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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.
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134

Comments

  • Get new MRI done. The doctors need to b behind u on the disability.
  • dilaurodilauro ConnecticutPosts: 13,526
    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 Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • 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.
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  • 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.

    best,
    Wendy
  • dilaurodilauro ConnecticutPosts: 13,526
    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 Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • sandisandi Posts: 6,269
    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.
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