HI, I am new to this forum. I am in my mid-30's, and have worked as a critical care RN for almost 10 years. Early on in my nursing career, I sustained a few work-related muskuloskeletal upper back injuries, and was off work recovering for about a month each time. Since then, I have had more or less mild chronic back pain. The pain has been getting more severe lately, so that I would have to take strong narcotics at the end of each shift. Then a few months ago, I suddendly developed numbness, tingling and severe pain in both my arms, and I had to stop working altogether. My MRI showed degenerative disc changes and severe lateral stenosis in my cervical spine. Since being at home on therapy (physio, massage, traction, analgesics etc.) the symptoms have largely improved. Here is the thing though - it seems that no one I have seen knows what to make of it. Even though I've never had any back injury outside of work, no one can tell me if this is work-related, if work will make it worse, and where do I go from here. The neurologist was unsure if I can return to work, and referred me to a neurosurgeon. The neurosurgeon said I was not a surgical case, and said that I return to my regular duties, that it's not work-related, and so the ICU work should not make this condition worse! I was very happy to hear this, and currently making arrangements to return to work. He is one of the best neurosurgeons in the city and I value his opinion. However I would also love to hear from anyone else who can relate, or has had experience with early-onset disk degenration & stenosis. All the literature I have found on this says this usually starts much later in life.
So my question is...has anyone else out there been diagnosed with severe stenosis/degenerative changes in their 30's (or earlier), and have you been able to keep working regular nursing duties (lifting, turning patients etc) without it becoming worse? Although I have been looking for another, more "sedentary" part time nursing job as a back-up option, the ICU is my "true love" and I would love to keep working there. I would love to hear from anyone else that has experience with anything like this as so far, I can not find much on it or anyone to relate to. I am very grateful for your support.
Welcome to our world. I had a lifting injury 12-08 (age 38). Was treated for only a lower back and right sacroilliac issues with pain meds, chiro, PT, steriod injection.. etc, (they disregarded my headaces, and neck pain) and told I could go back to work, that this was an issue I would be dealing with the rest of my life, that nurses notriously have early degenerative changes in there back early because of the work we do. I pushed for at least an MRI before they wanted to do a steriod injection of my right sacroilliac space at this WC Comp Clinic. My first MRI 2+ months after injury ..."Mild bilateral neural foraminal stenosis and central spinal canal stenosis at L4 – L5 secondary to ligamentum flavum thickening and facet hypertrophy". Long story short is they released me to work, and to ski!!! I was miserable, in pain, with headaches daily and increasing neurosymptoms in one arm. Finally asked for a QME with a neurologist since they never had me see one, and the treatment at this clinic was horrible - he dismissed my headaches as "migraines". I was on and off modified duty initally, but back on full duty in the ED. The WC insurance Company finally let me got to any Orthodpedic I wanted - chose one I know I and trust. He got me into agressive PT, and within a week, all my neuro symtoms multplyied by 10 and new ones came.. this was 9 months after injury... he knew then I needed a spinal specialist. Finally got to one who actually took films (no one had even taken films of my neck - 9+ months had already gone by! - they just did not want to listen to a nurse!), orderd an MRI of neck and low back.. and MRI showed.. "C5 – C6 Moderate Osteophyte Complex...40% Central Canal Stenosis > compression of spinal cord and thecal sac with mild signal changes within spinal cord; Minimal bulge at C6 – C7 > Indent of Thecal Sac; Minimal bulge L4 – L5, narrowing of foramin, hypertrophy, ligamentum flavum thickening." I did conservative therapy - 2 epidurals in neck and low back.. and finally not only did I have weakness in the left arm.. one day, the right hand dropped out and I could not write. I was scheduled for emergent surgery. Had it a year ago - I had anterior cervical discectomy with fusion C5 - C7 with plates, screws and BMG. Grips came back right away. Many neuro symptoms resolved (like the arm / shoulder pain, vaginal numbess - that was horrible), but I am still left with right sided (instead of all over) headaches from the base of the neck to the forehead, and a weaker left arm (mostly in the bicep now). For the lower, I still deal with right groin pain and right sacroilliac pain, and 3 right toes have occasioanl parathesis. Still dealing with all docs.
So no - I am not working in the ED or at the bedside.. and yes, I do miss it, but I wonder if I would have a little fear factor too if I was back at the bedside after all this. Our patients are not any smaller (the one I was assisting was 450 lbs +). Our staffing is not any better to get assistance. (The day I was injured was a Saturday - there was one tech for the whole ER, I believe another tech should have been there, but called in sick, there was a code going on in the room next to mine - and everyone was assisting there - so no one to help my guy who was circling the drain).
We only get one body.. by our nature, we tend to help others first before ourselves, and we end up paying the price.
You have to think long term what is best for you....The day I woke up and could not write scared the crap out of me! It was a wake up call.. I had been in denial of the whole injury and this whole process. Even after, it was taken me so much to come to terms with all this, and try to accept that I am damaged, and try and find a new direction.... still trying to figure it out...and doing consulting seems to be the best thing for me and my body.
My prayers to you on your journey. I do believe that God puts us through these trials to grow us, and to place us where he needs us most... eventhough it can be painful.
UPDATE December 2010..Status Post One Year Surgery ACDF C5 - C7: CT & MRI C-Spine because of continued headaches, right side neck pain, and left arm weakness.....new disc invovlement above surgery sight
- Work Comp (12-6-08 – CT findings 12-14-10): Anterior discectomy and fusion C5 to C 7 with disc space prosthesis at C5-6 and C6-7. Plate and screws; Mild to moderate central to right anterolateral epidural disc protrusion at C4-5 with dural sac imprint.; No significant canal stenosis; Right neuroforaminal stenosis at C4-5; Otherwise negative.
- Work Comp (12-6-08 – MRI findings 12-14-10): Anterior Discectomy and fusion with plate and screws C5 to C7. This is producing some artifacts; No spinal canal stenosis; Mild disc bulge C4-5 with focally greater but still mild disc protrusion central to right anterolateral epidural at C-5; mild right neuroforaminal stenosis C4-5; otherwise negative.
Last edit by ERNeck on Dec 28, '10
: Reason: UPDATE: New Radiology - more disc invovlovement!