One of the most common work injuries we see in PA is to the back, whether it is a herniated or bulging lumbar disc, an aggravation of degenerative disc disease, or a soft tissue injury, such as a strain or sprain. These injuries run from a minor strain, which can be cured by rest and medication, to a herniated disc encroaching on a lumbar nerve root, which can require injections and surgery.
When an injured worker has suffered a herniated lumbar disc, and is having pain or numbness down one or both legs (“radicular symptoms” or “lumbar radiculopathy”), surgery may be discussed. One of the more common procedures to relieve the pressure of a herniated lumbar disc pressing on a nerve root is called a discectomy, where the disc material is simply removed.
A recent article published in the Journal of Bone & Joint Surgery examined some previous studies regarding the timing and effectiveness of lumbar discectomies. One of the more interesting findings was that pain relief occurs first after a lumbar discectomy, followed by recovery of motor function (strength), then improvement in sensation. In other words, it is not unusual for the injured worker to continue to have abnormal sensation after surgery. This is an important thing to keep in mind after surgery, so that the injured worker does not feel as if his or her recovery is not going well.
Another interesting finding in the article is that once severe extensor weakness (in this case, the big toe) has begun, lumbar discectomy is not likely to help. In that situation, apparently the nerve has been damaged too badly by the pressure of the herniated disc.
Obviously, whether a patient needs surgery is a determination to be made between the patient and the doctor. Our role as workers’ compensation attorneys in Pennsylvania is to make sure our clients have that decision to make. In other words, we want to make sure the workers’ comp insurance company is covering the treatment the injured worker needs.