Acute Lower Back Pain After a Slip and Fall Incident

After slipping on February 28th, I felt a tearing sensation on the right side of my lower back when getting up from a lying position, similar to the feeling of twisting my back forcefully?

Hello Doctor: On February 28th, I accidentally slipped in the bathroom due to stepping on water and landed on my buttocks.
At that moment, I conducted a basic check and found no issues with my limbs, but I was concerned about a possible lumbar spine injury, so I crawled back to my room to get into bed.
Initially, I felt that my spine might have hit some objects in the bathroom and was slightly swollen.
After a few days of rest, the swelling subsided, and I had no issues lying flat.
However, for the first three days, I experienced slight discomfort when lying on my side.
My sleep and appetite were also affected.
Currently, when I lie on my side and try to sit up slowly or stand up from a seated position, I feel a cramping sensation in my right lower back (around the area just above my buttocks), similar to an acute lumbar strain.
I also find it difficult to bend backward or lie flat without arching my back.
When I try to shift my position while sitting, it causes discomfort in that area.
While walking, I only feel discomfort when I twist my torso.
When standing, I need to tilt my pelvis slightly forward to avoid discomfort.
While sitting, I feel as if I cannot exert force in my lumbar region.
I need to support myself with something when standing up, but I still experience the aforementioned discomfort in my right lower back.
I have had pre-existing discomfort in my right lower back due to poor posture from long hours of work, which usually eases after resting until the next day.
I have not sought medical attention yet because it is difficult to access healthcare in my area, so I would like to inquire if there are any possibilities for conservative treatment to facilitate self-recovery.
Thank you.

chq, 30~39 year old female. Ask Date: 2022/03/09

Dr. Wang Shouji reply Orthopedics

Hello, if resting alleviates the symptoms, there should be no major issues with the bones.
However, if the muscle injury is more severe, similar symptoms may occur.
It is recommended to start with rehabilitation and medication to relieve the symptoms.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2022/03/09

More Info

Acute lower back pain following a slip and fall incident, such as the one you described, is a common occurrence and can be attributed to various factors. Based on your account, it seems that you experienced a fall that resulted in immediate discomfort and subsequent symptoms that suggest a possible strain or injury to the lumbar region of your spine.

Understanding Your Symptoms
1. Initial Impact and Symptoms: When you fell and landed on your buttocks, the impact could have caused a strain in the muscles or ligaments surrounding your lumbar spine. The fact that you felt some swelling and discomfort initially is indicative of soft tissue injury, which is common in falls.

2. Pain Characteristics: The description of your pain as a "spasm" or "acute strain" sensation, particularly when transitioning from lying down to sitting or standing, suggests that there may be muscle spasms or irritation in the lumbar region. This is often seen in cases of acute lumbar strain, where the muscles and ligaments are overstretched or torn.

3. Movement Limitations: Your inability to bend backward or arch your back, as well as the discomfort when sitting or moving, further supports the idea of a muscular or ligamentous injury. The fact that you need to lean on something for support when standing indicates that your core muscles may not be functioning optimally due to pain or weakness.

Potential Causes
- Muscle Strain: This is the most likely cause of your symptoms. Muscle strains can occur when the muscles are stretched beyond their limits, leading to micro-tears and inflammation.

- Ligament Sprain: Similar to muscle strains, ligament sprains can occur from sudden movements or impacts, leading to pain and instability in the affected area.

- Disc Injury: While less likely given your description, it is also possible that the fall could have aggravated a pre-existing condition, such as a herniated disc, especially if you had prior issues with your back.

Conservative Treatment Options
Given that you are currently unable to seek medical attention, here are some conservative treatment strategies you can consider:
1. Rest: Allow your body time to heal. Avoid activities that exacerbate your pain, particularly heavy lifting or twisting motions.

2. Ice and Heat Therapy: Applying ice to the affected area for the first 48 hours can help reduce swelling and numb the pain. After that, heat therapy can be beneficial to relax tight muscles and improve blood flow.

3. Gentle Stretching and Strengthening: Once the acute pain subsides, gentle stretching exercises can help restore flexibility. Strengthening exercises for your core and back muscles can provide better support to your spine.

4. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help reduce pain and inflammation.

5. Posture Awareness: Pay attention to your posture while sitting and standing. Using supportive chairs and maintaining a neutral spine position can help alleviate discomfort.

6. Gradual Return to Activity: As your symptoms improve, gradually reintroduce normal activities. Listen to your body and avoid pushing through pain.

When to Seek Medical Attention
While many cases of acute lower back pain resolve with conservative treatment, you should seek medical attention if:
- Your symptoms worsen or do not improve after a few days.

- You experience numbness or tingling in your legs.

- You have difficulty controlling your bladder or bowels.

- You develop severe pain that does not respond to over-the-counter medications.

In conclusion, while it is possible to manage your symptoms conservatively, it is essential to monitor your condition closely. If your pain persists or worsens, seeking professional medical evaluation will be crucial to rule out any serious underlying issues. Take care, and I hope you find relief soon!

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