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L5S1 Firefighter needs help!

Hello,


I am very positive that this is a common theme for this forum but I felt the need to create a new discussion regarding my situation.  I am a firefighter recently injured while on a call.  I was transported in to the ER due to sudden sharp back and neck pain with a vision change, right leg and left arm numbness and constant vomiting for approximately 5 hours.  A CT was done in the ER with the findings of disc herniation at L5/S1.  

Over the next few days all symptoms disappeared, except for the back pain, which decreased in severity but remained constant.  Over the following month I participated in routine DR visits and PT where I saw improvement in rotation but still pain during left lateral bending and any time I stood up.  Pressure on the area of L5/S1 causes sharp pain and when I stand of bend forward I feel sharp pain in my right sciatic area (deep in my pelvis).  The movement of standing up and moving my pelvis under my spine (the best description that I can come up with) causes great pain anywhere from 50-90% of the time, even to this day which is a month an a half after the injury.  

I have also tested out two pain relievers (which don't touch the pain at all), one muscle relaxer (which only knocks me out for me to wake up drowsy and still in pain), and one narcotic (which makes me nauseous).

The occupational health Dr took numerous x-rays and reported finding nothing and it was only through preforming physical movements in front of him that he explained that I was not "faking" the pain.  I was then referred to a spinal surgeon who FINALLY put in the order for an MRI which I had last week.  I am now in a holding patter for the next two weeks until I can get in to see the surgeon for a follow-up/review of MRI results.  

PT helped for about two weeks and then leveled off.  The surgeon recommended stopping PT and doing an at-home routine which I have followed and paced myself as well.  I notice that I have pain, or at the very least extreme pressure, during most body weight movements.  I have also slowly introduced some weight lifting exercises at a very light weight and higher reps and noticed that it is very uncomfortable and I feel like my leg wants to give out at times.

In reviewing the report myself I get the overall impression that the findings are not too remarkable.  I am a little shocked considering that the amount of pain that I experience intermittently throughout the day.  At the very least I am very uncomfortable with sitting, standing for long period of time and all bending forward or backward.  The results mention a 3mm broad mid line disc protrusion, no nerve displacement or impingement, mild dextroscoliosis, disc degeneration at L5-S1 with moderate disk spacing, retrolisthesis and no evidence of impingement.

I see a lot of "unremarkable" and "no evidence of impingement" comments in the findings as well and get the impression that it is not going to be a big deal at the follow-up but once again, I am concerned about the symptoms that have not gone away or even subsided.  

Is there anyone here with any insight or comments or similar history?  I would appreciate any help.

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Comments

  • Did they ever do a cervical MRI or just a lumbar MRI?

    If I were you I’d want to rule out any issues in my whole spine.

    Did you take your MRI to a spine specialist like a neurosurgeon or orthopedic spine surgeon?

    An occupational health doctor is not a spinal specialist.

    Unfortunately it’s usually their job to minimize or downplay the true extent of your injury or injuries.

    If I were you I’d want more than an occupational health doctor or radiologist to tell me exactly what they see is my issue or issues on the MRI.

    Are you currently off work?

  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 259

    My surgeon never looks at the Radiologist report. He says he knows how to read the images AND my input about the level of pain and its location. It might help to get your doctors to review the images rather than only the report.

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  • Did they ever do a cervical MRI or just a lumbar MRI?

    If I were you I’d want to rule out any issues in my whole spine.

    Did you take your MRI to a spine specialist like a neurosurgeon or orthopedic spine surgeon?

    An occupational health doctor is not a spinal specialist.

    Unfortunately it’s usually their job to minimize or downplay the true extent of your injury or injuries.

    If I were you I’d want more than an occupational health doctor or radiologist to tell me exactly what they see is my issue or issues on the MRI.

    Are you currently off work?


    First off, thanks for the responses!!!


    They did a CT of the lumbar (L4 and 5 and possibly S1 herniation noted) and cervical spine (nothing noted) on the date of injury and they same regions were x-rayed a week later, this time the result was nothing to note.  They only preformed a lumbar MRI about a week and a half ago and found the above mentioned issues.

    Wednesday I follow-up with the spinal surgeon to review the images and report.  I'm anxious for a treatment plan but am concerned that if I at least get an epidural, I may be blocking the pain but gaining a false sense of strength and security only later to find that I have been hurting it.

    I am currently off work, yes.  I am mentally ready to go but I know that I cannot preform the work safely.  I can't even bend forward to pick up my kids backpack or put my shoes on safely.  Thanks.


  • So many times I've have read over and
    over where the diagnostic test results do not match the pain level that
    the patient states they are in.

    At times, it may be necessary to
    take those reports to another doctor for a second opinion.  Another set
    of eyes looking at something may come up with different analysis.

    But
    then there is always the situation, that when a second, a third or even
    a fourth opinion comes up with the same answer.    That is 

    there is nothing that proves the amount of pain that the patient claims they are in.

    That
    does not mean the pain is in their heads.  But at that point, I always
    suggest seeing a counselor that deals with pain.  It is amazing to see
    just how much emotional stress/turmoil can play on our physical pain.

    Thanks for the review and advice!
    I follow-up with the spinal surgeon in three days and am anxious to get his opinion and finding out about his treatment plan.  The thing that does bug me is that when I talk to seemingly everyone; Drs, RNs, other Firefighters, etc..., they ALL have a herniation or a slipped disc.  I feel that they actually can't emphasize or sympathize with this pain... I can understand that this is a common injury for a lot of people but I have to say, if this is a "normal" thing for people to go around in their everyday-lives with this level of pain, discomfort and lack of quality of life...well it is absolutely horrible.Anyways, thanks so much for your time and help!  Take care.


  • My surgeon never looks at the Radiologist report. He says he knows how
    to read the images AND my input about the level of pain and its
    location. It might help to get your doctors to review the images rather
    than only the report.


    Good input!  Thank you for your help.

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  • Good luck at your follow-up on Wednesday. Please let us know how it goes. 

  • Wishing you good luck on your appointment Wednesday. Hopefully you can get some answers and a good treatment plan that works for you.

    Nobody should have to endure spine pain, especially if it happened on the job.

    Take care.

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