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  • Avatardransberge
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    Post count: 2

    Hello I was a CNA and at my last job on 3/6/19 I hurt my lower back. I have had 1 epidural shot, physical therapy, 4 facet joint injections and even saw a chiropractor with the permission from my pain management doctor who is handling my issues through Workers comp. He has me on muscle relaxers and Naproxen. The first MRI showed disc bulges and facet joint arthritis. We requested a Stand up MRI flexion where I sat in a chair this MRI came back L2/L3 a disk herniation 4mm extending into the right sided neuroforamen and Anterior vertebral spurring..My question is could this require surgery he doesnt seem to think so and has said no surgery. L3/4 2mm anterior vertabral offset Posterior bulging w/ Bilateral foraminal encroachment , anterior vertebral suprring and reactive sclerosis in the facet joint. L4/5 left sided foraminal encroachment anterior vertebral spurring is noted with reactive sclerosis in the facet joints. This doctor gave me a 3 percent MMI rating, and has went on record no surgery needed. Now I am at the mercy of losing my income and insurance, if I dont qualify for disability. My attorney said a 4mm herniation is not that big? My symptoms are as follows.
    1. Lower back above tail bone center swells at times almost like their is fluid build up or bursitis

    2. Pain stems from that area into the hips and burns both left and right

    3. When Darlene lays back flat or tries to straighten up in proper posture she has sharp extreme pain that shoots up and down her legs , up from the swelled area.

    4. Feet tingle all the time.

    5. Legs feel real heavy and hard to move a lot of the time

    6. Afraid to fall , because legs are so week and feet feel funny.

    7. Anytime I try and straighten my spine , I set myself back a few days

    8. Most times when I try to do moderate walking or exercising I set myself back a few days, few days meaning 1 thru 7.

    I even tried to lift 9 lbs on my legs with weight machine did it 3 to 5 x and it hurt me and set me back again.

    Extended walks hurt me and set me back , that means just walking around the yard or walking slowly a half a mile

    I have to sleep in recliner because Its impossible for me to lay flat in the bed, I struggle almost every morning getting out of my chair and have to use a walker.

    9. I lock up my back locks up and I have muscle spasms that shoot up and down frequently

    10. The muscle relaxers are not helping neither is the Naproxen.

    11. I cant raise my arms over my head while standing most times.
    I need help asap!! My attorney is going to try and get the pain management doctor to sign some things to declare that I can not work in this condition but I have little faith in that. Also Comp sent me back to work. I lasted 2 hours before the nursing home nurses and director of nursing sent me back home, they said I was worse off then some of the patients they have and I was a liability.
    Thanks Darlene Ransberger

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7629

    You note: “L2/L3 a disk herniation 4mm extending into the right sided neuroforamen
    L3/4 2mm anterior vertebral offset Posterior bulging w/ Bilateral foraminal encroachment , anterior vertebral spurring and reactive sclerosis in the facet joint
    L4/5 left sided foraminal encroachment anterior vertebral spurring is noted with reactive sclerosis in the facet joints”. you note nothing of L5-S1 which can be a problem too but I will assume that the MRI report is negative.

    When I boil down your complaints, it sounds like lower back pain is the predominant complaint. I hear no localizing pain into one thigh or buttocks which would then lead me away from that disc herniation causing any symptoms. You do have degenerative spondylolisthesis at the level L3-4 and even maybe L4-5. This does not mean surgery necessarily but a good rehab program and possibly injections to reduce pain and inflammation.

    See https://www.neckandback.com/conditions/degenerative-spondylolisthesis-or-spondlylolysthesis/ and
    https://www.neckandback.com/treatments/conservative-treatment-mechanical-lower-back-disorders/

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    Avatardransberge
    Participant
    Post count: 2

    Thank you Dr. Corenman for those links they were helpful. L5 /S1, disc space maintained , disc well hydrated. Posterior bulging of the disc is seen, the neuroforamina are patent. So I dont think that one is too bad. What I dont understand is I have had a epidural it did not help. I had 4 facet joint injections it did not help. I went through a month of therapy it seemed to help a bit, but then I had a set back and it started all over like when I first got hurt I was using a walker again. I try to stay active at home walking around the yard when I have better days, but it always comes back and last 3 or more days to where I cant do much of anything. My Pain management doctor did not think therapy would help anymore…He gave me a MMI rating after only seeing me since May. I did get hurt on 3/6/19 but workmens comp too a while to get me into see the pain management doctor before then I was seeing MD’s . As I said they tried to send me back to work but work sent me right back home and said I was worse off then some of the patients in the nursing home. I will lose my income shortly….because of workmens comp only paying for the 3 percent rating my workers comp pain management doctor gave me. Because he said it was just muscles. So I dont know if disability is even a option for me. To be honest I am scared because anytime I do something lightly moderate to moderate I always get set back in a lot of pain. Even on better days I cant lay flat or straighten my spine without pain. It seems workers comp and my doctor has given up on me. Scared about my future. I do have a attorney but he doesnt answer many of my emails and I have a deposition coming up in January. I do not feel its right to settle for a little bit of money until I can work or get some kind of financial help like disability. Any other suggestions would be most helpful

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 7629

    You note “I have had a epidural it did not help. I had 4 facet joint injections it did not help”. I assume that you mean these injections did not help long term. Commonly, the diagnostic window is ignored which is a shame as the results with relief of pain in the first three hours is the key to knowing if these injected structures are the pain generators.

    See
    https://www.neckandback.com/treatments/diagnostic-vs-therapeutic-injections/
    https://www.neckandback.com/treatments/epidural-injections-and-selective-nerve-root-blocks-diagnostic-and-therapeutic/
    https://www.neckandback.com/treatments/facet-blocks-and-rhizotomies/ and
    https://www.neckandback.com/treatments/pain-diary-instructions-for-spinal-injections/

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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