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Stenosis and Disability

First I want to give a quick background.

It started close to 10 years ago. I had a quick onset of pain; it didn't take long to develop.
In a nutshell, I had and have L4-L5 lateral (something or another med term) stenosis but
they seemed unsure for a few years.

First I had to convince the VA clinic that I really needed Vicodin to cope with my work.
They resisted and I persisted. After getting to 5-6 Vicodin a day and still having a bad time
with sleeping I convinced the VA primary care to try something new since Vicodin is a bad
long term medication imho. They gave me morphine sulphate and now I could sleep. Eventually
I adapted gabapentin to my regimen as well as baclofen as needed for lower body tension.
This took about 5 years to develop and it works as well as I could expect.

They flip flopped over weather I had stenosis or not for a few years but remained firm on that
eventually. My question is why do I have such bad pain to: warrant the strong medications, make
standing in place +10 min excruciating , back core muscles feel like they are burning up, and
I get nauseous and sick feeling from what I believe to be inflammation? This is off and on 24/7.

I quit my care giving job of 8 years an applied for disability. Went the course of almost 2 years
and in the end they told me my stenosis does not not match the amount of pain that I claim to have.
What will it take for my doctors to actually see what is causing this amount of pain?

I really wanted vocational rehabilitation to help me learn to work from home but Social Security disability
does not offer that alternative. I applied and got laughed out of court, more or less.

Should I just inquiry on surgery? I am tired of not working and having no money.


  • Get new MRI done. The doctors need to b behind u on the disability.
  • dilaurodilauro ConnecticutPosts: 9,848
    of many spinal conditions. It can be very painful , but most of the time, surgery is not required. Most of the time patients with stenosis will fell more uncomfortable after walking or standing for a while. The pain subsides with rest.
    You need to discuss your situation in depth with your doctor. If you are in the amount of pain you state, then you need to ask the doctor why? Doctors rely on clinical examinations, diagnostic testing, to determine the degree of impact a spinal problem may have. What is the reason your doctor is telling you why he/she does not believe you should be in this amount of pain?

    And please do NOT demand a new MRI, that is something that the doctor has to justify and provide rationale. MRIs that are not needed are just one way health insurance can cost more. It is true in order to qualify for disability, you need to have your doctor 100% behind you.

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • impacts a person. It also depends greatly on where the stenosis is located, at one or more spinal vertebre levels, or the central canal, is it mild, moderate, severe? What is the opening of the area where the stenosis exists?
    Stenosis can easily be treated surgically in most cases to remove the bony overgrowth and relieve the compression on the nerves, therefore reducing both pain and neurological symptoms, assuming that the stenosis is in fact, causing the symptoms that you have and surgery is warranted.
    If surgery is not warranted, stenosis may or may not worsen over time, but not in a short time frame unless there are other conditions going on.
    Stenosis can be made worse by walking but leaning forward as if you are on a shopping cart, or sitting can ease the symptoms.
  • michele lenammichele lena Posts: 21
    edited 01/05/2014 - 12:43 PM
    You did not state your age and that's a huge factor with disability, and if you do get disability you have to periodically prove you are still disabled. I won't write everything here about my condition, but I have congenital stenosis affecting12 levels of my spine, with a compressed spinal cord. I see the moderator wrote most the time surgery is not required, which is true most the time, but not in my case. I have to have decompression surgery because I am doing so poorly. I did manage my condition since age 17 with a few procedures because I could not walk amd lost function of bowel and bladder. I had a desk job and worked till 42. When able to I swim 3-5 times a week, which I will do again after surgery. I was told to never "jar" my spine, so most physical activities are not suitable for a person with severe stenosis.
  • is totally dependent upon the symptoms of the patient, and the findings of the exams, and imaging studies....from the sounds of the original posters remarks, it sounds like he has some bilateral foraminal stenosis, but does not say what degree, mild, moderate or severe.....congenital canal stenosis is a completely different animal in the effects that it can have on the body's functions and ability to walk.
    If it is a case of mild stenosis in the foramen for the OP, then the large majority of surgeons are not going to offer surgery unless there is some debilitating neurological or mechanical symptoms and from his post, it doesn't appear to be the case.
  • I have moderate central canal stenosis of the lumbar spine at all but L-3 level. Plus, I just had a bilateral foraminotomy at L4 & L5. . The neurosurgeon told me that symptoms don't always match what shows on the MRI. They have to go by what the patient is feeling and how disabling the pain is despite the actual images shown on the MRI. Once they gactually get into the person's spine they can see what is really going on. One person may have an image that looks horrendous yet they have very little pain while another person has an image that doesn't match up with the symptoms at all. This happened to me. I was turned down for surgery by an orthopedic surgeon because the MRI didn't correlate with how bad my symptoms were. In other words, he didn't believe I was in as much pain as I said I was! However, I didn't give up and found a neurosurgeon who was able to think a little outside of the box. I am now able to walk more normally and for much longer periods of time whereas before I couldn't stand or walk for more than 5 minutes before I was in excruciating pain. I'm surprised you were turned down for SSDI as spinal stenosis is a qualifying circumstance. You should probably use a lawyer and re-apply. And find a (new) neurosurgeon to talk to about your problem.

  • dilaurodilauro ConnecticutPosts: 9,848
    just as they do with Degenerative Disc Disease. Either one of those conditions is not necessarily rationale for disability. Most of the time stenosis would be turned down as a reason. Social Security Disability requires a lot to justify its acceptance. Many times, lawyers who are trained in this area need to get involved.

    Some degree of DDD is normal for anyone over the age of 30. Stenosis is not so normal and can cause discomfort and pain. I've been living with moderate cervical stenosis for over 10 years and moderate to almost severe lunbar stenosis for over 20 years. The surgery to potentially correct this has not been as important as to correct other spinal and joint related problems and surgery.

    But it does sound like you did get relief ( I assume, but you didnt mention ) surgery. Its always good to hear that people find relief.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • sandisandi Posts: 6,343
    edited 02/10/2014 - 12:38 PM
    in a foramen is not necessarily going to be enough to qualify for disability. There are many other treatment options available for treating it, not including surgery.
    It might help to read this thread and start looking into the treatment options for foraminal stenosis and talk to your doctor about the options.
  • The doctor said the nerve was clearly pinched and had been compressed for a long time. One side was much worse than the other. Ron, you are absolutely correct about many people living with stenosis and that it isn't an automatic qualifying event for disability. However, it IS a qualifying event for SSDI if you need aides for walking such as a walker or canes or you are unable to walk. I was essentially couch-bound due to pain. I couldn't walk or stand for more than 5 minutes at a time before the surgery and then I needed a cane and 2 were better. I was on a ton of meds - topomax, Mobic, Cymbalta, morphine, flexeril, etc. I did PT, massage, home therapies, chiropractic care, anything and everything I could possibly do to help improve my back. The surgery was a life saver and I thank God for my neurosurgeon! He gave me back my life.
  • Most disability applications are denied the first time round, especially if you represent yourself. My advice, make sure the condition has been investigated to satisfaction. You will want to have had opinions of a spine specialist such as a neurosurgeon and probably a pain specialist too. If you have a surgery option, you will probably not be able to get disability without trying it. Part of qualifying for disability is having had all the reasonable treatments. If you've done all this, apply again with the help of a lawyer.
  • Dumb question, but how does the attorney get paid? If people are out of work they don't have the money to pay. This is not like your suing a company where that take their cut if you win damages, so how does this work?
    We can't always control the cards we are dealt in life, but we can control how we play the hand
  • If you win, they take a percentage of your back-pay. I think.
  • the attorneys who help file for disabiity take a percentage of your back pay if you win. There is a cap on the amount they can recieve, I believe it's around 5,000.00
  • Scor38SScor38 Posts: 1
    edited 03/27/2014 - 3:25 PM
    Your post brought tears to my eyes! I am 37 years old and am active (I crossfit, run 1/2 marathons and tris). I had been dealing with neck pain for the past 10+ years and would "tweak" it, at least once a quarter. It was awful, to the point of taking time off of work. Last Nov I herniated C5-7. I thought I had ripped a muscle in my shoulder as it went into a charlie horse with no relief. I lost an incredible amount of strength in my left arm in the matter of days. I would cry at night and the only relief was putting my arm up over my head and stand in the shower. I finally had an MRI and learned that I was a medical emergency. I had DDD and spinal stenosis (terms were foreign to me). I had surgery 4 months ago and I feel great. I have a 5 and 6 year old. I am scared to death of my future, but I too thank God for my neurosurgeon! Take care and best of luck to you. xoxo
    Never Give Up
  • Getting disability is not as easy as my think. When you first apply for disability you will be turned down unless you have a terminal illness like stage 4 cancer. After you are turned down you then appeal the findings. Again most are turned down for the second time. This is when most who apply quit especially when they find out that the next step is to go in front of a judge to decide if you should get the disability or not. A this point it is very important you get a lawyer. The lawyer will look at all your records before deciding to take you on. Since the lawyer only gets paid if you win he will only take you on if you have a good change of winning. The lawyer has the inside information that can help you do well. In my case when went to see the lawyer the first time I was told to wear the exact clothes I had on when I see the judge. What I was wearing was a nice pair of pants and a button down short sleeve shirt and loafers (no heals) and light makeup. My lawyer then told me about one of his clients who showed up wearing a very short and tight fitting dress and high heals. The judge denied her getting disability. My lawyer went on to tell me that the judge I would see I liked to tell jokes. I was then told to be polite and smile but don't laugh to much because I was in pain. I received my disability but many do not because they just do not know how to play the game.
  • If you read my "bio" you will see I have severe congenital stenosis with a collapsing spinal column from t11 down. I have 5 ruptured/herniated disks in my neck, and my entire lumbar spine is Calais destroyed, gone (ruptured/herniated does not apply). I had only seen the 2 ruptured in the thoracic from an MRI of the lumbar. I have serious spinal cord compressions, one tried to kill me in Jan of 2014. Also had a decompression in 4 levels of my lumbar, as walking was an issue. I am seriously disabled with 12 known ruptured disks and some of my vertebrae are half the size they should he. What makes my condition so serious is that pain sensors have ground away, so I don't had that much pain, I just start having dizzy spells and passing out due to the spinal fluid not reaching my brain sufficiently. I am dreading finding out how bad my thoracic is, but sometimes it hurts to breathe. I am on disability, but I have to say they tried to kick me off with 3 spinal cord compressions, 12 ruptured disks and all kinds of issues from my. 4 page MRI of my cervical and lumbar spine. I have severe congenital stenosis that has been life threatening, and could be again.
  • I did all my own disability and appeal. There is no reason to exaggerate or fake anything if you have current MRIs and a real medical issue that cannot be cured and/or has failed normal/treatments. Make sure all info is less that 6 months old, especially your MRI. Any info over a year old is not usually pertinent.
  • Great thread, thanks for good info.
    I wonder about how my MRI apparently shows "no impairment" and yet I can be in so much pain and I wonder how to describe that to a neurologist I am scheduled to see for a disability application..??

    I am 57, had bad car wreck at 39, was not expected to survive, then sent home after 16 days in ICU with vertical shear of pelvis repaired with a large pin through my pelvis and sacroiliac (and others elsewhere) with the prognosis of paralysis. I managed to recover much more than expected, walk and work and manage pain for years but the last ten years have been increasingly difficult: my back "goes out" - I have severe excruciating pain in my far lower back after sitting or standing or twisting in some way that I feel a snap - sort of- , and I literally can not move for about two to three days.
    Then with pain meds, massage, stretching, etc., I have less and less pain until it is almost "normal" with just some slight stiffness and pain - until it happens again.
    That was manageable when it was once a year, but over the past years has progressed to where it is now once every 2-3 weeks.

    Last October, I fell at work and that caused my back to "go out" for almost 6 months - I was literally in bed for 6 months. I began to get a little better, and as soon as I could walk, the doctor discharged me form worker's comp and put 0% impairment on the form.
    When I asked him how it could be 0% impairment when I can barely walk (I walk with a cane and it takes time to get in and out of the car, turn, etc., I have to do everything very slowly and stop and stretch, etc, and can't sit or stand for more than 10 minutes or so without pain setting in so strongly I have to try to stretch it out or just go to bed for a few hours...).

    He said there is nothing on the MRI but some stenosis.

    Ok, I understand that there is nothing on the MRI from the fall at work, and I see the stenosis on the MRI, but what causes the "attacks" of pain and long periods to recover range of motion, stop having severe pain, etc. when it "goes out"?

    I applied for disability. I have always worked one or two jobs (teacher, administrator), and tutored, and went to school until I finished my doctorate, I am not trying to avoid work, I just know I am unemployable and can't work, my back is ok today but my history tells me it won't last long, and I will be back in bed crying and wondering how I am going to survive....it has happened over and over again for the past years.

    I wonder why "something" that causes my back to "go out" so severely so often does not show up on an MRI and how I could be 0% impairment when for more days than not, each month, I am in bed unable to move without excruciating pain. (do they just mean 0% impairment directly from the fall, or does that statement mean I have 0% impairment, period...because I agree that now my problem is not necessarily from the fall at work, I am now getting the same "back goes out" I used to get before the fall, BUT get them a lot more often now.)

    I wonder what the disability doctor will say and how I can tell him that even if something is not on the MRI and the work's comp doctor said I am 0% impairment, I can not move, that majority of the days of each month?

    I also am very depressed, profoundly depressed, but I think anyone would be that spends this much time in bed in pain, unable to move without severe pain, in my lower back. I take tramadol and 12 to 24 Ibuprofen, every day; I take oxycodone only on the first or second day when my back goes out- as little as possible, because I think it makes me more depressed.

    Any suggestions or help would be greatly appreciated.

  • Given that this was a WC doctor, he most likely was basing his impairment scale on the issue related to the fall and concludeed that you had no impairment related to that incident.
    Have you seen a board certified spine surgeon to go over your MRI with you, and to evaluate you by examining you , your symptoms and any imaging? If not, before applying for disability of any long term disability it would be wise to start with a new evaluation. Find out what options you have regarding treatment, surgery or improvement.....



  • synsesssynses Posts: 2
    edited 05/17/2014 - 1:57 PM
    Thanks for the welcome and info.

    Unfortunately, I have no medical insurance, no savings, and no job, so seeing a doctor is impossible for me right now. I live in Florida, so no Medicaid, either.

    I already applied and the disability office scheduled me to see a neurologist next week. We shall see what he says from there.

    Thanks for the info and links, I agree/hope that seeing someone else is the answer, of course I hope I get disability and Medicaid or Medicare or whatever might come with it to be able to get healthcare, but at the very least, I hope that I can find out why I get the pain spasms or attacks or whatever they are called, and the debilitation that follows them.

    It is such horrible pain there has to be a reason for it, a physical reason for it, not just "my mind". (-:



  • that could be the cause of the episodes, but there isn't any real way to know the degree or location of the stenosis, without having it evaluated by a spine surgeon.
    The worst thing you can do is lay in bed.......I know that isn't what you want to hear, but it's the truth. All laying in bed or any inactivity does is weaken an already weakened area of the body, and over time, leads to even more weakness, less stamina, and even more lessened physical activity.
    Did the doctor tell you if it was canal stenosis or foraminal? It does make a difference........do you have any areas of numbness or what feels like muscular tiredness or weakness in your legs?
    The local hospitals should have sliding scale clinics and doctors available in your area.......call them and ask them how to get in touch with the clinics.......even without health insurance, if you don't have the income or insurance, there are still options for treatment available .
  • I'm 56 years old and have worked since 18, 25 of which have been in the retail fine jewelry business. This past December, I went to shower for work and bent to retrieve my clothes when I was struck by excruciating pain in my back and right leg.
    To make a long story short, my femoral head has degenerated to the shape of an egg and I have mild to moderate stenosis in L3-4 and L4-5. They've also discovered COPD.
    I haven't had an operation since age 4 for tonsils and have had 2 stays in the hospital for a total of 3 days. My brother had discectomy and fusion in the mid 1990's on L4-5 which left him horribly screwed up.
    My physiologist is arranging for an epidural to my spine. The hip injection lasted less than a week but it was a great diagnostic tool to help sort out the pain. He's very unsure if the epidural will have a prolonged effect.
    I've contacted an attorney and am filing for disability since I can't stand more than a max of 15 minutes and lifting is excruciating. I have all the tests ( MRI, CAT scans, EMG.. no nerve damage thankfully, range of motion tests etc.
    Here's the kicker..I am terrified of surgery. The osteopathic surgeon told me I'd need a new hip "sooner or later" and I know as with knees, when one goes the other will follow suit down the road. I want to delay both for as long as possible. I am already using a cane. I'm in fear that the SSA will order me into surgery sooner than later.
    Thanks for listening and letting me get this off my chest.
  • donrichard55ddonrichard55 Posts: 1
    edited 08/13/2015 - 7:53 PM
    I am 50 years old and have lumbar stenosis with neurogenic claudication, also I have cervical sponylosis, High blood pressure and diabetes. I can walk less than a block, but after that need a walker.I have had cortazone shots but am now scheduled for surgery because they are no longer affective. I can sit comfortably but when typing the right hand gets painful after about 5 minutes. I have a social security hearing next Tuesday to determine if I will be approved for disability. My primary care physician has provided a statement saying that my limitations preclude any substantial employment. My lawyer says I have a fairly strong case but he is concerned that I can sit for long periods and am fairly dexterous with my hands, although typing is difficult with the right hand due to pain. He said to mention that to the ALJ. I know for sure That I can not do the work I once did and I know and also that I can not do any thing with my right hand (my smart one) for more than 5 min. I trust my lawyer but I am nervous of what the outcome will be. Does anyone think I have a good shot at this?

    Welcome to Spine-Health
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  • dilaurodilauro ConnecticutPosts: 9,848
    The approval process differs so much from state to state.

    I know a family, that moved from Connecticut to South Carolina just to get an easier shot a permanent disability. That same person could never get it up north. She bikes every day 10 miles, runs 3 miles, swims laps, etc but her claim is that her physical limitations are too crippling. Shortly after moving to South Carolina, she was approved for permanent disability.

    So, that being said, its so hard to identify what are the formal guidelines that will be accepted to get approved for disability. But I do know that you should not try to do this on your own. It is worth hiring a lawyer he is qualified in this area and knows how to work around things to get the approvals.

    Unfortunately, it is not always pure black and white.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Jeanie69JJeanie69 Posts: 1
    edited 08/16/2015 - 8:12 PM
    I am a 64 yrs old female diag. With spinal stenosis and MS in 1999. My symptoms are excessive burning in pelvic and buttock area as well as total numbness in my lower body. My neurologist left Kaiser in Mar. Of 2014 and now I only see my primary Dr for my symptoms. I am scared to see a new Neurologist as the new diag. might be too devastating for me right now. I have been housebound for about 3 weeks and severely depressed because of pain 24/7. I'm taking NORCO and BACLOFEN.
    The BACLOFEN makes me extremely drowsy during the day. My question is which symptoms are from MS and which are from the spin. Stenosis? Does anybody else out there have both like me? Please help me... I'm really scared... Thanks

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  • I have extreme pain in my middle back when I do anything that requires support for my spine. I have had x-rays showing that I have lumbar stenosis, osteoarthritis, degenerative disc disease, facet arthrosis and neural foraminal stenosis. I've been trying to fight this pain for 4-5 years now. Tried gabapentin, 800 mg ibuprofen, Cymbalta, Tramadol. Been seeing a new pain specialist for about a month. And I also see a physical therapist three times a week. When I first starting seeing the pain specialist he said he would like to start me on Vicodin, but they don't prescribe on the first visit. No problem. So, every appointment after that they have brushed me off and not given me anything. Finally, at my last appointment he said he wanted to give me Tramadol. I said I already tried that with my previous dr. and it didn't work. He said he still wanted to give it to me for a month. I asked if he would like to call my other dr. for proof that I already tried it, and he said he just wants me to start with Tramadol. I cannot stand this pain anymore. Every day I wish I would just die and get it over with. I don't understand why they won't listen to me. I need to stop this pain NOW! Anyone else been going through this? I'm from Washington state if that matters.
    amy davis
  • SavageSavage United StatesPosts: 5,427
    edited 10/21/2015 - 1:34 AM
    Welcome to Spine-Health
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  • SavageSavage United StatesPosts: 5,427
    Yes. You are not alone.
    I have shared experience, not only with Doctor response, but with my response to doctor.
    For me, trying to be good patient...and then choosing a time to..well, like challenge his order for me.
    I had to learn to better stand up for myself more consistently.

    Also, I know the trial and try again of pain management can be crazy making at times. Please be patient.

    It seems as though you let it pass at first appointment when Doctor did not give you script for Vicodin.
    And then for subsequent visits, he brushed you off...?

    Does that mean he ignored your reminder of Vicodin? Refused it? Knew you were without pain relief those months?
    I don't see noted how many months you were then without pain relief, before he wanted you on tramadol....?

    Or did he allow you to continue some sort of pain med that your previous PM doc ordered?
    But now wants you on tramadol?
    Did you take script and try tramadol again?

    Depending on how long ago you were on a medication, Doctor may want to try it again.
    My Doctor wanted to see for himself what the issues were, what relief or symptoms I had or didn't have, from a med I was on previously.
    I don't know how, but it helps him in figuring out what is best for me, by what pain remains or changes and .....I don't know what all.

    It may be good to kind of start again with your PM. When he says something about med change, and forgets or brushes you off, before you leave appointment, I would remind him again, and if necessary, ask him to explain why he said would prescribe and now changed his mind.
    If you feel ignored, to politely bring up topic again..maybe saying you need further explanation for understanding.

    It is so difficult while trying to manage pain within our body, but we need that extra effort to speak up for ourselves.

    Spine-Health Moderator
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  • Backtoliving.62BBacktoliving.62 Posts: 1
    edited 12/05/2015 - 12:54 PM
    sandi said:
    is totally dependent upon the symptoms of the patient, and the findings of the exams, and imaging studies....from the sounds of the original posters remarks, it sounds like he has some bilateral foraminal stenosis, but does not say what degree, mild, moderate or severe.....congenital canal stenosis is a completely different animal in the effects that it can have on the body's functions and ability to walk.
    If it is a case of mild stenosis in the foramen for the OP, then the large majority of surgeons are not going to offer surgery unless there is some debilitating neurological or mechanical symptoms and from his post, it doesn't appear to be the case.
  • SavageSavage United StatesPosts: 5,427
    Welcome to Spine-Health
    Please click on link for helpful information!
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    Please read my medical history at: Medical History

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