be mutually agreed between the Company and the Union, and the decision of
this doctor shall be binding on both parties.[29]
From the following findings of respondents physician, respondent is
entitled to the benefits under the POEA Standard Employment Contract of
2000:
IMPRESSION:
Lumbar spondylopathy
Lumbar disc protrusion, L5-S1
Mr. Talaveras back pain has improved since his physical therapy. However, he
still experiences pain and discomfort with exertion. He also now has started to
complain of numbness that radiates down his thighs. His diagnostic tests are
significant for degenerative changes and disc protrusion which are conditions
due to wear and tear. That is, with more exposure to activities producing back
stress, more injuries, and disability are to be expected. He has lost his preinjury capacity, and I now recommend a partial permanent
disability with Grade 8 Impediment based on the POEA contract. He
is UNFIT for further sea duties.
xxxx
Degenerative disc disease is a wear and tear condition and is associated with
degenerative changes in the articular cartilage. In the vertebral column, the
fact joints are involved. A single episode of trauma may not initially be
significant, but repeated trauma, such as excessive and strenuous physical
activities may play a role.
Through degeneration, wear and tear or trauma, the annulus fibrosus
containing the soft disc material (nucleus pulposus) may tear. This results in
protrusion of the disc or even extrusion of disc material into the spinal canal or
neural foramen. In addition, the nerve fibers of the affected root are also
compressed and this situation leads to radiculopathy in the appropriate
muscles. When the nerve roots become compressed, the herniated disc
becomes significant. The most common complaint in patients with a herniated
disc is that of severe low back pain developing immediately or within a few
hours after an injury.
The mainstay of therapy for a herniated lumbar disc is conservative treatment,
that is, nonsurgical. The mechanism of injury is often an episode of trauma or
a continued mechanical stress of postural or occupational type. Therefore,
torsional stresses on the back, and activities such as lifting and repetitive
bending should be avoided. The more these patients do, the more they hurt.
Prolonged relief is less likely if no permanent modification in the patients
activities is made. Over time, as the patient resumes his normal work of