Expert: Dr. Paul Newhart - 8/25/2007

Question
I am a 33 year old NYC paramedic and am currently planning to enlist with a contract for Ranger School; US Army. My enlistment date would be approximately 6 months to a year from now.

To complete Ranger school you must go through 9 weeks of Basic Training, complete Airborne training and then graduate Ranger assessment school and then the actual Ranger course: all told rough 1.5 years of training to become a member of the teams. There are many miles of rucking with 50lbs of weight, the shocks of parachute opening/landing to the spine and of course the attendant stress of PT and unarmed combat.

I herniated L5 with radicular involvement of R leg x 3 weeks ago. No MRI but daily ice/chiro care with minimal improvement (localization of lower back pain is increasing with some radicular symptoms decreasing). there is/hasn't  been a loss of muscle tone or cauda equina syndrome. no pn. with dorsiflexion of plantar flexion. Really bad focal pain at night radiating into the perenium and leg. Last herniation x7 years prior: same L5.

Is it even realistic for me to hope to get through the military training with this lumbar injury?  regarding the spectrum of injury and the concurrent likelihood of recurrence given the stressors of Ranger training?
Thankyou
Nate Wilson, EMT-P

Answer
I hate to be the bearer of bad news, but it MAY cause you problems given the rigors of military training, especially Ranger school.  I currently have a patient, with similar symptoms, who, with the course of "military intelligence" and red tape, has been fighting for over a year and a half to be discharged.  MD's, Orthopedists, and myself all concur that the pain will only aggravate.  It may not be worth the hassle, and the affects on your health.