Can a car accident lead to sciatica?
Dear Vice Dean,
My mother is 57 years old and was previously in good health, never mentioning any back pain.
However, after a car accident in February of this year, she began experiencing pain in her lower back and back.
The consulting physician diagnosed her with sciatica.
Despite several consultations, there was no improvement.
My mother then sought a referral to a rehabilitation department at a hospital in Beitou based on recommendations.
However, the doctor started rehabilitation treatment without first taking X-rays.
After several consultations, my mother began to experience severe tearing pain in her back, making it impossible for her to stand, and she developed weakness in her legs along with urinary and fecal incontinence, requiring the use of a wheelchair.
It was only during the last consultation that the doctor took X-rays and indicated that there was a fracture in the bone, stating that the hospital could not manage her case and recommended transferring her to another facility.
Following family advice, she was transferred to a public teaching hospital, where X-rays revealed suspected compression fractures at the tenth and eleventh thoracic vertebrae, along with signs of infection and necrosis, necessitating immediate surgical intervention.
I would like to ask the Vice Dean, what is sciatica? Is it possible for a car accident to lead to sciatica? Furthermore, how can one identify a fracture in the bone from an X-ray?
A Yi, 30~39 year old female. Ask Date: 2004/12/27
Dr. Shi Qiming reply Orthopedics
Hello, Ayi: First, let me answer your first question.
What is sciatica? The sciatic nerve is a nerve that branches from the lumbar and sacral spine and runs along the back of the thigh.
This nerve is responsible for the sensory and motor functions of the lower limbs.
Therefore, if there is compressive injury, it can result in symptoms such as pain, weakness, and numbness.
If a car accident leads to lower back pain, weakness in both legs, and incontinence, one should suspect vertebral fractures with nerve compression, which requires prompt treatment.
Regarding your mention of suspected compression fractures at the tenth and eleventh vertebrae with signs of infection and necrosis, if infection is confirmed and there are symptoms of neurological deficits, early intervention is also necessary.
Both situations are indications for surgery; however, due to the complexity of your mother's condition, a definitive diagnosis cannot be made here.
It is advisable to go to a well-equipped hospital to confirm the diagnosis and clarify the condition for timely and appropriate treatment.
Hsinchu Hospital, Department of Orthopedics, Ministry of Health and Welfare.
Reply Date: 2004/12/27
More Info
Sciatica, commonly referred to as sciatic nerve pain, is a condition characterized by pain that radiates along the path of the sciatic nerve, which extends from the lower back through the hips and buttocks and down each leg. This condition often occurs when the sciatic nerve is compressed, typically due to a herniated disk, bone spur, or narrowing of the spine (spinal stenosis). Symptoms can include pain, numbness, tingling, or weakness in the affected leg.
In the context of your mother’s situation, it is indeed possible for a car accident to trigger sciatica. The trauma from the accident can lead to injuries such as herniated discs or spinal misalignments, which may compress the sciatic nerve. In your mother’s case, the initial back pain following the accident could have been a sign of such an injury. Unfortunately, the delay in obtaining proper imaging (like X-rays) and the subsequent mismanagement of her condition may have exacerbated her symptoms, leading to more severe complications such as the suspected compression fracture and infection.
Regarding the identification of bone fractures on X-rays, a radiologist or physician looks for specific signs. A fracture may appear as a discontinuity in the bone cortex, which is the outer layer of the bone. In cases of compression fractures, the vertebra may appear flattened or wedged, and there may be associated changes in the surrounding soft tissues. Additionally, signs of infection, such as changes in the bone density or the presence of fluid collections, can also be assessed through imaging.
It is crucial for individuals experiencing back pain, especially after trauma, to receive timely and appropriate diagnostic imaging. X-rays are often the first step, but in some cases, further imaging such as MRI or CT scans may be necessary to provide a more comprehensive view of the spine and surrounding structures.
In summary, sciatica can indeed be triggered by car accidents due to the potential for spinal injuries. It is essential to seek immediate medical attention and appropriate imaging following any significant trauma to the back to prevent complications and ensure proper treatment. If your mother is experiencing severe symptoms such as weakness, incontinence, or inability to stand, it is critical to follow up with a specialist who can provide the necessary surgical intervention and rehabilitation.
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