Lumbar Disc Herniation: Causes and Symptoms After a Fall

Medical inquiry, please respond, thank you (forwarded from the Director's mailbox)?

Dear Director Jun-Jian,
I hope this message finds you well.
I have several medical questions that I would appreciate your insights on.

1.
What are the causes of lumbar disc herniation accompanied by contusion?
2.
Can a slip and fall incident immediately cause lumbar disc herniation and contusion, or do the symptoms of lumbar disc herniation and contusion typically appear the following day?
Wishing you good health and all the best.
Sincerely,
Han

Han Chengzhou, 30~39 year old female. Ask Date: 2004/08/02

Dr. Wang Zikang reply Orthopedics

Dear Mr.
Han,
Intervertebral disc protrusion generally occurs in younger populations, primarily due to improper use, excessive weight-bearing, overly intense exercise, prolonged poor posture, and congenital disc injuries.
Therefore, contusions and disc protrusions often occur simultaneously.
The time interval between sustaining a contusion and developing a disc protrusion can vary; it may happen immediately or take several months to manifest.
Thus, good protection and avoidance of improper activities and excessive strenuous movements can help prevent such injuries.
Sincerely,
Dr.
Wang Tzu-Kang
Director of Orthopedics, Hsinchu Hospital, Department of Health, Executive Yuan

Reply Date: 2004/08/02

More Info

Dear Han,
Thank you for your inquiry regarding lumbar disc herniation and its potential causes and symptoms following a fall. I appreciate your detailed questions, and I will address each of them comprehensively.

1. Causes of Lumbar Disc Herniation and Contusion: Lumbar disc herniation occurs when the soft inner gel-like core of the disc (nucleus pulposus) protrudes through the tougher outer layer (annulus fibrosus). This can happen due to several factors, including:
- Degenerative Changes: Over time, the discs can lose hydration and elasticity, making them more susceptible to herniation. This is often seen in older adults.

- Acute Injury: A sudden injury, such as a fall or lifting a heavy object improperly, can cause a disc to herniate. The force exerted on the spine during such activities can exceed the disc's capacity to withstand stress.

- Repetitive Strain: Repeated activities that put stress on the lumbar spine can lead to gradual wear and tear, eventually resulting in herniation.

- Genetic Predisposition: Some individuals may have a genetic tendency toward disc degeneration or herniation.

- Obesity: Excess body weight can put additional stress on the lumbar spine, increasing the risk of herniation.

2. Immediate vs. Delayed Symptoms After a Fall: When it comes to the timing of symptoms following a fall, it can vary significantly from person to person. In some cases, individuals may experience immediate symptoms, such as pain or discomfort in the lower back, radiating pain down the legs, or numbness and tingling. This can occur if the fall causes an immediate injury to the disc or surrounding structures.

However, it is also common for symptoms to develop gradually. In some instances, individuals may not feel significant pain or discomfort until the following day or even later. This delayed onset can be attributed to several factors:
- Inflammation: After an injury, inflammation can develop over time, leading to increased pain and discomfort as the body responds to the injury.

- Muscle Spasms: Following a fall, the muscles surrounding the spine may go into spasm as a protective mechanism, which can lead to delayed pain.

- Nerve Irritation: If a herniated disc compresses a nerve root, the symptoms may not manifest immediately but can develop as the inflammation and pressure on the nerve increase.

In conclusion, lumbar disc herniation can arise from various causes, including acute injuries like falls, degenerative changes, and repetitive strain. Symptoms can appear immediately or may be delayed, depending on the nature of the injury and the individual's response to it. If you suspect you have sustained a lumbar disc injury, it is crucial to seek medical evaluation. Imaging studies, such as MRI, can help confirm the diagnosis and guide appropriate treatment options.

I hope this information helps clarify your questions regarding lumbar disc herniation. Please feel free to reach out if you have any further inquiries or need additional assistance.

Wishing you good health and well-being.

Best regards,
Doctor Q&A Teams

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