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Got injury. Experiencing leg and back pain. MRI done. Given steroid injections. Surgery needed?

Dec 2012
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Answered by

General & Family Physician
Practicing since : 2012
Answered : 1704 Questions
Injured at work last week of Feb. I am still waiting to see an ortho Dr and have been treated by a chiro and a neurologist so far. Off work since then without pay and workmans comp is very slow to get an ortho dr appt. To date I have paid for all medical care myself.

MRI summaries are as follows:
Findings: There is patient motion artifact.
There is reversal of the normal cervical lordosis, Disc desiccation evident at C5-C6, There is a mild broad-based posterior
disc bulge at C6-C7. No central spinal stenosis or neuroforaminal narrowing. No significant marrow signal abnormalities.
Cervical cord is normal in caliber contour and signal.
IMPRESSION: Nonspecific reversal of cervical lordosis which can be associated with muscle spasm
Mild posterior C6-C7 disc bulge without central spinal stenosis or neuroforaminal narrowing.

•     Left lateral disc bulge at L5/S1 that impinges on the left L5 nerve root.
•     Non-compressive right lateral disc bulging at L4/5.
•     Mild L4/5 and L5/S1 disc degeneration.
•     Mild right L5/S1 facet joint degeneration.
•     Incidental Tarlov’s cyst at S2.
•     No acute disc herniation or spinal stenosis.

I had a month of chiro care 3 times a week and my neck was worse The Chiro told me if I return to my job which involves a lot of heavy lifting and ten to fourteen hour shifts that I would be likely re injure myself.

My job does not have light duty positions. I need someone to be honest with me and tell me if I need to start preparing to seek employment in a less physically demanding job.

I do not see an ortho dr for a couple of more weeks as wc is very slow to get appts.

Based on the fact that I still have daily leg and back pain how long does this take to heal? I also have horrible constant muscle spasms in the neck and have been given valium for that. The meds work but at what point should the spasms in my neck stop?

The neurologist did steroid injections to the shoulder areas because I was having intense migraines. I have seen no improvement from the injections at all. The only thing that stops the neck spasms are the meds and if I don't take them the spasms come right back.
How long do these injuries take to heal and will an ortho Dr send me back to work in this condition?

In all honesty should I accept the fact that I may have to find employment that is less demanding as far as these injuries go? I just need some advice my job is classified as moderate/heavy and heavy lifting, bending, twisting are all a part of it.

Ten hour shifts are the minimal and I don't feel like I can stand up that long without my neck and back locking up in spasms.
Trying to figure out what I need to do employment wise in the future and how long this injury is going to take to heal.
What is the probability of surgery if I have already done chiro, physical therapy and steroid injections?
Posted Sun, 12 May 2013 in Bones, Muscles and Joints
Answered by Dr. Nsah Bernard 5 hours later

Thanks for posting on XXXXXXX

I am pleased to be able to assist you with your health query,

I understand your worry and that is mostly because of your work related to your health. Looking through your results, I see that you have vertebral column lesions which could be very impeding to your present job description.
All the measures done to alleviate you from your pain and muscle spasms seem to have given you but temporary relief and to be honest with you, your problems might not have a definitive solution even if orthopedic surgery is considered as final option. After surgery we can not be 100% sure that you will get a perfect quality of life but there could be much improvement (besides the fact that there are possible post-operative complications such as paraplegia or others).
Your orthopedic surgeon can further evaluate you and determine your risk level of post-operative complications then decide on surgery or not. Since your job description involves a lot of carrying (heavy things), it is normal that you will keep having the problems unless of course you change your job and get one that requires less effort. Your vertebral column plays the greater rule in lifting weights, hence having lesions there, means they could be aggravated by continuous lifting.
Normally chiro, physical therapy and steroid injections would have been of great help.
My recommendation is that you should consult an orthopedic surgeon, continue taking valium, doing physiotherapy and you may include to your treatment analgesic medications (with dosage that could help give you a better quality of life). I understand the difficult you may have not doing your work, but you need to understand that your health primes to your work and your situation may degenerate if you continue with the efforts.

Hope this info helps and let me know if you want more info.

Best wishes.

Dr. Nsah
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