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Concrete finisher not ready to find another profession!!!!!

AnonymousUserAAnonymousUser Posts: 49,731
I am a 46 yr old female concrete finisher. I recently was seeing my chiro for mild to moderate sciatica due to a long season of concrete paving (very labor intense, constant twisting and bending, 14-16 hr. days, 6 days week). I was relatively pain free until one day at work I had an unusually challenging task, where I had to climb on top of and straddle a rebar structure (waist high), hook my feet in the rebar, and twist to the side so I could reach down to the ground to shovel out and finish the concrete. During one of these exercises I felt a sudden sharp pain shoot down my leg. I barely made it through the rest of the day. As a matter of fact, after work I sat in my truck for awhile to aleve the pain. A short time later my fiance had to come to my job and physically carry me out of my truck. I have since seen work comp docs, attempted physical therapy, went to the er via ambulance due to leg pain that doesn't even compare to labor pains. I have since had an mri and work comp has referred me to a neurosurgeon. This is a summary of my mri:

L3-4 broad-based disc bulge. anterolateral indentation upon the thecal sac. Mild facet and ligament flavum hypertrophy.

L4-5 large broad-based disc bulge and a superimposed far right foraminal disc protrusion that is contacting the right exiting L4 nerve. Mild anterior indentation upon the thecal sac. Facet hypertrophy with mild ligmentum flavum hypertrophy.

L5-S1 Large disk bulge slightly eccentric to the left. Mild to moderate left and mild right neural foraminal narrowing. Spinal canal is patent. Bilateral facet osteoarthropathy.

Degenerative disc disease of the lumbar spine.

After 2-1/2 weeks of severe pain in my right leg and various pain meds, ibuprofen, vicodin, percocet, dilaudid and steroids and muscle relaxers; my pain is mild to moderate on 5 mg vicodin every 4-6 hours. HOWEVER: I now have the most intense pain on the top of my right foot. It feels as if the top layer of my skin was scraped off. Visually there is no abbrasions but the lightest touch will send me through the roof. I also get shooting pains in my big toe. I have tried every topical anesthetic I can get OTC, lidocaine, benzocaine, capsasin, nothing helps. I know it has to do with the nerve pinched in my low back, I'm scared to think it may be permanent.

If anyone can interpret the mri results I would truly appreciate it. I don't know the severity of the injury. It is work comp and I am terrified it may be career ending. I want to choose a course of treatment that would give me a better chance of continuing my concrete profession. As I am in the union, there are no desk jobs available if they put me on restricted duty. At the minimum I have to be able to lift 15-20 lbs., bend, twist, etc. With those requirements, how long might I need to rehabilitate before I can return to manual labor?

Anyone that can help or comment I would appreciate it. I am a single mom with 2 kids that I have to support. I'm hoping for some insight and maybe a heads up if I need to start looking for an alternative income to get me through till I can get back to work.
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Comments

  • Big toe pain is classic of L5 nerve root compression. I understand the burning feeling on your foot, for a while I couldn't even have a sheet touch mine. I wear sandles in the winter because I can't handle the compression of socks and real shoes. I have bugs(not literally) crawling on that foot and sometimes water dripping on it.

    Most of the time conservative treatment is recommended first, like physical therapy, epidural steroid injections, time, meds, etc. Many work comp carriers require 3 epidural steriod injections before they will approve surgery.

    I am not a doctor but if I were a patient in your shoes, I would push for an epidural and selective nerve root injection to try and calm things down for relief and then seriously consider surgery if the doc recommends it. Your symptoms sound very severe and the longer the nerves are compressed the more likely permanent damage.

    As far as recovery-no one can predict that, you don't know what you need done. If you had to go as drastic(and it's usually not the first step) as a fusion, I think most people can go back to lifting 15-20 pounds at some point. Bending would be tougher and walking/standing on hard surfaces for periods of time without changing position might be difficult. I don't know your state laws, but if the union doesn't have work if you have permanent restrictions, some states mandate that the employer pay for vocational rehab. That means new job training which might include paying for you to go to college and child care while you go.

    That's far off in the future right now for you. I think the best thing right now is for you to get good surgical opinions(notice the plural, you need more than one) and try to rest. You might try to make a concise list of what happened and what your symptoms are to present to the surgeon so that you can be very clear in the appointment.

    Good luck to you, please post an update.
  • I'm very sorry for all your pain and it sounds like you have a tough road ahead. I am no expert...but it sounds like you will require surgery. I don't know anything about workers comp cases though. I hope everything turns out well. If you are able to make extra income from home, it would be a good idea. When you feel this much pain, there isn't much you can do though.

    Keep us updated...
  • Sorry to hear about your injury. The neurosurgeon will need to be the one to interpret your MRI report / films.

    However, the good news is that most herniations go away within the 1st 6 weeks. It's the ones that stick around longer than 6 weeks, that may require surgery.

    So even if your Doc recommends surgery, schedule it after the 6 week mark.

    Of course injections, Chiro, PT, etc...should all be tried 1st.

    As for your return to the concrete business...

    If surgery is required, you may end up being able to lift 20lbs within a couple of months. However, twisting is out of the question, especially if it is combined with even light lifting. That's just my humble opinion, of course. I'm not a doctor, and I haven't stayed in a Holiday Inn Express in years. :)

    *I suppose you might be able to handle the twisting 6 months post-op. But it's a big roll of the dice, depending on what type of surgery you are recovering from.

    **It's early yet. Hopefully you will improve over the next 4 weeks, and not require surgery at all. If you can go back to work without having surgery, do it.

    Again, sorry for what you are going through.

    ____________
    3/27/08 L5-S1 Microdiscectomy
    6/27/08 L5-S1 Microdiscectomy
    12/01/08 L5-S1 Microdiscectomy

  • I'm sorry all this happened to you. I have a herniated disc also and sciatica. I've been off work since February. Everyone has a different treatment plan. Some need surgery and some need conservative measures. I hope we can be s support for you. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Sorry I have not posted a response in forever. I've seen the neurosurgeon. He wanted to try the least evasive things first. I told him my main goal is to return to finishing concrete. I had two epidural steroid injections and my right leg pain diminished considerably. I still have a raw feeling on top of right foot and my toes go numb on both feet after walking. I went through two months of physical therapy, the last month consisted of work conditioning for 2 hours at a time 3 days a week.

    The beginning of March I was released to full duty as a concrete finisher. The neurosurgeon wanted to see me in a month to verify my back was holding up to the physical work I would endure. Due to weather, I averaged 3 days a week at work. I noticed after 3 days in a row I would have faint pains in my right leg. I would also ache in my low back but I attributed it to being off work since November 08.

    Three days before my follow-up visit with the neurosurgeon I was at work mixing a five gallon bucket of VERY THICK epoxy with a piece of rebar and immediately felt pain across my lower back that took my breath away. I could not straighten up, bend or move without severe pain. I waited for my appointment with some improvement in symptoms as I went back on disability from work. When I met with the Dr. he promptly referred me for another MRI. His interpretation of the new MRI showed a worse situation than the original MRI I had when I injured myself in November 08. He suggested spinal fusion from L4-S1. He then referred me for a CT scan which supported more detail on why he recommended fusion. I do not have the actual report yet but he gave me a summary of what I am dealing with.

    L5-S1 is unstable due to Spondylolisthesis. There is disk herniation protruding to the left.

    L4-L5 has disk protrusion to the right. There is also another form of Spondylolisthesis (I can't remember what he called it but the slippage of the disk is side to side?

    He suggests fusion through front and back to ensure it is stable. I also have some degenerative disk disease.

    He said that within the last three months I rested, had epidural shots and physical therapy but only lasted 3 weeks back at work (not even a full work load). He says without surgery my back cannot withstand the physical labor. He did not guarantee anything, but he feels if there is any chance of me returning to work, it would only be possible with the spinal fusion.

    I need advice. Is there anyone that had L4-S1 fused that could tell me what my chances will be of finishing concrete. I do probably more twisting than I do lifting. I am very commited to any and all physical therapy and exercise needed to build up any strength and range of motion I loose. I just need to know if it is physically possible to go back to this type of work. I have the ambition and perseverence to give it all I've got. I have every motivation in the world as I love my job and make a good living. I just need to know if that is going to be enough.

    Any help or suggestions would be so appreciated.
  • I know about wanting to return back to the work that you enjoy and love. I am a teacher which doesn't require heavy lifting, but some twisting and a lot of bending. I had two microdiscectomies (a surgery not as aggressive as fusion) and I cannot to return to work until the end of the school year.

    You want advice, so here it is---Since your dr wants to skip microdiscectomy and jump to fusion, your back must be in bad condition. I read and been told that the recovery from fusion takes a long time--months, so I can't see you going back to work any time soon.

    While you are in recovery (hopefully getting disability pay), you can be trained to do something less strenuous.

    This is my opinion. I just would hate for you to undo what your surgeon will do for your back.
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