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Could this work injury be the cause of my autonomic dysfunction symptoms?

38 year old Caucasian male. 5'8 165 pounds. Muscular and fit for all of my life. I've gained about 20-25 pounds over the past year and haven't been as active due to not feeling well on a daily basis. I've recently had a back injury at work in November 2020. I've worked in a distribution warehouse for the past couple of years in an overworked environment lifting hundreds of 30+ pound packs of products daily. I started the job in March 2019 and started having random autonomic dysfunction symptoms in December 2019 after an insane amount of overworking and stress. Since mid-December 2019,I have had episodes of rapid heartbeat, shortness of breath, palpitations, lightheadedness, feeling jittery and shaky, adrenaline, frequent urination, blood pressure and heart rate rapidly going up and down, intermittent stomach pains, intermittent lumbar pain, bladder pain and colon pain about 2 inches below the navel. The lumbar pain grew with time and I figured it was just a little back strain due to all of the lifting. Certain positions make me quite lightheaded. Curiously, some days when I get out of bed, my back doesn't hurt as much and yet I'm super lightheaded and feel awful. Other days I walk around for an hour hunched over before I can stand up straight due to stabbing lumbar pain and on the days when I have the sharp pain, I'm not very lightheaded. Some days it's both and the more it hurts, I start having increased bowel and bladder functions and can feel the pain radiating through the center of my body from my lumbar to the colon/bladder and somehow making them hurt a lot. I fainted one time due to the lumbar pain and hit my head on a door frame.

A lot of my coworkers quit frequently and I rarely had enough help. I stocked a 40-50 foot long 4-tier shelf daily with 30+ pound packages of product and lifted them sometimes hundreds of times per day. The upper shelf is about 7 feet high and I would have to lift probably 50-75 of them above my head on a daily basis, downstack a couple of hundred of them from pallets to other pallets on a daily basis to sort the mixed product and that was just the first half of the day. The second half of the day was bending about a thousand times a day at the waist to pick those individual products from the front side of the shelf to build orders in trays and then stacking those 30+ pound trays onto pallets down near the floor. I did all of that every day from March 2019 until November 2020 when I hurt my back during the day and went to HR. They immediately sent me to a worker's comp doctor the next morning. I had a number of visits with her over 1.5 months and had a lot of physical therapy sessions on-site, which did not help. My lumbar area has had severe pain since November 2020. Some days even at home, I can barely stand up straight. I've been out on worker's comp unable to do much of anything since the end of February.

Long story short, my worker's comp doctor cut my sessions when physical therapy didn't work and said there was nothing she could do for me. She blamed the lower back pain on my "Dysautonomia" even after an MRI showed:

1. There is mild-to-moderate degenerative spondylosis at L4-5 associated with Scheuermann's disease. 2. The L4-5 disc space level demonstrates moderate degenerative spondylosis and narrowing of the disc with prominent Modic changes related to stress response. There is a bulging disc indenting the thecal sac across the midline. In addition there is a left lateral and left foraminal herniated disc protrusion and bone spur measuring 3 x 6mm in size touching the epidural space with minimal extension into the left neural foramen. The right foramen is normal.
3. The L5-S1 disc space level demonstrates a small amount of fluid in the right facet joint. There is no evidence of herniated disc or spinal stenosis. The neural foramina are normal. Age of injury of all bony changes: Chronic.  Age of injury of all herniated discs: Indeterminate"

Workers comp doctor said it is the Dysautonomia causing my back pain. My personal doctor refuted that in a letter and said my back injury is totally unrelated to the Dysautonomia that he treated me for for nearly a year before the back injury. Now locked in a legal fight with the employer's insurance company who isn't wanting to pay for worker's comp and is denying everything.

A lot is wrong with this situation.

1. Worker's comp doctor erroneously blamed Dysautonomia for physical injuries and pain. I've been to all kinds of doctors and specialists since December 2019 and none of them found any disease or specific condition to cause those autonomic symptoms.
2. I asked the worker's comp doc (she's supposed to be a former Medical Director) about the increased bladder and colon pain that got even worse after November 2020 when I hurt my back. She said, "The nerves from the back go around to the front and cause that."  Then later blamed it on the Dysautonomia in a letter to my employer and said it isn't work related.
3. Employer gets letter and their worker's comp insurance cuts my worker's comp benefits. Employer files for FMLA for me to go on leave for "serious medical condition" that I have never been diagnosed with and wants me to go to my personal doctor to get the FMLA forms filled out before I can work.
4. I get a worker's comp lawyer. A couple of days later, the HR manager at work emails me and says my "worker's comp bucket has been restored again" and says to not worry about going to my doc to get the FMLA forms filled out. So the FMLA expires and I get a letter from the governing body saying I failed to submit paperwork and no longer qualify for FMLA. HR never cancelled it when my worker's comp benefits were started again.
5. I'm going back and forth emailing with my employer's insurance adjuster to get a second opinion doctor (spine doctor) and she says I can. I email her back the name of the doctor and 10 days later she controverts the case legally and says the employer isn't responsible and the insurance company is only partially responsible. Worker's comp benefits cut for the second time. No checks even paid in over a month out of work and unable to stand for half of those days. My neurologist looked at my MRI disc and said I have Sciatica and nerve impingement. The worker's comp doctor that I first went to brushed that off.
6. Lawyer is fighting them and has requested a court hearing. They have been refusing contact up until the hearing request was submitted and now want to retrieve my medical records for the last 10 years thinking that they'll find a way to get out of paying for my back injury. The insurance company said the employer is denying indemnity in whole and claimed that compensable medical benefits are being provided, but I haven't received a dime from worker's comp weekly checks and they've cut my treatment benefits. Insurance company also states that there is no medical to support disability related to a work accident.

Could my back injury be the cause of all of this autonomic dysfunction? It seems like sometimes after a bowel movement, I'm not as lightheaded. I have also been to a gastro doctor in the past who noted that if the colon couldn't evacuate and wasn't working properly, that it could cause my autonomic symptoms. Could my back be the source of this? I didn't have any back injury issues before I worked at this place.
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Avatar universal
I think you have to separate the workman's comp issue, which is you seeking money, and the pain you're living under, which is your life.  Also, disc problems are found in almost everyone, and aren't always or even usually the cause of pain.  It's usually muscular.  Given what you do for a living, it appears you have to not do that anymore no matter what else happens.  I realize you can't claim disability if you just up and quit, but hey, you've got all the symptoms of a back problem and it's pinching on nerves and wrecking your whole life.  You also don't mention having seen an orthopedic surgeon, who would be the specialist in diagnosing a back problem, not your regular doc nor your workman's comp doc.  You also haven't seen a pain specialist, who also can diagnose such things.   But you know, you have those other symptoms that don't have anything to do with strain on your back or your muscles from work, so you also need an accurate diagnosis of that.  Again, you'd have to see specialists in the heart, nervous system, hidden viruses, thyroid, blood sugar, electrolyte balance, I mean, a whole panoply of things that can cause your symptoms.  Until you get an accurate diagnosis from a specialist who doesn't care if you get workman's comp or not but only cares what's actually going on with you this will just keep going on.  
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In case you need a second opinion, I agree with everything Pax said.

I have some cardiac issues that sometimes make me feel lightheaded when I stand up. Then again, it might be my hypoglycemia. Either way, You need to get a full evaluation to find out what's happening, from doctors who don't care about your worker's comp stuff.

Your worker's comp doc is ultimately concerned about saving the company money, not you. They aren't interested in investigating anything other than the bare minimum.

You could easily have injuries from work AND something else going on. I hope you get it all figured out. It sounds pretty miserable.
Stress EKG (treadmill) and ultrasound, Echocardiogram...lots of EKGs, Holter monitor for a month and patch heart monitor found nothing. I also had my sugar checked numerous times and not diabetic. I've been to every specialist that I could find and the only thing they've found wrong is autonomic dysfunction with symptoms, but no condition to pin it to. I know for sure that I do have Sciatica as noted by the neurologist. Apparently those nerves being crushed go all the way to the bladder/colon area and can cause them to malfunction. My gastro doc said that if the colon was paralyzed or malfunctioning, it could cause the lightheadedness and symptoms I was having. Plus there are some spinal injuries that apparently cause autonomic dysfunction, but autonomic dysfunction can't cause back pain. I haven't had the autonomic dysfunction until I worked at that warehouse for nearly a year and at 38 years old, I would think that if I had some kind of disease or condition, it would have shown it's head before now. I could be wrong, but will keep checking other docs.
Not really.  Diseases that cause your kind of symptoms happen when you age, usually, as your immune system breaks down.  Sugar is hard to judge -- docs look for quick tests usually and normal ranges, but you can be at the low end of a normal range and for you that could mean trouble.  Not saying that is your problem, probably not, just saying, when you have a range of odd symptoms that don't seem to go together, it might just be something that is very hard to find unless a doc is looking really really hard.  Could be Lyme disease, which docs almost never find until a patient persists for years.  Thyroid can be the same, as the usual thyroid test doesn't actually test the thyroid.  There are so many diseases we can have that can make us sick.  There's also the possibility you are working in a sick building, which would cause a lot of what you're suffering.  Could be food senstitivities.  Which is to say, I have no idea what's going on though it does sound like two very different problems.  As for sciatica, having had it, it travels along the outside of your leg usually and down.  When it curls into the groin and bladder, it could be that, but it could also be from the hips.  A small muscle that doesn't show up in any diagnostic picture is the periformis, and that is a main cause of sciatica.  Even pinching in the neck can cause problems where you're feeling them.  But that wouldn't cause the other stuff.  Wish I could do more than just say see better docs.  Best of luck with this.
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