Post-Car Accident: Managing Lumbar and Cervical Spine Issues

Lumbar and cervical spine after a car accident?

Doctor: Hello, I was in a car accident in mid-June where I rolled onto my right side, resulting in a pelvic contusion and bruising, a torn rotator cuff in my right shoulder, a dislocated right wrist with radial and ulnar ligament injuries, and a triangular fibrocartilage tear.
Starting on July 12, I began to experience weakness in my lower limbs and pain in one segment of my lumbar spine.
I went to an orthopedic specialist for X-rays, which showed no issues with my spine, but I have continued to experience some pain in the lumbar region over the past four months.

1.
In the lumbar area, sometimes when I lie down and then get up, I feel pain.
Additionally, there have been instances where I felt unable to stand up, and my lower back also hurts during those times.
On September 20, I visited a rehabilitation specialist who used ultrasound and indicated that there is a hematoma, which has not resolved after four months.
Given this situation, do I need to go to a larger hospital for further examination?
2.
Occasionally, I feel discomfort at the first cervical vertebra, which I suspect may be due to poor posture.
When I change positions, it feels compressed and uncomfortable, but this sensation subsides after a while.
I did not have this issue before the accident, but it has occurred about 4 to 5 times since then.
3.
Since September 21, I have experienced weakness below my left scapula during exertion, particularly noticeable in my biceps.
Could this be a strain, or is there a possibility of other injuries? Or could it be that the electrical therapy during rehabilitation is too intense, causing this condition?

Yujie, 20~29 year old female. Ask Date: 2018/10/23

Dr. Li Yongheng reply Orthopedics

1.
Lower back pain and lower limb weakness, with ultrasound showing a hematoma, symptoms have persisted for 4 months.
It is recommended to arrange an MRI at the orthopedic outpatient clinic.

2.
If the cervical spine X-ray shows no abnormalities, further observation is advised.

3.
Left shoulder pain and weakness may be related to an unresolved rotator cuff tear in the right shoulder.
It is recommended to arrange an MRI at the orthopedic outpatient clinic.

Reply Date: 2018/10/23

More Info

After a car accident, managing lumbar and cervical spine issues can be quite complex, especially when symptoms persist despite initial evaluations and treatments. Your situation involves multiple injuries, including a pelvic contusion, rotator cuff tear, wrist dislocation, and ligament damage, which can all contribute to ongoing discomfort and functional limitations.

1. Persistent Lumbar Pain: You mentioned experiencing pain in your lumbar region that has not resolved after four months. The presence of a hematoma, as noted in your rehabilitation assessment, can indeed lead to prolonged discomfort. Hematomas can take time to resolve, and if they are pressing on surrounding structures, they may cause pain or discomfort. It is essential to monitor this closely. If the pain persists or worsens, further imaging studies, such as an MRI, may be warranted to assess for any underlying issues that may not have been visible on X-rays, such as soft tissue injuries or nerve compression.

2. Cervical Discomfort: The discomfort you feel in the cervical spine, particularly in the first cervical vertebra, could be related to postural changes or muscle strain following your accident. Poor posture, especially if you are compensating for pain in other areas, can lead to muscle fatigue and discomfort. It is not uncommon for individuals recovering from significant injuries to develop secondary issues due to altered movement patterns. If this discomfort continues, it may be beneficial to consult with a physical therapist who specializes in post-injury rehabilitation. They can provide targeted exercises to improve your posture and strengthen the supporting muscles of your neck and back.

3. Shoulder Weakness: The weakness you are experiencing in your left shoulder, particularly under load, could be attributed to several factors. It may be a result of the rotator cuff injury you sustained during the accident, or it could be related to nerve involvement, especially if there is any compression or irritation in the cervical spine. Additionally, if you have been undergoing physical therapy, it is possible that the intensity of the treatments could lead to temporary muscle fatigue or strain. It is crucial to communicate any new or worsening symptoms to your healthcare provider, as they may need to adjust your rehabilitation program or investigate further.

4. Need for Further Evaluation: Given the complexity of your injuries and the persistence of your symptoms, it may be advisable to seek a second opinion or further evaluation at a specialized facility. A multidisciplinary approach involving orthopedic specialists, neurologists, and physical therapists can provide a comprehensive assessment of your condition and help tailor a treatment plan that addresses all aspects of your recovery.

In summary, while some discomfort may be expected following significant injuries, persistent pain and functional limitations warrant further investigation and possibly a more aggressive treatment approach. It is essential to advocate for your health and ensure that you receive the appropriate care to facilitate your recovery. Regular follow-ups with your healthcare providers, open communication about your symptoms, and adherence to a structured rehabilitation program will be key to managing your post-accident issues effectively.

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