Go Back  PPRuNe Forums > Ground & Other Ops Forums > Medical & Health
Reload this Page >

Back complaint - medical checks affect employment?

Medical & Health News and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME. Due to advertising legislation in various jurisdictions, endorsements of individual practitioners is not permitted.

Back complaint - medical checks affect employment?

Old 23rd Sep 2010, 08:02
  #1 (permalink)  
Thread Starter
 
Join Date: May 2008
Location: UK
Posts: 525
Likes: 0
Received 0 Likes on 0 Posts
Back complaint - medical checks affect employment?

I have recently experienced some pain in my lower back and have Bupa health care so getting treated by a physio and guess it will resolve itself with time. I'm in two minds if I should visit my doctor to see if I can get an MRI scan to fully understand if it's a disc issue and possibly remedy more effectively. However, I wouldn't want anything on medical records that might affect future employment. Are such checks made and is it a valid reason for keeping clear of the doc?
Okavango is offline  
Old 23rd Sep 2010, 09:10
  #2 (permalink)  
 
Join Date: Jan 2001
Location: In the boot of my car!
Posts: 5,982
Likes: 0
Received 0 Likes on 0 Posts
Okavango

Excuse my ignorance but why would you want a scan? where could that option lead? a spinal operation? Not a good idea unless you are a complete invalid through it and thats the last option.

In my 20s i raced formula ford and was shoved through the side of the car in a crash. I had a scan which said impact to the spinal chord but still only physio. I lost all the feeling in the back of my ankle couldnt stand on my toes with that foot and was told I would have to live with it.

Walked and climbed hills every other day and it went. A lot of these back problems are a sedentary lifestyle and muscle tension.

Only you can answer that? Now I have gone back to skulling and rowing in my fifties another earlier pastime and have never felt so supple.

My advice have the physio and walk it will resolve itself. May I add I am a pilot have an interest in medicine but thats it NO KNOWLEDGE so I am sure somebody better qualified will advice you

Pace
Pace is offline  
Old 23rd Sep 2010, 11:17
  #3 (permalink)  
 
Join Date: Jan 2008
Location: UK
Posts: 1,464
Likes: 0
Received 0 Likes on 0 Posts
Suggest you look for 'Treat your own back' by Robin MacKenzie, an NZ physio. As he says, the exercises don't work for everyone but they work very well for a lot of people and it's not an expensive book.
cats_five is offline  
Old 23rd Sep 2010, 11:25
  #4 (permalink)  
Thread Starter
 
Join Date: May 2008
Location: UK
Posts: 525
Likes: 0
Received 0 Likes on 0 Posts
Simple - to understand whether the most beneficial remedy and exercise is being followed (as I had stated in my original post). For example, the Physio told me that the stretches I'd been doing thinking it was a repetition of a muscular injury from a couple of years ago could actually be aggravating a new disc complaint, rather then helping it. My understanding is that only an MRI scan will correctly identify any disc abnormality - even then as you say most people are treated with manupulation and exercises but I'd at least like to know they're the most effective ones. The other issue is that I only have access to a Physiotherapist through Bupa, rather than an Osteopath which I'd ideally like to see (and which I'd be referred to through the Doc).

Now back to the actual question - are they able to and do employers make any medical checks and if so would such a complaint be looked upon unfavourably?

Edit:thanks for last reply - this response sent at same time in answer to previous post.
Okavango is offline  
Old 23rd Sep 2010, 14:04
  #5 (permalink)  
 
Join Date: Sep 2007
Location: london
Posts: 741
Likes: 0
Received 1 Like on 1 Post
As with a lot of common conditions, there is a lot of ******** spoken.

If you just have muscle pain localised to the back and physio settles it down in a week or so that is fine.

If you have weakness in the legs, cant urinate or defaecate, get to hospital immediately

But most people are in the middle. An MRI is a completely safe radiation free test that gives a diagnosis. I wonder how many of us would take an A/C which was misfunctioning but nobody had bothered to ask WHY? In Germany an immediate MRI is the norm and some 90% of acute back pain patients are back at work in 3 weeks. In the UK MRIs in the NHS are effectively rationed and less than 70% of people are back at work in 6 months. The data is clear.

So please get an MRI and if there is significant pathology see a spinal surgeon. This does not mean definate surgery, but even if surgery is needed, it is not the death sentence suggested above. Many patients benefit from local anaesthetic blocks - injections into the nerves - that can only be done by specialised doctors.

In my experience, the CAA is fairly disinterested unless you have weakness of the legs or bladder/bowel dysfunction and then surgery is mandatory anyway. You need to notify if you have an operation, but I have been involved with a number of pilots and they have resumed flying unrestricted.

If you want advice through this maze, let me know and I will give you some names
homonculus is offline  
Old 23rd Sep 2010, 15:04
  #6 (permalink)  
 
Join Date: May 2001
Posts: 10,815
Likes: 0
Received 0 Likes on 0 Posts
I personally suffered with lower back pain for 2 years off and on from doing something to it while shutting of all things a stiff aircraft door at chest height on a slippy apron.

My GP recommended a good bone cruncher who was qualified in both the bone alignment and muscles etc. 3 sessions, plenty of walking and a bit of sticking pins in me followed by a visit to the physio to teach me the strengthing exercises and it was cured.

Apparently you need to get everything aligned and not in spasm before strengthening otherwise you end up lop sided and still favouring one side of your back and it turns into a bit of a viscous circle. First couple of sessions was manipulation and after the second one I had no back pain. The third one was more geared towards the stomach muscles. Touch wood I haven't had a problem since.

Some Medics swear by Chiropraters, Osteopaths and Acupuncture to help with backpain others see it as quackery.

If you haven't been before its all a bit scary with popping noises and them sticking you in stress positions then leaning on you until you feel things "move". Afterwards it feels sore but more like you have done an hour of circuit training and nothing compared to the pain you had before hand.

My GP said that a bad one can cause more damage than good but a good one in his opinion (and experence himself) can aid your back recovering.

Good luck finding your cure its soul destroying living with backpain and out of the blue spasm's.
mad_jock is offline  
Old 23rd Sep 2010, 21:49
  #7 (permalink)  
 
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes on 0 Posts
However, I wouldn't want anything on medical records that might affect future employment
I should imagine an important factor would be the duration, rather than the severity, of your symptoms.

6 weeks duration usually marks the threshold between acute and chronic back pain.

As homonculus indicates, a decent clinician should be able to work out the difference between mechanical back pain and anything more sinister, ( eg cancer, cauda equina ) through listening to your symptoms carefully.

MRI scans can be useful, although in the short term, justifying using public money on an expensive test, which is unlikely to add to the management of your care, may be difficult.

It's unlikely that it would be authorised by your GP, so you may well be in danger of going down the specialist route, which would, of course,medicalise your problem further.
gingernut is offline  
Old 29th Sep 2010, 16:21
  #8 (permalink)  
 
Join Date: Sep 2007
Location: london
Posts: 741
Likes: 0
Received 1 Like on 1 Post
An MRI is justified Gingernut if the pain is more than fleeting, and is routine in many countries

As to public money, it costs about £40 because the MRI is running all the time - once you have bought the machine the cost of doing more images is basically salaries, but the employees are paid already. Good old NHS rationing more like!
homonculus is offline  
Old 29th Sep 2010, 20:06
  #9 (permalink)  
 
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes on 0 Posts
As to public money, it costs about £40 because the MRI is running all the time - once you have bought the machine the cost of doing more images is basically salaries, but the employees are paid already. Good old NHS rationing more like!
Fair enough comment, a fact I wasn't aware of.

Can we please have open access in primary care then?

Have you got any up to date pathways homon? I'm still working to the Royal College of Physiotherapy stuff. Should our threshold for referral be lower?

Might stop some innapropriate lumbar x-rays.
gingernut is offline  
Old 29th Sep 2010, 20:30
  #10 (permalink)  

Plastic PPRuNer
 
Join Date: Sep 2000
Location: Cape Town
Posts: 1,898
Received 0 Likes on 0 Posts
One of my chums had an MRI (for something unrelated to his back) and the (negative) report remarked on a lot of degenerative spinal pathology.

He was horrified and rushed off to consult one of our spinal surgeons who looked at it and shrugged saying, "Most people over 40 have spines that look like that, if we were to operate on all of them we'd never stop! If you don't have any significant symptoms then forget it."

As Ginger says, don't medicalise a minor problem.

Treat the patient, not the X-Ray

Mac

Mac the Knife is offline  
Old 30th Sep 2010, 02:36
  #11 (permalink)  
Psychophysiological entity
 
Join Date: Jun 2001
Location: Tweet Rob_Benham Famous author. Well, slightly famous.
Age: 84
Posts: 3,267
Received 22 Likes on 13 Posts
So much tosh talked about backs.

Facet joints trapped on full travel are a big one. Encapsulation material jamming the surface. All good stuff for a chiropractor. A popped disc, there's only one way to go.

How do you decide?

There is a triage clinic in a lot of places, and the detective work they do follows a set routine that has been established over many, many years. It's a sound logic. But nothing compares to an MRI done on a machine with a good coil. Then, a good man looking at the pictures. It took me hours to finally make out what I was supposed to be looking at, and I was being instructed by a spinal surgeon.

40 quid for an MRI? Direct operating costs? Yeh, right...if your NHS doesn't buy the time from a private company that happens to be physically embedded into the hospital building so as you'd never know. 500, ten years ago. And get on a cancellation list being ready to get there in 30 mins. Be ready for your insurers to pay 1,000. And that would be a gift over here in the US.

Put me down for what homonculus says. FFS, it's a few quid. If the spiky bits of a herniated inter-vertebral disc are prodding into the sheath of the spinal chord it will not be resolved by manipulation. It will just piss it off.

Think of a radial tire/tyre...the steel wires bursting out of the periphery.

It's true not to rush into surgery. Your call, but let me tell you, constant back pain marks an end to the life you know.
Loose rivets is offline  
Old 2nd Oct 2010, 19:24
  #12 (permalink)  
 
Join Date: Aug 2001
Location: UK
Posts: 2,410
Likes: 0
Received 0 Likes on 0 Posts
HNC wrote:

B
ut most people are in the middle. An MRI is a completely safe radiation free test that gives a diagnosis. I wonder how many of us would take an A/C which was misfunctioning but nobody had bothered to ask WHY? In Germany an immediate MRI is the norm and some 90% of acute back pain patients are back at work in 3 weeks. In the UK MRIs in the NHS are effectively rationed and less than 70% of people are back at work in 6 months. The data is clear.
Wow

Some amazing data.

Can you provide a reference for this?

MRIs are an effective tool in managing the appropriate care pathway for patients where indicated but to suggest that by sticking everyone in a scanner you get magnificent success rates in getting people back to work is not true nor the converse that without an MRI people are doomed to a life of misery.

Nor is the suggestion true that MRIs on the NHS are rationed.

Or that the true cost of an MRI is in the region of 40 quid.
Flyin'Dutch' is offline  
Old 3rd Oct 2010, 20:13
  #13 (permalink)  
 
Join Date: May 2008
Location: With the Care Bears.......
Posts: 42
Likes: 0
Received 0 Likes on 0 Posts
From what you've said (and correct me if I've misunderstood), you've had this complaint a relatively short period of time. You/the physio thinks it's muscular, possibly a repeat of an old injury. You've not mentionned any trauma, other symptoms or that you have any weakness etc associated with this pain.

Is the Physio working?

To be honest a scan at this point may not really add to anything. If you've slipped a disk, in the absence of any neurological symptoms associated and with often effective non-operative treatment (Physio initially), I doubt you'd find a surgeon who would advise an operation at this point. And why would you want one before trying the non-surgical options first?

My point is....... given the relatively short course of the problem so far, stick with the physio....... if it's not working (bearing in mind muscular back pain can take weeks to recover) then see your doc and discuss a scan plus further treatment options. You may not need to worry about the medical records/access part of your post.

The part about access to notes - are you a pilot? Do you hold a medical already? If so which one? If you have a JAR medical, yes the CAA can request notes form your GP (I think you sign to approve this on the medical form). I don't work down there so whether they actually do or not I'm not sure.

Best of luck

B
beany is offline  
Old 4th Oct 2010, 04:01
  #14 (permalink)  
Psychophysiological entity
 
Join Date: Jun 2001
Location: Tweet Rob_Benham Famous author. Well, slightly famous.
Age: 84
Posts: 3,267
Received 22 Likes on 13 Posts
To be honest a scan at this point may not really add to anything.
No, flying blind without instruments is a doddle.

If you've slipped a disk,
Just what does this mean? Discs don't slip.


in the absence of any neurological symptoms associated and with often effective non-operative treatment (Physio initially), I doubt you'd find a surgeon who would advise an operation at this point.
If this sentence was reconstructed, I'd agree with it...I think.

And why would you want one (MRI scan) before trying the non-surgical options first?
Because manipulating a badly herniated inter-vertebral disc can cause irreversible nerve damage.

The thing is, permanent relief/cure of back pain can sometimes be gained from a chiropractor or osteopath in just one session. It's my opinion, that if the first session doesn't bring relief, then either the procedure is not being carried out properly, or the problem is not going to be resolved by manipulation. Deciding on the course of action is the $64,000 question.

Advising on that is what the Triage session is all about. Sadly, this logical step is often never offered. It is a long established routine of questions and procedure, like pricking the legs and feet to test for responses. It can take an hour of very careful positioning of the back and legs while the test are done, and IMHO still very good diagnostic medicine.

MRI technology is a science on the borderline of man's knowledge of quantum physics. It removes the problem of other types of tomography - with its accumulative X-band radiation. CAT scans are incredible, but they use low levels of X-rays for protracted periods. Some very disquieting questions are being asked about the risk / benefit ratios.
Loose rivets is offline  
Old 4th Oct 2010, 14:23
  #15 (permalink)  
 
Join Date: May 2008
Location: With the Care Bears.......
Posts: 42
Likes: 0
Received 0 Likes on 0 Posts
‘Slipped disk’ refers to abnormal protrusion or bulging of an intervertebral disk from it’s normal anatomical position, usually (although not always) in a posterolateral direction. This can compress the corresponding nerve root as it exits the spine and cause neurological symptoms. Not always though.

No, flying blind without instruments is a doddle – I wouldn’t agree with this to be honest. I don’t think that flying blind without instruments would be a doddle at all. I may be quite stressful as tasks go.

I asked whether this person is a pilot? ATC? Does he/she have a medical? What medical are they after? That’s why I asked! There is no suggestion yet that he is actually flying. Please point me to where ‘flying blind’ or instrument flying is mentionned

I was simply suggesting that –

If it’s muscular as suspected by the patient and the physio and it’s not yet been given the time and treatment needed in the first instance AND there is worry about access to notes etc, why would you do a scan? It won’t help just at the moment. I’m not suggesting it won’t be needed, perhaps not just yet. Now if they had said – “I’ve got this back problem and physio is making it worse” that’s a different matter. That’s not been said, we don’t even know how old the injury is.

I’m not saying an MR is not needed, but more info is needed. Then the advice may be more specific, you see? Ask the right questions and you get the right answers.

Last edited by beany; 4th Oct 2010 at 14:27. Reason: MS word blarb!
beany is offline  
Old 4th Oct 2010, 14:25
  #16 (permalink)  
 
Join Date: May 2008
Location: With the Care Bears.......
Posts: 42
Likes: 0
Received 0 Likes on 0 Posts
And why would you want one (MRI scan) before trying the non-surgical options first?

I just spotted this!

I think you added words to my post there LR. My question was - why would you want an operation (NOT MRI SCAN!!) before trying the non-surgical options first.
beany is offline  
Old 4th Oct 2010, 19:04
  #17 (permalink)  
Psychophysiological entity
 
Join Date: Jun 2001
Location: Tweet Rob_Benham Famous author. Well, slightly famous.
Age: 84
Posts: 3,267
Received 22 Likes on 13 Posts
Yes, I agree it would have been better to clearly state that the bold and bracketed insert was mine. It's a bad habit I learned from PpruNe. It's a sort of convention, but not a very sound procedure.

Reading and re-reading,

To be honest a scan at this point may not really add to anything. If you've slipped a disk, in the absence of any neurological symptoms associated and with often effective non-operative treatment (Physio initially), I doubt you'd find a surgeon who would advise an operation at this point. And why would you want one before trying the non-surgical options first?
I accept you pass on from the scan and talk about surgery. Re-Reading "why would you want one?' obviously means surgery, but being rather dismissive about the scan in the first line, then referring to a substantial surgical procedure as 'one' had me fooled.


This 'Slipped Disc.' term is a oft used misnomer which has confused the layman for years. I even paid good money to a so-called Physio - a successful man who also looked after a football team. He puggled about with my back and told me he'd pushed the disc back in. He later said I'd been unlucky, because it had come out again.

He earned a great deal of money doing this kind of thing.


Making that first decision is the most difficult. Do you trust an Osteopath in the first instance?

One of those sudden clicks that results in a disabling spasm leaves you with the decision to go one of two ways.

I think that if the problem had NOT been caused by lifting something very heavy, then there is a good argument that a Chiropractor or Osteopath may well see you back to normal in 20 minuets - albeit, a little stiff for a couple of days.

There's a good chance it will work and it's so frustrating to go for days, or even months, in pain, when the "basic three" manipulations can work magic.

I don't know the ratio of cases where there's visible displacement, but so often the facet joints are jammed at the limits of their travel, and this can be felt, if not seen, by the Osteopath. It really is a clear symptom. With a young and flexible disc, there may be no damage whatsoever to that disc, and unlocking the facet joints will let everything drop back into place.


The horrible thing is, the huge muscular forces caused by supportive and corrective computations in the spine, often cause lumps of muscles to appear to be something they're not. It really ups the anti in diagnosis.


If however, the sudden back pain is the result of the careless lifting of something far too heavy, then one should not rush into having it pulled about - especially if there is associated twitching or pain in the leg/s. I believe that this requires the full Triage process which will - or should - include an MRI as a standard procedure. This package of information is (or should be) put before some sort of committee who decide on how to progress the case. Sadly, a great many patients in the UK don't get past this point, and never see the surgeon. They can insist, but most don't know that. Pain control is one option, and good luck with that in Essex. Death in extreme old age will probably come first.
Loose rivets is offline  
Old 10th Oct 2010, 13:58
  #18 (permalink)  
Thread Starter
 
Join Date: May 2008
Location: UK
Posts: 525
Likes: 0
Received 0 Likes on 0 Posts
Just to update - this back problem is still niggling. Frustrated with progress with physio, I went to see an Osteo and he thought it was muscular (the Physio suspects it's a disc problem). The remedial therapy they suggest conflict against one another therefore I really want an MRI scan to understand what the issue is so I'm going back to my GP to talk through and request a referral to a consultant. I'm in Bupa so this wouldn't be a drain on the NHS. I don't mind about the medical records issue if there is no disclosure required or it's something a future employer (note not the CAA) could not find during their own medical checks (ie if there doc could check my medical records). Any further advice appreciated.
Okavango is offline  

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Thread Tools
Search this Thread

Contact Us - Archive - Advertising - Cookie Policy - Privacy Statement - Terms of Service

Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.