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Low back pain

Please offer suggestions of what I should do next? I'm 47 years old.
First let me say that prior to my injury I gained a lot of weight pretty quickly over an eight month period, when I quit smoking...about 30 lbs.. I originally weighed 127lbs , about 24% body fat at 5'6" and wore a size 4, and now weigh 165lbs, a size 12-14, and am 40% body fat ( I have gained more weight since my injury). Which I'm pretty sure adds to my problem. Prior to my injury I was very active, either bicycling, hiking, aerobics, etc, pretty much  on a daily basis plus the working conditions at my job provided  lots of activity; In one 10 hour shift I could log over 7500 steps on my fitbit.
In January of this year I fell off of a rolling stool at work , which by the way is a hospital, and landed on back/hip. I tried going back to work on several occasions but after a few hours on the job my low back would hurt so bad that I couldn't walk, every step would send  excruciating pain, like lightening bolts, up my back. Since my job was not accommodating the restricted work status of my Worker's Compensation physician, he took me out of work completely. I went throuh physical therapy, high dose predinisone for a week, muscle relaxants, NSAIDs, Norco, lidocaine patches, and back brace and after 3 months an MRI was done. When my doctor received those results, he performed a medial branch block (I think that's what its called) at the facet joints, 6 shots in all. After that didn't help my pain he ordered an FCE, but WC rejected it and sent me to have an IME. The IME physician, a physician at the hospital where I work, made a few other treatment suggestions, and my physician chose the epidural steroid injections. So after I had the 3 shots with no signicant improvement in my pain, he just completely discharged me back to work stating that there was nothing else he could do for me, that the problems in my back are age related and to "just live with the pain," and wrote me a script for more pain meds. I also requested another IME, but that physician said the MRI quality was too poor to see anything  other than a lot of inflammation nd requested that a high resolution MRI be done.
I actually just received a written copy of the MRI Report read by the radiologisy that my LTD Insurance company sent to me. It reads the following:
Paraspinous soft tissue:  Normal
Alignment: There is a loss of normal lumbar lordosis. Minimal retrolisthesis of L5 vertebra over S1 is seen.
Vertebrae: The vertebral body heights are normal.
Conus: Conus signal and configuration are unremarkable.
Mild degenerative endplate changes and Schmorl's nodes are seen at multiple levels. Marginal osteophytes are seen at multiple levels.
T12-L1: Disc is desiccated and reveals mild diffuse bulge . It indents the thecal sac, without any significant Central Canal or neural foraminal narrowing . The bulge measures approximately 2 millimeters in size.
L4-L5:Disc is desiccated and reveals mild diffuse bulge . It indents the thecal sac, without any significant Central Canal or neural foraminal narrowing . The bulge measures approximately 2 millimeters in size.
L5-S1:Disc is desiccated and reveals mild diffuse bulge . It indents the thecal sac, without any significant Central Canal or neural foraminal narrowing . The bulge measures approximately 2 millimeters in size.
Mild facet arthropathy is detected from L3-4 to L5 - S1 levels.
All other findings read "UNREMARKABLE" (L1-2, L2-3, L3-4

Here is my dilemna:  I have a profession license to practice my profession and I do not want to risk that and/or perhaps hurting one of my patients by practicing while taking pain killers and I cannot physically do the job without them. I was just recently awarded private LTD benefits and I run the risk of losing that if I go back to work, even for just a day. I have a WC attorney, but he has clearly stated that he cannot help me with anything but the Worker's Compensation end of my problem. I need to get back to work for financial reasons, but I want to get better so I can have my life back also. I don't know what to do or what my next step is? Could all of my pain just be related to an aging spine that just erupted it's ugly head after my injury or could it be something else? Where do I go now to get help to fix my back and not lose my disability benefits?  Please help! I am still in a lot of pain and I can't get any help or cooperation.



  • LizLiz Posts: 9,745
    hello cyclist

    no one on the spine-health patient forums is medically qualified to provide any advice or recommendations on any diagnostic test. however, the following key words can always be applied.
    mild treated with conservative measures such as physical therapy and mild medications. many times these situations can be cleared up and the condition can be resolved.
    moderate some more treatments may be needed, ie spinal injections, ultra sound and stronger medications. always a possibility of more aggressive treatment if the conservative measures don't help 

    severe need for stronger medications. the requirement for surgery may be necessary  

    please click on the link for useful information


    Veritas-Health Forum Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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