Sacral Injuries: Could It Be a Pelvic Fracture?

Pelvic fracture

Last week, I accidentally fell down the stairs at school and slid down step by step.
It was very painful at the time, and later that evening, my dad took me to see a doctor.
However, the clinic was unable to perform X-rays at that time, so the doctor only asked about the general location of the pain and whether there was a fracture.
The doctor said I had a sacral injury and prescribed pain medication, which I took.
I felt some improvement at home, but while walking got better, sitting at certain angles still causes a lot of pain.
Is it possible that I have a pelvic fracture? (My dad initially thought so, but the doctor said it was a sacral injury.)

jenny, 10~19 year old female. Ask Date: 2023/01/18

Dr. You Dianqi reply Orthopedics

Hello! When a sacral fracture occurs, there may not be obvious changes, making it difficult to identify on X-ray images.
If you continue to experience numbness and pain in the lower body, please return for a follow-up appointment as soon as possible.
Thank you!

Reply Date: 2023/01/18

More Info

Based on your description, it sounds like you may have sustained a sacral injury from your fall down the stairs. The sacrum is a triangular bone at the base of the spine, and injuries to this area can indeed be quite painful and may sometimes be associated with pelvic fractures. While your doctor has indicated that you have a sacral injury, it is essential to understand the potential implications and the need for further evaluation.

Understanding Sacral Injuries
Sacral injuries can range from minor bruising to more severe fractures. The sacrum is part of the pelvis, and injuries in this area can affect your ability to sit, stand, or walk comfortably. Symptoms of a sacral injury often include localized pain, especially when sitting or moving in certain ways, tenderness in the area, and sometimes swelling or bruising.

Could It Be a Pelvic Fracture?
While your doctor has diagnosed you with a sacral injury, it is crucial to consider the possibility of a pelvic fracture. Pelvic fractures can occur due to significant trauma, such as falls, and can involve various parts of the pelvis, including the sacrum, pubic symphysis, and iliac bones. If there is significant pain, especially when sitting or moving, it could indicate a more severe injury that might not have been fully assessed without imaging studies like X-rays or CT scans.

Importance of Imaging Studies
Imaging studies are vital in diagnosing the extent of your injury. X-rays can help identify fractures, while CT scans provide a more detailed view of the pelvic structure. If you continue to experience pain, especially if it worsens or if you have difficulty with mobility, it is advisable to seek further evaluation.

Pain Management
In terms of pain management, you mentioned that you were prescribed pain medication, which has helped to some extent. Over-the-counter options such as ibuprofen or naproxen can also be effective for managing pain and inflammation. However, if your pain persists or worsens, you should consult your healthcare provider for a reassessment and possibly a different pain management strategy.

Recommendations
1. Rest and Avoid Aggravating Activities: It is essential to rest and avoid activities that exacerbate your pain, such as sitting for extended periods or lifting heavy objects.

2. Follow-Up with a Healthcare Provider: If your pain does not improve or if you have concerns about the diagnosis, consider following up with a healthcare provider who can perform the necessary imaging studies.

3. Physical Therapy: Once the acute pain subsides, physical therapy may be beneficial to strengthen the muscles around the pelvis and improve mobility.

4. Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, swelling, or difficulty with mobility, and report these to your healthcare provider.

In conclusion, while your doctor has indicated a sacral injury, the possibility of a pelvic fracture should not be overlooked, especially if your symptoms persist. Proper imaging and follow-up care are essential to ensure a complete and accurate diagnosis, which will guide your treatment plan and recovery.

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