I am hoping for some advice. i am a 27 year old male. and about 5 months ago i had a deck fall on me and it caused spinal stenosis in c2 threw c5 herniated disks in c2 and c4. t2 t3 t9 t10 and ddd in l2 l3 l5 too boot. pt has been helping a little bit but the pain numbness does not stay gone for long i was wondering if any one any advice on things i should and shouldnt do my doctors have not been much help as they are workers comp drs
Advice? Moved from General Questions to IMHO.
samclem, moderator
That’s a lot of levels. How was this diagnosed?
threw mris and cat scans
i have workers comp doctors im in the process of finding my own doctor. because my pt looked over my mri’s and told me they are much worse then what my dr told me. now my syptoms got worse from the type of pt my dr prescribe. any sugestion on what kind of exercise i should stay away from
I’m not a doctor, but it impresses me that back issues affect different people in very different ways, and folk pursue all different kinds of treatment. One thing to be aware of - whatever health care provider you go to will very likely recommend the form of treatment he/she offers. Go to an orthopedic surgeon, he will want to cut. Go to an accupuncturist, he will bring out the needles.
Words like stenosis and herniation by themselves convey little information - a lot depends on the degree of neurological impingement and associated symptoms.
A couple of things I would suggest:
-Explore progressively aggressive treatment. Start with PT and meds, then maybe injections, then a TENS unit, before jumping into surgery. And all surgeries are not the same. A laminectomy is far less radical than fusion.
-Be patient. IME, it can take well over 5 mos to reach max medical improvement from a spine injury.
-Be aware of longterm effects of pain meds.
-In many cases, it is far better to be as active as possible, than to be inactive.
Good luck.
And if they give you, say an injection, follow up with PT and even when it feels better, keep doing the PT. Its really important to keep the muscles strong.
A physical therapist is not qualified to overread an MRI so I wouldn’t be so inclined to trust his/her opinion. Get a second opinion from an orthopedic or neurosurgeon.
You’ve really got three things going on, and they’re apt to be treated or managed in different ways.
We’ll get the bad news out of the way first - unless you’ve got broken thoracic vertebrae, or a life-threatening herniation, there’s very little that will be done for thoracic injuries as access to that part of the spine is extremely difficult and dangerous. Vital parts like yor heart and lungs are in the way as the parts that need to be fixed are at the “front” or anterior side of your spine.
When you say pain and numbness, are you referring to pain just at your back or radiating down your arms or legs? If you’ve got multiple herniated discs causing radiculopathy, you may be better off with workers’ comp than not - there are different rules for WC versus regular insurance and you might qualify for multiple cervical and/or lumbar disc replacement. (I’m assuming you’re in the US.) There’s a lot of info on disc replacement at the ADR Support Forum.
You’re getting close to the point where WC tends to say “We’re done with you” and sends you to see a “QME” or qualified medical examimer to determine if your injuries are “P&S” or permanent and stationary. ie: not getting better. Push for a consult with a neurosurgeon before they do this.
I was going to joke that it sounds like someone dropped the entire casino on you, rather than just one deck, but that would be cruel. I’ve been dealing with back problems for years, and have had a cervical disc replacement a year and a half ago, and tomorrow, I’m having a two-level lumbar fusion (L4-L5-S1) as DDD has taken my L5-S1 to bone on bone. I’d prefer a replacement, but my L5 is unstable, so disc replacement is not a suitable option.
As for your physical therapist reading MRIs, they’re probably not professionally qualified to do so, but they have probably seen enough to be functionally good as a radiologist, and there’s no guarantee that the radiologist who interpreted your MRIs did an accurate job.