Lower back pain seriously neglected in the defence force

Have him bend slowly forwards. Is there a rib hump?

Have him bend slowly forwards. Is there a rib hump?

Lower back pain seriously neglected in the defence force is a tale of woe.



Hi,

My partner has been having lower back issues for around 18 months. As he is in the defense force and gets free healthcare, it's a lot harder to get any issues or symptoms resolved. At the beginning he had been told by his doctor to that he just needs to take panadol, however, after having to go back repeatedly telling them it's not working (at least 4-8 weeks) they finally referred him to their physio. When physio hadn't helped, his physio suggested and noted he should get X-rays however when he went back to his defence doctor they said it was fine and he didn't need any. So back and forth this went (with his back getting worse, some days its so painful) until recently he managed to finally get them to refer him to get X-Rays.

The Radiologist reported these:
PELVIC
Clinical History: Lower Back Pain Thoracic Scoliosis
Report: Mild loss in the neck offset on the right.

THORACIC SPINE
Report: Three views of thoracic spine show slight convex left curvature. Vertebral body height is maintained. Disc space height is preserved.


LUMBAR SPINE
Report: Two views of the lumbar spine are submitted. Slight 5% loss of the anterior vertebral body height at the T12 vertebral body is identified.

As this has occurred with deference, the fact they have taken so long to get him diagnosed with anything and his doctor was being very vague and unhelpful, we weren't sure what this all really meant in terms of treatment and pain relief. Can anyone help explain this better?

Being a defence issue, we plan to put in a claim but weren't sure the severity of his back problems and were wondering whether it was worth putting anything in as it was caused by his position in the defence force.





Hello Stephanie,
Your partner's lower back pain seriously neglected in the defence force really is a tale of woe. And alas it's the story of 'free healthcare'. Doctors are forced to keep costs down, and sometimes are downright lazy. Just ask him how thoroughly he is examined when he sees the doctor; does the latter even get up from his chair before reaching for the prescription pad?

That radiological report, if that's really all that was written is a case in point. The analysis of the lumbar spine is shockingly inadequate; it tells us nothing.

My first question is such matters is, is he every single day doing lower back exercises? They should start in bed before arising, and then be added to during the day. Seeing Medicine, at least the way it operates in the Defence Force, isn't going to help him, he has to focus on helping himself; and there's much he can do.

Secondly the cause of a scoliosis is often a short leg; kneel down behind him, placing your hands on the top of the iliac crests and simply eyeball them. Are they more or less level? A few millimetres is difficult to gauge, but is one side obviously lower than the other? If he bends slowly forwards, with no shirt, is there obviously a list to port? Or starboard?! Is the ribcage obviously unlevel? Getting the correct insert for his boot is no easy matter, but that needs to be sorted out if he has a significant leg length deficiency. Is there a family history of back pain? It's strongly hereditary.

I wish I could tell you that chiropractic has a quick fix to offer but after all these months which ever way he turns is going to be difficult. A true 'cure' is unlikely and a lifetime of exercise and care with bending, twisting and lifting lies ahead. One good thing is that there's no mention of radiating leg pain.

Sitting often is the greatest enemy.

I hope this contributes. Let me know what comes up and feel free to add more specific questions. Please revisit that radiological report; is that really all that was offered about the lumbar spine and pelvis?

Dr. Barrie Lewis


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