Posted on Mar 14, 2020
WO1 Property Accounting Technician
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I've been dealing with lower back pain for the past four months. Recently the pain has extended down my buttock all the way to my left foot. The pain got so bad yesterday that I had to call 911 and get transported to the hospital. All I got was an X-Ray, steroid shot, and some pain meds.
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Lt Col Charlie Brown
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If your doctor is not responsive, get a referral to PT and have them "suggest" it to your doc
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SFC Retention Operations Nco
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Because an MRI is thousand dollar picture, it takes half an hour to an hour to take one, and your hospital only has one machine. The waiting list for most hospitals is about a month for an MRI. You won't receive one at the ER because they aren't going to cancel someone else's appointment who waited a month unless your condition is life threatening. You have a chronic pain issue meaning it would follow a chronic pain protocol. Just like you don't administer antibiotics and IVs for every illness, you don't start off with the most expensive or invasive treatments for chronic pain either.
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CW2 Electronic Warfare Technician
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SGT(P) (Join to see) aha. Little info goes a long way.
4 Kelvin!!!! Almost as cold as my ex-wifes heart!
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SGT(P) Healthcare Specialist (Combat Medic)
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SGT Michael Hudgens Cost is always relevant when you have budget constraints.

I would also not recommend demanding anything from anybody in the military weather private or general. You might get what you want but you're going to piss everybody off and everybody can play fuck fuck games to make your life hell while you wait for them to help you.
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SGT(P) Healthcare Specialist (Combat Medic)
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CW2 (Join to see) lol sounds like a cold hearted lady.

I'm glad I could help.
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SGT(P) Healthcare Specialist (Combat Medic)
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SGT Michael Hudgens Even the military has a budget. I'm not sure why you think they don't.
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CSM Darieus ZaGara
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Sounding like a sis doc attack. If you had an MRI, it will likely reveal that you have a herniation or a bulge, or even some level of arthritis. This pinched off the nerve and causes that horrible pain. Steroid is what they would recommend. You can ask about a combination of FA spent in and a muscle relaxer and PT. You should have an MRI, just ask for it and wait, as it may take a while.
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Why is it so hard to get an MRI?
CAPT Kevin B.
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What is missing is medical systems require their providers to follow "protocol". That is essentially start cheap and go up from there; grudgingly. Demanding something from a doctor that isn't there yet on the protocol timeline is pointless because they can be disciplined for bypassing it. Depending on what it is, the chronic label kicks in somewhere between 3-6 months. You are in the early stages of MIL medicine which is throw drugs at it and go away. You will be made to needlessly suffer until you meet the protocol standards. Likely protocol is you'll get a CAT scan first to take a look at the softer tissue around the vertebrae. Slipped discs etc. are fairly well visualized. If that tells the story, then the response will be according to protocol. If that doesn't work, maybe you'll graduate to MRI. It'll differentiate the soft tissue better along with the nerve sleeves. If that doesn't lead to resolution, you may be out of luck as that is usually the end of the protocol chain. I don't know if a PET scan, which looks at how the body functions on a cellular level, would be viable. These are the most expensive. BTW, CAT scans are relatively cheap now and machines are found in nearly all hospitals. Our small rural hospital (20 beds) has the fastest CAT scanner in Idaho because it's the newest. Head to toes in 54 seconds.
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SSG Laurie Mullen
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Good luck! It took me 13 years to get an MRI for an injury that I frequently went to sick call for.
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CDR Terry Boles
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Good question. For the past 4-months have your symptoms worsen? Have you received a referral to physical therapy? Does your x-ray reveal any info that could suspect spinal cord nerve encroachment? (DO NOT ANSWER HERE) Is your back pain associated with an injury? Sudden on gradual onset? Again (DO NOT ANSWER HERE) on this forum. This is food for thought.

These are some of the questions and medical history your doctor, and you should have to help decide your plan of care.

IF you have any lingering concerns after all this, then seek a second opinion along with your MRI request.

I wish you the best!!
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CPT Pharmacy Specialist
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Providers are now trained to only reach for the MRI when red flags are present:
History:
-Cancer
-Unexplained weight loss
-Immunosuppression
-Prolonged use of steroids
-Intravenous drug use
-Urinary tract infection
-Pain that is increased or unrelieved by rest
-Fever
-Significant trauma related to age (e.g., fall from a height or motor vehicle accident in a young patient, minor fall or heavy lifting in a potentially osteoporotic or older patient or a person with possible osteoporosis)
-Bladder or bowel incontinence
-Urinary retention (with overflow incontinence)

Physical examination:
-Saddle anesthesia
-Loss of anal sphincter tone
-Major motor weakness in lower extremities
-Fever
-Vertebral tenderness
-Limited spinal range of motion
-Neurologic findings persisting beyond one month
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LTC Jason Mackay
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I have similar pain. Sounds like a pinched sciatic nerve. You may have vertebrae, your hips, or discs that are damaged or misaligned.

If you are dissatisfied with your care, demand a second opinion and a referral to a specialist. An MRI may or may not tell the provider anything. I remember different providers staring at mine and it didn't tell them much. If they push back, go to the ombudsman or patient advocate at the MTF.
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1SG Retired
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Maybe take leave, and give a shot at a civilian ER on TRICAREs dime.
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1SG Retired
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WO1 (Join to see) and still no MRI?
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WO1 Property Accounting Technician
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Negative 1SG, gave me an X-Ray to check for tumors and that’s it. I’m currently seeing a Physical Therapist on post so I’m going to push for the MRI during my next appointment
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1SG Retired
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WO1 (Join to see) likely worth researching for the type of injury/condition they suspect (sciatica pain), how they arrived at that diagnosis (exam (straight leg raise, slump test, X-ray), history, diagnosis, courses of therapy tried so far, etc., so you're prepared for the discussion.
Are there other symptoms (bladder, bowel, different type of pain, muscle weakness)?
Saying, "I want an MRI," may only get you an "Ok, you do supply, and let us do the medicine."
Better to say: I was diagnosed with X, X-rays show/don't show, condition has progressed to include, the pain has lasted for X days.
Won't necessarily get you the MRI, but may get you an explanation that is good enough for you.
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MAJ Byron Oyler
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1SG (Join to see) - Very wise advice.
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MAJ Audiology
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Sounds like sciatic nerve issues. https://en.m.wikipedia.org/wiki/Sciatica

Most likely either you have ruptured/herniated disc, inflamed a disc in your back, or like most of us who have lifted weights and carried heavy packs for years have the beginning of degenerative disc disease.

Ask for a referral to PT. They can show you some stretches and other exercises to help and they also can urge for an MRI after they evaluate you if they think it’s actually a ruptured or herniated disc.

Just speaking from a differential diagnosis perspective it’s like everything else in medicine. They are going to start with least invasive and then move on from there. So don’t be surprised you got a shot. You should actually be happy you got that to be honest. I had some horrible neck pain recently in the civilian sector. Went to the urgent care. They gave me a muscle relaxant and told me to take ibuprofen and go home and rest. 3 days later pain was no better. Range of motion was no better. Went back to same urgent care at the hospital. They sent me for an X-ray after I insisted and it was of course negative. Then they gave me a shot after I asked for one and a prednisone taper. I had to ask to be referred to physical therapy because they didn’t even want to do that. Took a week to get in for a PT eval. PT confirmed Cervical strain with most likely old ligament tear or strain from back in September and shoulder weakness from compensating for the issue when lifting and working out. Gave me some stretches and exercises to do. Did some manipulation (which was great!) I am feeling about 50% better and have two upcoming PT sessions. Still no one is wanting to do an MRI and this is with my private insurance in the private sector just for some perspective.

Chronic pain sucks. I get it and you have my empathy because it sucks waking up in pain and feeling like your activity is limited. I hope you get into PT and get some relief!
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WO1 Property Accounting Technician
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I’m currently in Physical Therapy. The stretches don’t work for me. I actually think they irritate the nerve. I have an appointment with my PT soon so I’m going to push for an MRI. It’s only so much the pain meds can do.
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MAJ Audiology
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Hope you get some relief and some answer! WO1 (Join to see)
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