Lower back pain and Class 1 medicals
Thread Starter
Join Date: Mar 2006
Location: -
Posts: 8
Likes: 0
Received 0 Likes
on
0 Posts
Lower back pain and Class 1 medicals
Hi guys,
I recently sustained a lower back injury in flight (in fast jets), and am grounded. Docs have been unable to pinpoint the cause of the pain so far, however the pain/ache happens during G onset, and I will probably be facing a reassignment due to this.
On the x-rays there seem to be no issue, and the pain doesn't come on in normal everyday life unless I bend backwards at a weird angle. I am still able to exercise/play sports with no issues with the back.
I'm just curious, will this be an issue if I apply for a civillian class 1 medical in the future (FAA/CAA/JAA or otherwise)?
I recently sustained a lower back injury in flight (in fast jets), and am grounded. Docs have been unable to pinpoint the cause of the pain so far, however the pain/ache happens during G onset, and I will probably be facing a reassignment due to this.
On the x-rays there seem to be no issue, and the pain doesn't come on in normal everyday life unless I bend backwards at a weird angle. I am still able to exercise/play sports with no issues with the back.
I'm just curious, will this be an issue if I apply for a civillian class 1 medical in the future (FAA/CAA/JAA or otherwise)?
Join Date: Apr 2010
Location: Home soon
Posts: 0
Likes: 0
Received 0 Likes
on
0 Posts
I'm just curious, will this be an issue if I apply for a civillian class 1 medical in the future (FAA/CAA/JAA or otherwise)?
Seriously it shouldnt be a problem at all,however if your medical is suspended or revoked,you will need to mention it during the class 1 application.
I wouldnt worry.
Best is go to your local medical caa examiner and ask him/her.
I agree with de facto. Lumbar pain is very common and rarely an issue unless it prevents you doing your duties. Leaning back at funny angles might ring alarm bells if it is synonymous with leaning back for an overhead panel or leaning back to get a chart or tea tray.......
Not sure what species of doc you saw, but the definitive investigation is an MRI not an X ray. If a spinal surgeon cannot help after an MRI I would go see a chronic pain specialist. Your symptoms may warrant a standing MRI and may signify facet joint problems but this isn't an area for armchair diagnosis. So make sure you really can't be diagnosed or helped before putting up with your symptoms
Not sure what species of doc you saw, but the definitive investigation is an MRI not an X ray. If a spinal surgeon cannot help after an MRI I would go see a chronic pain specialist. Your symptoms may warrant a standing MRI and may signify facet joint problems but this isn't an area for armchair diagnosis. So make sure you really can't be diagnosed or helped before putting up with your symptoms
Uncle Pete
Join Date: Jul 1999
Location: Frodsham Cheshire
Posts: 915
Likes: 0
Received 0 Likes
on
0 Posts
See a specialist, possibly one recommended by the CAA, and listen to what he tells you.
Take his/her advice to prevent any possibility of further damage. Prevention is a far better option to cure when it comes to backs.
Take his/her advice to prevent any possibility of further damage. Prevention is a far better option to cure when it comes to backs.
Join Date: Nov 2013
Location: Nearest Marriott
Age: 39
Posts: 23
Likes: 0
Received 0 Likes
on
0 Posts
Slipped Disc
Having injured my back in the RAF and having had 4 weeks of misdiagnosed physio. Resulting in the physioterrorist pushing on my later discovered pair of permeated discs once a day until tears came out. I would definately push for getting a MRI. Especially if the pain you experience radiates elsewhere. When my back hurt I got pain down one leg into my toes. Even when I suggested that the two pains (back and nerve pain in leg) were associated the RAF doctors insisted they weren't. Long story short- if I had gone to see a specialist who knew what they were talking about and got an MRI done I would have had the surgery I needed earlier and most likely wouldn't still have niggling pain some 5 years on.
Good luck getting it sorted! PS its never caused me any problems getting a class 1 and a civvie job
Good luck getting it sorted! PS its never caused me any problems getting a class 1 and a civvie job
Join Date: Mar 2006
Location: Queensland
Posts: 95
Likes: 0
Received 0 Likes
on
0 Posts
Not sure that I agree that you should get an MRI. The majority of asymptomatic adults have abnormalities such as "disc bulges" on their MRI. Therefore, it is difficult attribute back pain to any particular abnormality on an MRI. Rarely, an MRI may demonstrate a stress fracture, or spondylolysis, but this should show up on the X-ray you had. An MRI is really only useful if you have pain referred to your legs. Even then, the abnormality, such as a disc prolapse, must correlate with your symptoms. For example, if the MRI shows that you have a disc prolapse compressing the right S1 nerve root, but the pain is in your left shin, then it ain't the cause. Unfortunately lumbar back pain is extremely common, and 80-90% of us experience an acute attack at some point in our lives. The important thing is rule rule out sinister causes, e.g. fracture, infection, cancer - that is what we all worry about, but it almost never is. Pain associated with these problems tend to be constant, unremitting, worse at night, perhaps associated with fever and weight loss. These are the so called red flags.
on a final note, I had acute back pain last year, and it is bloody awful. Good news is the majority of back pain settles spontaneously. Hope it gets better soon.
on a final note, I had acute back pain last year, and it is bloody awful. Good news is the majority of back pain settles spontaneously. Hope it gets better soon.
This thread is becoming a synopsis of spinal pathology - a large and rapidly changing area of medicine.
Most spinal pain does resolve spontaneously and indeed pure disc problems eventually settle as the disc dries out. However, in Germany where back pain is actively investigated with MRI and treated within days the number of sufferers returning to work is far far higher than in the UK where treatment is or has historically been conservative. Pilots have the additional problem of poor seating, cramped working conditions and long periods with dehydration. OP asked about the problems of long term pain and the advice was correct - get it investigated.
Personally I would always have an MRI. It is risk free and in the older person eliminates fractures and cancer. It allows early referral to a spinal surgeon who would not simply proceed to surgery for any abnormal finding. Indeed early local anaesthetic and steroid injections almost always are the way to go not surgery, but they terminate the acute pain and muscle spasm that so often results in long term absence from work
The red flags are loss of control urinating or incontinence and the same with bowels. These indicate the need for immediate referral.
Most spinal pain does resolve spontaneously and indeed pure disc problems eventually settle as the disc dries out. However, in Germany where back pain is actively investigated with MRI and treated within days the number of sufferers returning to work is far far higher than in the UK where treatment is or has historically been conservative. Pilots have the additional problem of poor seating, cramped working conditions and long periods with dehydration. OP asked about the problems of long term pain and the advice was correct - get it investigated.
Personally I would always have an MRI. It is risk free and in the older person eliminates fractures and cancer. It allows early referral to a spinal surgeon who would not simply proceed to surgery for any abnormal finding. Indeed early local anaesthetic and steroid injections almost always are the way to go not surgery, but they terminate the acute pain and muscle spasm that so often results in long term absence from work
The red flags are loss of control urinating or incontinence and the same with bowels. These indicate the need for immediate referral.
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
Always good to rule out the nasties such as fracture, cancer, TB and Cauda Equina. Red flags are of course key, I admitted a patient only recently who presented with saddle anaesthesia.
Interestingly our local spinal clinic does the decision making over the phone !
I take your point about the MRI Radgirl, I guess I'm coming from a different perspective, if I sent every patient who attends with back pain, (about 3-5 a day), then I'd probably flood the system. And even if the scan was negative, when would I then re-refer ? If they were in pain still in a month, a year etc. I'm not sure that the results always correlate to the symptoms.
I'm wondering if the German experience is more to do with work ethic rather than intervention ?
Guess the worse thing we could do is send them for a traditional x-ray :-) Can't remember the statistics exactly, but isn't a lumbar x-ray equivalent to about 80 chest x-rays ? And medical radiology (UK) sparks off about 200 cancers a year.
Interestingly our local spinal clinic does the decision making over the phone !
I take your point about the MRI Radgirl, I guess I'm coming from a different perspective, if I sent every patient who attends with back pain, (about 3-5 a day), then I'd probably flood the system. And even if the scan was negative, when would I then re-refer ? If they were in pain still in a month, a year etc. I'm not sure that the results always correlate to the symptoms.
I'm wondering if the German experience is more to do with work ethic rather than intervention ?
Guess the worse thing we could do is send them for a traditional x-ray :-) Can't remember the statistics exactly, but isn't a lumbar x-ray equivalent to about 80 chest x-rays ? And medical radiology (UK) sparks off about 200 cancers a year.
Gosh Gingernut you see more new patients with back pain than a full time spinal surgeon!!!! I think you hit the nail on the head with the word ethic. My previous post was aimed at people with no previous symptoms who suddenly get lower back pain that prevents them working, and in many cases getting out of bed. Unless you are advertising in the local paper you shouldnt get this number.
Perhaps you are describing patients with a bit of an ache which is quite different, or may be they are after a sickie! I see that in your country the number of A and E attendances has tripled whereas in the rest of the developed world it has fallen by 20 - 30% (except the US where they still shoot each other).
Strange country. Also sorry to see my neighbouring country is struggling with MRIs. Surely we should provide the best level of care and not simply ration it? However, I suspect there is enough capacity to MRI all initial presentations with significant symptoms.
Perhaps you are describing patients with a bit of an ache which is quite different, or may be they are after a sickie! I see that in your country the number of A and E attendances has tripled whereas in the rest of the developed world it has fallen by 20 - 30% (except the US where they still shoot each other).
Strange country. Also sorry to see my neighbouring country is struggling with MRIs. Surely we should provide the best level of care and not simply ration it? However, I suspect there is enough capacity to MRI all initial presentations with significant symptoms.
Join Date: Mar 2014
Location: In the Air
Posts: 3
Likes: 0
Received 0 Likes
on
0 Posts
The good news is that most back pain gets better within 4-6 weeks, and your symptoms sound relatively mild. Unless you have radiation of the pain or numbness into your buttocks or legs, it is not clear that an MRI is needed earlier than that.
I had no trouble getting and renewing a Class 1 despite being A3G4Z1 , unfit bang seats, heavy lifting etc with a disc prolapse for the last 20 years!
Top tip, find a good osteopath or chiropractor as doctors can't 'cure' mechanical lower back pain and it's your posture that needs attention.
Top tip, find a good osteopath or chiropractor as doctors can't 'cure' mechanical lower back pain and it's your posture that needs attention.
Join Date: Jun 2011
Location: UK
Posts: 34
Likes: 0
Received 0 Likes
on
0 Posts
http://www.naturaljointmobility.info/lowback.pdf
Not sure if this would fix the original poster's maybe rarer problem, but might help people who have the more common condition of lower back pain.
This talks about using exercises in a book called 'Treat your own back' by Robin Mckenzie to fix lower back problems.
After years of worsening pain I found the exercises in Mckenzie's book have removed all my pain.
Have a read, it might help!
I simply found out about the book by surfing the net and reading the reviews on amazon. And honestly it has fixed my problem and a couple of my friends.
P.S. My MRI scan showed two prolapsed discs before I started the exercises.
Not sure if this would fix the original poster's maybe rarer problem, but might help people who have the more common condition of lower back pain.
This talks about using exercises in a book called 'Treat your own back' by Robin Mckenzie to fix lower back problems.
After years of worsening pain I found the exercises in Mckenzie's book have removed all my pain.
Have a read, it might help!
I simply found out about the book by surfing the net and reading the reviews on amazon. And honestly it has fixed my problem and a couple of my friends.
P.S. My MRI scan showed two prolapsed discs before I started the exercises.
Thanks Cruise Zombie
Here is this little island we call it physiotherapy and offer it to our patients for free. Still, not a bad dissertation from an electrical engineer.
Glad you are better. Take care
Here is this little island we call it physiotherapy and offer it to our patients for free. Still, not a bad dissertation from an electrical engineer.
Glad you are better. Take care
Join Date: Jun 2011
Location: UK
Posts: 34
Likes: 0
Received 0 Likes
on
0 Posts
Thanks Radgirl, I take your point.
But I wonder why there seems to be so much back pain about. My GP never sent me to see a physiotherapist, preferring instead to throw pills at me which did nothing apart from giving me some unpleasant side-effects. Likewise my friends who benefitted from the exercises I mentioned were never sent to a physiotherapist by their GP and the few that did see a chiropractor had little joy. The excercises were a surprise to all the friends of mine that were helped, a surprise to my GP and, it would seem, a surprise to many people who left reviews on Amazon.
Maybe, given the large number of days off work due to back pain mentioned in the media, a study should be done to scientifically check on these exercises and how GP's approach the whole problem of back pain. Treatment may be different in different countries of course.
Although I'm free of pain, I don't know if my prolapsed discs are still prolapsed! They may be because if I stop doing the exercises (like I did one month) the pain gradually comes back.
But I wonder why there seems to be so much back pain about. My GP never sent me to see a physiotherapist, preferring instead to throw pills at me which did nothing apart from giving me some unpleasant side-effects. Likewise my friends who benefitted from the exercises I mentioned were never sent to a physiotherapist by their GP and the few that did see a chiropractor had little joy. The excercises were a surprise to all the friends of mine that were helped, a surprise to my GP and, it would seem, a surprise to many people who left reviews on Amazon.
Maybe, given the large number of days off work due to back pain mentioned in the media, a study should be done to scientifically check on these exercises and how GP's approach the whole problem of back pain. Treatment may be different in different countries of course.
Although I'm free of pain, I don't know if my prolapsed discs are still prolapsed! They may be because if I stop doing the exercises (like I did one month) the pain gradually comes back.
Last edited by Cruise Zombie; 1st Apr 2014 at 10:39.
Great points Cruise Zombie
I alluded to differences between countries in an earlier post. As has been said, this is often a self limiting condition as the disc dries out or dessicates. It shrivels up and no longer presses on the nerve root which is the cause of pain. My take on it is that if you have significant symptoms you have a risk of long term immobility which makes it difficult to return to work so treatment is needed. A bit of an ache for a couple of days can be left.
Injections of local anaesthetic and steroids is the most efffective way of terminating symptoms but physiotherapy which reduces the pressure on the nerve also works.
Yes your prolapse cant disappear so it is still there until the disc dessicates but can as you demonstrate be controlled
I alluded to differences between countries in an earlier post. As has been said, this is often a self limiting condition as the disc dries out or dessicates. It shrivels up and no longer presses on the nerve root which is the cause of pain. My take on it is that if you have significant symptoms you have a risk of long term immobility which makes it difficult to return to work so treatment is needed. A bit of an ache for a couple of days can be left.
Injections of local anaesthetic and steroids is the most efffective way of terminating symptoms but physiotherapy which reduces the pressure on the nerve also works.
Yes your prolapse cant disappear so it is still there until the disc dessicates but can as you demonstrate be controlled
Join Date: Oct 2003
Location: The East
Posts: 31
Likes: 0
Received 0 Likes
on
0 Posts
Another take on back pain/herniated discs
I realise this is quite a bit after 'the event', but for those of you interested who have lower back pain, a herniated disc, RSI, tendonitis etc, then take a look at Dr Sarno's work on Healing Back Pain.
I used to fly Fast Jets and soon after my last FJ tour I had surgery on 2 lower back discs around the L5 region. I really thought this would cure my pain, but sadly it did not. Years later (and after a re-herniation of one of the discs) I was once again in pain and was contemplating surgery once more. Doing my research I stumbled upon Dr Sarno's work and decided to read his book. Well, within a week my pain had subsided by 50%, and within a month I was pretty much pain-free. This is not a mind-over-matter issue, but it looks at what the actual cause of the pain is...essentially, a 'bulge' pressing on a nerve doesn't necessarily cause the pain. It does cause some numbness and tingling, but not the pain.
So, here I am another couple of years down the line and I have a very acute episode of sciatica that causes me to call an ambulance and go to emergency. I discharged myself after a few hours once the pain had subsided, and decided to re-visit the Sarno book, despite an MRI showing a massive herniation at the L5/S1 level. After a week, I see a spinal surgeon who is amazed at my recovery, and decides that as long as I'm not in pain there is no need for surgery. I'm now pain-free, off medication a month after the sciatica flared up, and only have some low-level weakness that I am working on with the help of Dr Sarno's methods.
Long story, but worth it if just one person takes a look at the book/Youtube videos/podcasts regarding Tension Myositis Syndrome (TMS). All of this is free online, and could help you get rid of that pain whilst awaiting your MRI...
Good luck!
I used to fly Fast Jets and soon after my last FJ tour I had surgery on 2 lower back discs around the L5 region. I really thought this would cure my pain, but sadly it did not. Years later (and after a re-herniation of one of the discs) I was once again in pain and was contemplating surgery once more. Doing my research I stumbled upon Dr Sarno's work and decided to read his book. Well, within a week my pain had subsided by 50%, and within a month I was pretty much pain-free. This is not a mind-over-matter issue, but it looks at what the actual cause of the pain is...essentially, a 'bulge' pressing on a nerve doesn't necessarily cause the pain. It does cause some numbness and tingling, but not the pain.
So, here I am another couple of years down the line and I have a very acute episode of sciatica that causes me to call an ambulance and go to emergency. I discharged myself after a few hours once the pain had subsided, and decided to re-visit the Sarno book, despite an MRI showing a massive herniation at the L5/S1 level. After a week, I see a spinal surgeon who is amazed at my recovery, and decides that as long as I'm not in pain there is no need for surgery. I'm now pain-free, off medication a month after the sciatica flared up, and only have some low-level weakness that I am working on with the help of Dr Sarno's methods.
Long story, but worth it if just one person takes a look at the book/Youtube videos/podcasts regarding Tension Myositis Syndrome (TMS). All of this is free online, and could help you get rid of that pain whilst awaiting your MRI...
Good luck!
Join Date: Dec 2015
Location: United Kingdom
Posts: 39
Likes: 0
Received 0 Likes
on
0 Posts
Do be careful though as it asks if you were medically discharged from the military on your UK CAA Medical form with details. But then again it's up to the AME discretion at that time. It may change by location though.
Last edited by Drussjnr; 17th Feb 2016 at 17:54.