l4/l5 annulear tear and transitional l5

chiku · #1 (**permalink**) 01-24-2011, 01:53 AM

I slipped and fell at work 2 1/2 years ago. The MRI showed an annulear tear at l4/l5 and a transitional l5. At the time I had a hard time believing that it was from my back, so I also had an MRI of my hips, and a full body bone scan. At the begining my pain went from about the middle of my left butt cheek, around the front of my thigh, then down my leg and curls around the arch of my foot. In the past year I have also been experiencing low back pain. I did PT for 3 months, until WCB said that I reached my MMI, and PT discharged me (I am still able to work-desk job and I am the manager or else I am sure I wouldn't be able to work).

My Dr says that the tear and transitional l5 should not cause me pain. There has not been any other testing done in the last 2 years. I am grateful for what my Dr does for me, but I think that this maybe this is different from what he is used to treating. He talked about sending me to the 1 PM in my area , I think that all he does is injections, but WCB was not okay with me going there. I think the biggest strike against me, in terms of WCB, is that I can still work. Seeing a specialist etc is not possible, it would take a referral, and WCB approval. Since my claim started with WCB, health care won't cover it.

So...I am wondering if anyone else has similar problems? I have been thinking that maybe, an ADR at l4/l5 could help, does anyone know if that is possible with a transitional l5? This is not something that I can do in the near future, single mom so money is an issue. However I am 30 years old, and I refuse to accept that I will be in this much, or more, pain the rest of my life.

Thanks so much for letting me vent, and any advise you may have.

dshobbies · #2 (**permalink**) 01-24-2011, 05:32 PM

Hi Chiku,

Vent away and get on your high horse. Absolutely your pain could be coming and probably is coming from your back.

I realize money is an issue and you're dealing with a bureaucracy, not an easy thing to do but you must get a second opinion from a spine specialist, especially one who is well versed in ADRs which may or may not be indicated in your case. However, only a doctor who believes in them can tell you that. Many doctors, particularly those who don't perform this specific surgery won't recommend them - end of story.

BTW, welcome to the forum- it sounds like you - and your health care professionals need more information. You're open to it, they're not

Dale

Keano16 · #3 (**permalink**) 01-24-2011, 06:57 PM

Hi Chiku and welcome to iSpine community.

To be honest, I've never heard someone having problems just because of transitional syndrome.

However, annular tears can cause big pains, depending on size of tear.

Additional tests that could be done in your case are MRI with contrast (contrast will help differentiate tear), discography, etc. This will show if your annular tear causes pains.

Regards.

mmglobal · #4 (**permalink**) 01-24-2011, 08:36 PM

Many people have transitional levels with no issues. By itself, IMH(laypersons)O, it's not an issue. However, I've had clients with the symptoms you describe with the issues related to piriformis syndrome, SI joint dysfunction, or the bad disc.

Has someone WHO KNOWS piriformis syndrome ruled it out?

Has someone WHO KNOWS SI joint dysfunction ruled it out?

Was discography done?

It's often very sad that WC is involved, because they often stand in the way.

Good luck... keep us posted,

Mark

chiku · #5 (**permalink**) 01-27-2011, 12:26 AM

The only people who I have seen are my GP, the WCB Dr (also a GP), and the WCB physiotherapists. I asked my Dr about piriformis syndrome and SI joint dysfunction, he just said no it's not that. A discography has not been done, that is not something that he does. Seeing another doctor is not possible at this time, where I live 1/4 of the population does not have a family doctor. I am trying to save up money for traveling to see someone else, it just always seems like something comes up and takes a chunk out of those savings. The last one was the engine going on my car, 10 months over warrenty, 84 000 km's...sometimes it seems like I am cursed.

I am in Canada, and I don't know anything about private care, or choosing doctors. I had the same GP until I was 25 and he retired, and I was lucky to get the GP I have now. It's going to be a steep learing curve.

I have to agree about WCB getting in the way, at least in my experience. My doctor had wanted me off of work when this first happened, and the WCB physiotherapist overruled him. They were good about tests, PT for the first 3 months, when I didn't get better they just said that I had reached my MMI and that was it. They washed their hands of me. Health care won't pay if it's a work injury, so I'm stuck trying to come up with the money. Unfortunetly as long as I can work, they don't care about my quality of life.

Thanks to all for your replies.

dshobbies · #6 (**permalink**) 01-27-2011, 06:55 PM

You're stuck between a rock and a hard place. Personally, I think the US might be headed into the same health care nightmare - not that we're not in one now.

My only advice is some kind of appeals process that will allow for a second opinion from a specialist. No GP is well versed in spinal procedures. For that matter, not all spine specialists are either.

Good luck, Dale