months as AD Army, and I just got diagnosed with SI joint sclerosis and atrophy bony bridging. I already had a Spinal fusion back in 2021 and Ive been dealing with that since then. I am currently in PT for "Tennis Elbow" forearm tendonitis, and all kinda of Sh.. in my right shoulder after surgery and now my SI diagnosed. It seems that my route will be an MEB from what I have searched on the internet and what I have read here above. from yall experience, what should I realisticlly expect to be the otcome?
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Do you have an ADSO causing you to serve beyond 20 years? If not, I would drop your retirement packet as soon as eligible. There are almost no tangible benefits to medically retiring verse a 20 year regular retirement. As long as your total VA% is 50% or higher you will get all of your earned pension and all of your VA compensation. That is the most you can get.
 
Provis said:
Do you have an ADSO causing you to serve beyond 20 years? If not, I would drop your retirement packet as soon as eligible. There are almost no tangible benefits to medically retiring verse a 20 year regular retirement. As long as your total VA% is 50% or higher you will get all of your earned pension and all of your VA compensation. That is the most you can get.
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I do, I recently got promoted. Still have some time to serve in rank. If it wasn't because of that, I would've put my retirement already. :-/
 
BrokenIvan said:
I do, I recently got promoted. Still have some time to serve in rank. If it wasn't because of that, I would've put my retirement already. :-/
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Okay. I would still try to make sure you hit 20 years even if delaying a bit. That way the results don't matter as long as you are found unfit. That and a 20 year retirement earned means you get all of your pension and VA compensation as long as your total VA% was 50% or higher. If you get kicked out at 19 years and 10 months for example any VA compensation received would offset your chapter 61 pension. Its possible all of your pension is offset leaving you only VA compensation and tricare which would be a tragedy.
 
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