Lumbar Spine Injuries: When to Seek Medical Advice

Lumbar spine injury?

Hello Dr.
Wang, about two years ago while I was doing laundry, I squatted under the showerhead and when I stood up, my lumbar spine hit the water pipe where the shower switch is located.
At that time, I had a significant bruise.
After it healed, I noticed that the area of my spine feels slightly indented when I touch it.
At night, when I stretch my lower back, I hear a popping sound in that area, but I don't hear it at other times and I don't have any particular discomfort.
Should I see a doctor about this popping sound? What could be the potential issues? Would seeing a physical therapist for adjustments be helpful? Thank you for taking the time to respond, Doctor.

Niming, 30~39 year old female. Ask Date: 2021/05/08

Dr. Wang Shouji reply Orthopedics

Hello, it is advisable to first assess the condition of the illness before proceeding with the next steps in treatment.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/05/08

More Info

When it comes to lumbar spine injuries, understanding when to seek medical advice is crucial for ensuring proper recovery and preventing further complications. Based on your description, it seems you experienced a significant impact to your lumbar region two years ago, which resulted in bruising and some changes in the area. Now, you are noticing a slight indentation in the spine and a "cracking" sound when you stretch, particularly at night. While you are not experiencing significant discomfort, these symptoms warrant careful consideration.

Firstly, the "cracking" sound you hear when you stretch your back is often referred to as crepitus. This sound can occur due to several reasons, including the movement of tendons or ligaments over bony structures, the release of gas bubbles in the joint fluid, or even changes in the joint surfaces themselves. In many cases, if there is no pain associated with these sounds, they are not a cause for concern. However, given your history of trauma, it is essential to monitor any changes in symptoms closely.

The indentation you mentioned could indicate a change in the structure of your spine, potentially due to previous trauma. While it might not be causing you pain now, it is essential to consider that structural changes can sometimes lead to complications later on, such as instability or increased risk of injury. Therefore, it is advisable to consult with a healthcare professional, particularly a spine specialist or an orthopedic doctor, to assess the situation more thoroughly. They may recommend imaging studies, such as X-rays or an MRI, to evaluate the integrity of the spine and rule out any underlying issues.

Regarding physical therapy, it can be beneficial for many spinal conditions. A physical therapist can help you strengthen the muscles around your spine, improve flexibility, and teach you proper body mechanics to reduce the risk of future injuries. They can also provide specific exercises tailored to your needs, which may alleviate any discomfort you might experience during certain movements. However, it is crucial to have a thorough assessment before starting any physical therapy to ensure that the exercises are appropriate for your condition.

In summary, while your current symptoms may not seem alarming, the history of trauma and the changes you are observing in your spine suggest that a medical evaluation is warranted. Consulting with a spine specialist can provide you with a clearer understanding of your condition and help you determine the best course of action, whether that involves imaging studies, physical therapy, or other interventions. Taking proactive steps now can help prevent potential complications in the future and ensure that you maintain optimal spinal health.

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