DC 5237 — Lumbosacral or cervical strain
Also known as: back pain, Cervical strain, lower back pain, Lumbosacral strain, neck strain, lumbar strain, low back, pulled back muscle, neck pain, cervical strain, upper back pain, thoracic pain, mid back pain
These are commonly claimed secondary connections linked to this primary disability. Use them as a screening tool for conversations with your doctor, VSO, or VA-accredited attorney.
Lumbosacral or cervical strain → Knee, other impairment
How the connection is commonly explained
Altered gait from back pain puts abnormal stress on the knees. This is a well-documented biomechanical link.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened knee, other impairment.
Lumbosacral or cervical strain → Major depressive disorder
How the connection is commonly explained
Chronic pain is one of the strongest predictors of depression.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened major depressive disorder.
Lumbosacral or cervical strain → Migraine
How the connection is commonly explained
Cervical spine conditions are a well-documented cause of cervicogenic headaches and migraines
Filing tip
File as a secondary claim to DC 5237 (Lumbosacral or cervical strain). Provide medical records showing cervical spine conditions are a well-documented cause of cervicogenic headaches and migraines and request a nexus opinion linking Migraine to your service-connected condition.
Lumbosacral or cervical strain → Sciatic nerve, paralysis
How the connection is commonly explained
Disc problems, strain, or stenosis can compress the sciatic nerve and cause sciatica symptoms.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened sciatic nerve, paralysis.
Lumbosacral or cervical strain → Thigh, limitation of flexion
How the connection is commonly explained
Altered gait compensation from back pain places extra stress on the hip joints.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened thigh, limitation of flexion.
Lumbosacral or cervical strain → Upper radicular group, paralysis
How the connection is commonly explained
Cervical and upper spine involvement can compress nerves affecting the arms and hands.
Filing tip
Ask your doctor to clearly state that the secondary condition is at least as likely as not caused or aggravated by the primary service-connected condition. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened upper radicular group, paralysis.
Lumbosacral or cervical strain → Erectile dysfunction, with or without penile deformity
How the connection is commonly explained
Nerve compression in the lumbar spine can affect sexual function. Pain medications also contribute.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened erectile dysfunction, with or without penile deformity.
Lumbosacral or cervical strain → Flatfoot, acquired
How the connection is commonly explained
Gait changes from back pain alter foot mechanics, causing plantar pain and flatfoot-related symptoms.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened flatfoot, acquired.
Lumbosacral or cervical strain → Generalized anxiety disorder
How the connection is commonly explained
Chronic pain and physical limitations often cause anxiety about future function and employment.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened generalized anxiety disorder.
Lumbosacral or cervical strain → Median nerve, paralysis
How the connection is commonly explained
Double crush syndrome — cervical nerve compression worsens carpal tunnel
Filing tip
File as a secondary claim to DC 5237 (Lumbosacral or cervical strain). Provide medical records showing double crush syndrome — cervical nerve compression worsens carpal tunnel and request a nexus opinion linking Median nerve, paralysis to your service-connected condition.
Lumbosacral or cervical strain → Sleep Apnea Syndromes
How the connection is commonly explained
Pain medications such as muscle relaxers and opioids can relax airway muscles. Reduced mobility can also contribute to weight gain.
Filing tip
A nexus letter and treatment records explaining the progression from the primary condition to the secondary condition can make a big difference. For this pairing, ask the provider to explain how lumbosacral or cervical strain led to or worsened sleep apnea syndromes.
Lumbosacral or cervical strain → Temporomandibular disorder (TMD)
How the connection is commonly explained
Cervical strain affects jaw alignment and function
Filing tip
File as a secondary claim to DC 5237 (Lumbosacral or cervical strain). Provide medical records showing cervical strain affects jaw alignment and function and request a nexus opinion linking Temporomandibular disorder (TMD) to your service-connected condition.
Lumbosacral or cervical strain → Tinnitus, recurrent
How the connection is commonly explained
Cervical conditions can cause or worsen somatic tinnitus through nerve pathways
Filing tip
File as a secondary claim to DC 5237 (Lumbosacral or cervical strain). Provide medical records showing cervical conditions can cause or worsen somatic tinnitus through nerve pathways and request a nexus opinion linking Tinnitus, recurrent to your service-connected condition.
This condition may also be secondary to
Flat feet change posture and gait, causing lower back strain.
Limping and altered gait from knee injury place abnormal stress on the lumbar spine.
Limitation of knee extension commonly causes limping and abnormal mechanics that strain the lower back.
Limitation of knee flexion often leads to limping and abnormal mechanics that strain the lower back.
Changed gait mechanics from foot pain affect spinal alignment
Sciatica and lumbar conditions are bidirectionally linked
Hip and back are biomechanically linked — hip dysfunction stresses the spine
Gait compensation from ankle injuries affects spinal alignment
Shoulder conditions often involve compensatory neck strain
Arthritis in weight-bearing joints alters gait, stressing the spine
How to File a Secondary Claim
Disclaimer: Secondary connections shown are based on commonly established medical links. Individual claims require medical evidence. Consult a VSO or VA-accredited attorney.