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  • Jillga
    Member
    Post count: 3

    Dear Dr Corenman,
    I have just discovered your wonderful website and your location.. I live in Denver.

    I am an RN of 31 years, injured on the job 11/10, now I am being told I have arthritis and there is nothing more they are responsible for.

    I still have significant symptoms , improvement for a short time after 2 RFs. Low back pain that radiates to vice like pain in hips and thighs, which I take norco 10 TID, occasionally dilaudid. I was very active prior to the incidence and if I even try to be that active now, am laid up in incredible pain for days. I do excercise about 6-7 hours a week with meds. I am unable to work – cant sit or stand for long periods.

    My Mri 11/10 showed edema in paraspinal musculature at the L4 L5
    L2-L3 annular ter and shallow L posterolateral disc protursion
    L3-L4 disc bulge mild canal narrowing L greater tha R lateral recess narrowing
    L5-S1 Annular tear w no associated disc herniation

    there is heterogeneous T2/STIR hyperintensity withing the paraspinal musculature at the L4- L5 levels, charateristic of edema

    I have been told that basically I had an injury that is healed and I am not dealing w degenerative processes

    Do you think the injury can cause the extended pain Ive been experiencing?

    I am most grateful for your reply

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    An on the job injury that creates pain that was not present before the injury is a workman’s compensation issue and not from “arthritis” that was present before the injury. Preexisting degenerative changes which are present but asymptomatic in a substantial portion of the population make injury more likely.

    The pain that radiates into your hips could be from the foraminal or lateral recess stenosis at L3-4. Is your back pain greater than your hip and thigh pain or reverse?

    Dr. Corenman

    Jillga
    Member
    Post count: 3

    It usually starts w severe back pain then radiates to the hips and thighs. The hips then seem to hurt the worse, or I notice it more.

    So, is the foraminal or lateral recess stenosis at L3-L4 from injury or arthritis?

    Thank you for the quick response!!

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    Again, symptoms that are only present after the accident can reasonably attributed to the accident. Regardless as to the presence of the spinal disorder prior to the accident, if it was asymptomatic before the injury and symptomatic now, it is injury related. The only caveat is that if the disorder could be predicted to become symptomatic regardless of the injury, then it would not be related to the work comp injury.

    If your pain is mainly lower back pain, this would most likely be a discal or instability problem and not from nerve compression.

    Dr. Corenman

    Jillga
    Member
    Post count: 3

    Thank you Dr Corenman,
    The instability in my back I can feel. It actually moves and pops… I can have R sciatica or L depending on where it wants to go. BUT I never had this prior to the injury…..

    How is the caveat predicted?

    I so appreciate your comments and I am hoping to be approved for a consult with you

    Jill

    Donald Corenman, MD, DC
    Moderator
    Post count: 8455

    The caveat is unusual and probably does not apply to you. Popping could be from facet instability but they are most likely not pain generators as your facet rhizotomies did not work.

    Dr. Corenman

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