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What are the chances I ever get back to work?

JenniferJJennifer Posts: 4
edited 06/11/2012 - 8:45 AM in Lower Back Pain
I need some advice from actual people that have a clue of what I'm going through. The way things are looking I will never get back to work. I was injured Jan. 2, 2010 and diagnosed as a lumbar strain, or so they thought. I did physical therapy and light duty for two weeks and then went back to work. Five shifts later I was hurled over in debilitating pain in my low back, right side, right hip, leg, and groin area. I went home and ended up in the ER. They did nothing accept give me pain meds and tell me I had to go to occupational health. I did and had an MRI. Doc said I had a minor bulge on L5-S1, go home and take prednisone and it should heal itself in a few weeks...That was 6 months ago. I didn't trust him at all and requested a referral to an orthopedic. Ortho said it was actually a grade 4 annular tear of the disc. I had two epidural cortisone shots and they didn't help. I have been on mumerous meds but I think he believes I'm 'faking' or not as serious as I appear when I'm hunched over in pain since he continues to deny medication that is therapeutic for me. I got referred to an orthopedic surgeon who said was a candidate for total-disc-replacement surgery and would need a discogram. My ortho did the discogram; most painful procedure ever!! Apparently the test wasn't 'ideal' so surgeon said no. So now ortho says there is nothing more he can do and so does the surgeon. I'm fighting with Comp to get authorization for another opinion. I went for the IME(independent medical exam) and that doc said "I can not say for sure that this individual will ever return back to full duty without surgical intervention." He says decompression or spinal fusion might be best option for me. So...one doc says nothing more to do and other says surgery, I think this warrants another opinion. Especially since doc 1 says nothing more he can do and sends me to work conditioning when I haven't even been able to do physical therapy yet. Make sense? No. Does anyone here have a similar story? Obviously no one wants surgery but if that's what will work then lets do it. Every day I sit here I get weaker and weaker which will only increase my recovery time. The hard thing about this is my job is so physically demanding. I'm an EMT. I don't sit at a desk, my job is to lift and carry people and gear all day, treat people while standing in a moving ambulance and climb up and down stairs; not easy for even the most healthy. So what are my chances of getting back to work? Really looking for an honest un-biased response other than the doctors BS...


  • This is really an answer you need to get from a doctor, though. So far, you've had doctors tell you that you have an annular tear that they won't operate on, and that you won't work again without surgery. Logically, can you see that those two opinions don't fit together?

    You need a board certified neurosurgeon or orthopedic surgeon who will work with you and talk to you, and will really help you figure this out.

    Nobody here can tell you what your prognosis is, or what your outcome is going to be. People recover from disk injuries often without surgery, but sometimes surgery is required. Very few people never go back to work after a disk injury, but it isn't unheard of. All good reasons why you need to find yourself a great doctor to help you through this.

    As for the meds, some of us have better luck with a pain management doctor. Also, PM doctors offer other minimally invasive treatments, such as steroid injections. Your mileage may vary.
  • I'm working on finding another doctor now. I understand what I have to do I just don't know where to start. How do you convince workers comp to authorize another opinion? The last thing they want to do pay me throughout recovery after surgery so they have a biased opinion. Also, how do you find a reputable doctor? I've asked around and everyone I've asked said that thier doc is 'the best in the state'...I don't know how there can be atleast ten best doctors in little Connecticut. It's not so much as going to a Specialist as it used to mean, there are so many orthos out there now, I don't know where to go or who to ask. I need this extra opinion for the PM reasons too. I do not like the current regimen of constant vicodin and muscle relaxers, it's too much...comp is going to end up paying for rehab after all of this, lol. Seriously though, thank you for the feedback. I understand that those questions are for a doctor I just need to find a reputable one, which isn't easy. So I guess overall I'm looking for how to find a good orthopedic or neurosurgeon and some statistics on recovery relating to different methods of treatment.
  • I understand hating to be on pain meds constantly, but having been on them for 2 1/2 years, you do learn to deal with it. Sometimes there is no fix, and you deal with what you have.

    As for finding a good doctor, it's not easy! I don't know about worker's comp at all- maybe someone else will have advice for you there. I found my good doctors through different ways- recommendation from friends, recommendations from doctors I respect, research online, those online ratings sites (those are especially helpful for things like wait times and finding out if a doctor is board certified), etc.

    I don't think you can get stats on recovery until you get a clear idea of what's going on. I think that information will come from your doctor. For us to know what your prognosis is, we'd have to have some medical knowledge- like why you are not a surgical candidate, etc.- and we don't.

    But you hopefully will get some stories from people with more similar injuries to yours :)
  • I understand some of what you're going through. I have been on "government work comp" for 9 months. I started out having a fracture at work in one of my upper vertebrae. They supposedly fixed that with an injection of cement called Kyphoplasty, but I still had mid and lower back after that. I could not work at all. Couldn't even be on my feet more than 20 minutes and had horrible pain. I have been on pain meds for awhile. Then in May, I went to my daughter's Neurosurgeon and her Orthopedic Surgeon, (I tried to find someone who had success at a back surgeon and she did). So, in May I had an MRI, and then A Disco-gram. I needed surgery at L3/4 & L4/5, a double fusion. So, I had the surgery along with a bone graft and a bone stimulator and rods and screws put in. I'm 59 years young, and believe me, the last thing I ever wanted to happen to me was a back surgery. Every one is different. My recovery is different from my daughters. I had to use a walker when I got home and had to have a nurse come in 3 days a week. My daughter was back to work in 5 months. Me, I filed for Social Security Disability 3 months ago. Haven't heard yet. Also, Work Comp referred me for Vocational rehabilitation, but the man that came to my house took one look at me and recommended I try to get Work Comp. to include the lower back with my previous injury. Already tried that and that's a long road to go down and many don't win. Try to find a Dr. with proven outcomes, and that will exhaust all avenues before surgery, as it sounds like you are already doing. For my surgery, the Neurosurgeon did the first 2 hours as far as the fragments laying on my spine and repairing the discs, and the Ortho did the next 2 hours doing bone graft etc...
    Can I ask how old you are, and how long you have been working?

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    Post Edited by Moderator haglandc
  • Hello,
    You can only change what you can and have to manage whatever is left and we have to live with the best that we can when in constant pain, if you are sufficiently determined then you will look for ways of seeking your long term objective or getting as close as we can if that is appropriate.

    It is difficult when a disproportionate element of our success is out of our control and we are reliant on circumstance for expected improvement. You need to place yourself in the best possible position for the chance of self improvement for development to happen, identify what needs to be done, you have some responsibility in that process, as said, never give up hope, even in my darkest black dog days, I always envisaged returning to work and we have to make those changes happen as far as is practically possible.

    Your progression sounds very similar to the experience of many here and they are best placed to help, support and encourage you. Never feel guilty, pain is never easy to live with and be kind to yourself.


  • sorry to hear about your situation.
    1st i too am on work comp.
    ok now have you talked to a lawyer, one who only deals with work comp., most of them give a free consulation.
    as far as finding a doctor or surgeon try going to a local hospital's web site and click link for surgeons on staff and you will be able to see what they have to offer and a brief summary on the surgeon, that is very helpful.
    as far as another opinion, you have 2 choices of doctors you can see, it's the law. if one of those doctor's referred you to a doctor and put it in writing, that is not considered one of your choices. so if you still can ask doctor for a referal and have him put in writing and submit it to work comp.

    remember one thing work comp. has lawyers on retainer to save them money,dont try to fight them by yourself. work comp. lawyers only get paid when you receive a injury settlement from company, so you dont have to worry about up-front fees.

    hope this helped you, if any more questions just ask. i've been down this road before.

    take care and good luck
  • I have hired a lawyer and he has been helpful...Workers comp. has been impossible. I went to one orthopedic who referred me to his surgeon for a consultation for a disc relplacement, so I consider that one opinion; A surgeon and ortho that work for the same practice. The result ended up no surgery and meds along with PT. Then I went to my IME and he stated "I can not say for sure that this employee will ever return to full duty without surgical intervention". (reminder- I'm an EMT). So one says surgery and the other says PT and meds. I asked for another opinion and was refused. My lawyer got comp to put it into writing saying they are refusing coverage for another opinion since I have already had '3'. I say one and and IME, of which they hired. I wanted an unbiased opinion and I finally got one. I used my own insurance and went to another doctor who referred me to an neurosurgeon in the practice and stated that surgery is absolutely necessary in order for me to return to work. So I went to my 'attending ortho' who said there is nothing more he can do. I told him it was a waste of both our time if there is nothing more he can do I keep going back there. I respectfully asked for a referral to the previously recommended neurosurgeon...and he did it!! I felt such a weight lifted off my shoulders. It's not that I want surgery but if three out of 4 doc recommend some type of surgery then that's what I'm doing. He's also only recommending an minor disc excision to just remove the part of the disc that is protruding out. One small step at a time, but at least its something... I guess I would be more of an aggressive than conservative physician. I have exhausted all of the conservative treatments. It's sad, I used to be able to carry people up and down stairs with med. equip. and now I can barely get up off the table at PT without assistance. I guess my philosophy this whole time has been "I'd rather try something and know 'what' than do nothing and wonder 'what if?' ....anyone else feel this way?
  • I have read your post and sorry you are having so much pain, back pain is the worst. I so understand how you feel, and wish the best for you. I want give you my opinion and only opinion on your issues, from my past experience.

    When you injured your back did you fall? That is very important factor for back pain with injuries and how did you land if so.

    Have you thought maybe the pain in low back area may be coming from another area Like your SI joints , the SI joints have the same symptoms as last few lumbar disc, they have a long time period for healing if a injury is present, just a thought...

    I read that you have had a few test done and not good out come, when having the injections if there is no relief at all there is a concern that the pain may not be coming from the bulging area, if the discogram comes back neg. means the disc is still healthy to function and a fusion is not needed. I guess the big question is has your injury been long enough to know if the damage to disc is gona be a long term thing.

    There are so many things to consider when thinking of having any type of spine surgery. 1st of all have you tried everything non surgical, traction is huge relieve for a bulging disc, PT, and giving the proper time to heal, it can take a year or more for a disc injury to heal if it does.

    As to your question about returning to work after surgery. NO ONE can tell you when or how things will be after. I had the surgery you are talking about and did nothing for me it was just a quick fix, but my condition is different than yours mine were from spine diseases not injury. I know some one who had the same surgery and he is great no lingering issues and could not tell he had any type of back surgery. was better right after surgery stayed home 1 week off work, but he sat at a desk.

    I also read an article that said most people that have 2 or more back surgeries do not EVER return to a full duty job. Some study a university out east did.

    There is the huge concern that a fusion may help the nerve pain, but the hardware associated with the fusion may cause more pain and discomfort, that was my case and I suffered bad until I could get the hardware out which was 3 years. Then the worry of fusion causing other disc to go bad leading to other surgeries. So by a Dr saying to fix the disc and see how it goes you may be opening up yourself to 3 surgeries, something to deeply think about. Disc surgery if that fails a fusion and most likely you will have more pain and need a hardware removal.

    I hope you find the treatment and get the help you need with workmens comp, And maybe some of the things I said may give you a little info.

  • Sorry to hear about your injury. I too had a physical job as an RN and the Drs said it could of contributed to my over 20 years with constant lifting, twisting, bending and general healthcare heavy work such as your own being an EMT.

    My L5-S1 herniated disc and annular tear healed on it's own within 18 months when I got my second MRI. I'm not saying yours will heal on it's own but it may and wish I had surgery to resolve mine but my injury now is Degenerative disc disease with nerve compression. I had an EMG/nerve test that my Primary GP Dr. booked because I had numbness in my leg and I saw the Neurologist the same day. I received many injections that helped ease the pain and numbness and also take Cymbalta for the nerve pain. I'm awaiting my 4th referral to an Orthopedic Surgeon and also have seen 3 Pain Management Drs. So never give up and keep looking for a Dr. to help you. I hope your Primary Dr. could help you. What did your EMG/nerve test show?
    Take care and hope you're having less pain. 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
  • Jennifer, I agree with Tooyoungforthis about the SI joint possibly being the problem, especially since you've had a lumbar strain. However sometimes the ligaments that hold the SI joint together NEVER heal. I've had 5 lumbar strains in my life and my SI joint became hypermobile. Prolotherapy injections are safe and effective at tightening up the ligaments in the SI joint and thus reducing pain. Surgery must be the absolute last resort. A good book for you to read is Treating Back and Joint Injuries by Dr Valdez.
    Good Luck
  • Glad to hear things are finally moving in the right direction for you.
    As you already know dealing with work comp. can be frustrating, so if you have any problems or questions dont heaitate to call the lawyer.
    You were hurt at work and comp. is by law obligated to take care of you.
    Comp will always try to get off on the cheap, so dont let them bully you around.
    Hope now that you are able to see the doctor of your choice that he/she has a plan that will point you toward recovery.
    If you have any questions, just ask and i hopefully will be able to answer for you.
    I've been there, done that.

    take care.
  • I am sorry but I can't answer your question about being able to go back to work.
    One thing I can tell you is NEVER to give up hope!! Please hang on to your hope.
    For several years I suffered with savage chronic pain in my feet and legs. My Doctor REFUSED to give me the strong pain meds I needed to be even half way confortable. I tried the SCS(spinal cord stimulator) and had great hopes it would be my answer for my savage pain. It failed me and I had it removed. Then my Doctor put me on an even lower dose of pain meds and would only give me a 25 day supply that had to last me 30 days. I truly suffered Jennifer. I would always run out before my 30 days were up and then I had to suffer the full force of my pain for several days!
    But I NEVER gave up hope. I could not find a Doctor that would take a chronic pain patient but I still never gave up hope.
    At long last I found a Neurosurgeon who implanted my pain pump!! Help at long last!!
    I still have some pain when I am on my feet but it is nothing like it use to be. I am now able to go back to work because I am self employed and can set my own pace and hours.
    My hope kept me going.
    Hang on to your hope Jennifer!! Things WILL work out. I do not know how or when, but they will. I now have my life back and I am sure you will too.
    Sending a hug coz you need one. >:D<
    Patsy W
  • That's a question I've been asking myself since my final back injury in June of 2009. I was off work and unable to sit, stand, or do anything but lay in bed in misery. It took the docs two months to do an MRI. Another three weeks waiting for surgery. After surgery I had heart problems, etc. that weren't directly related to the surgery. I had so much pain after the surgery... and it went untreated. They had me on three percocet a day. That allowed me to go to the bathroom and shower... and sit in a recliner with heat on my back. That was all. My back felt like I had a turtle shell where the muscles were. No amount of muscle relaxers would loosen it up. They refused to put me in PT because of the heart problems that had developed after surgery. I lost my job and was denied long term disability by my employer. I tried to go back to work as a case manager in Jan. 10, but I'd missed work for continued doc appts. and was in the hospital once due to my heart. The pain was obvious on my face and I was still using a cane some days to walk. I was let go at my 90 day review. I went to my docs and demanded they do something so I could return to work. I was put on Fentanyl patches and then steriods. I was OK for a few months, then the pain started to increase. I missed a few shifts. I work in ICU...so it's a very physically demanding job. It got quickly where all I could do was work. After that, I didn't have the energy or pain tolerance to do anything else. So I don't spend time with my family... I can't take care of simple house keeping tasks... I'm in severe pain 24/7. I kept working. I also have autoimmune things wrong, though, so I go through 'flares' that make the pain and exhaustion worse. I went off work again about two weeks ago after the SCS failed to do what I needed it to do. They already started decreasing my pain meds although he knows it's not working. I can't use the thing at work. I'm tired of having no life. I think I may be done with work. Although it's not going to give me my life back by any means... it will keep me from being in crying pain within hours of starting my shift and maybe it will make it so I can do some things at home eventually. Right now I'm still not able to do much of anything, but I'm also in a flare which adds another layer of things to it.

    I've been sick for many years. I've been in pain constantly for many years. The only thing that's changed is 'how much'. I think you get used to it to a point. Your life changes... you stop thinking that it will get back to normal at some point. I hope that you can get back to doing what you love. I tried, I really did. All but one doc thought I was crazy for even trying. I was told that people with as much done as I had done had gone back to work doing the same job without issue. I find that very hard to believe. Of course, I since learned that the doc that told me that lied about a lot of things. I didn't have a choice with the surgery, but if I did... I would've tried everything else. The burning of the disk... traction... anything. Once they've cut into your back, I don't think things are ever the same.
  • I agree with Tooyoungfothis and make sure it's the disc causing the pain and numbness. I had a herniated disc and annular tear and the MRI showed it was in contact with the L5 exiting nerve so there was nerve irritation and disabling. But now I have the same pain and have mild DDD throughout my Lumbar spine and the pain may be coming from the narrowed space at L1 and nerve compression as the second MRI showed no more herniated disc. There have also been people who have herniated discs and have no pain but others experience much pain.

    I hope you can get a discogram to make sure it's that disc causing the issues. What did your nerve test/EMG say? Best wishes and keep us posted. 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
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