Seeking Guidance on Spine Pain and Related Injuries After an Accident

Please provide information regarding spinal pain?

Hello Dr.
Chu,
My mother is around 40 to 50 years old and has been suffering from diabetes for over a decade.
She also has sciatica.
She has been receiving treatment at Taoyuan Provincial Hospital for her diabetes.
A few days ago, she was involved in a motorcycle accident where she was hit by a car, resulting in abrasions below her left knee and on her left elbow.
She had an X-ray at St.
Paul’s Hospital in Taoyuan, which showed no fractures.
The doctor prescribed anti-inflammatory and pain relief medication for two to three days and advised her to observe her condition for a week before returning for a follow-up.
Subsequently, she has been experiencing pain and difficulty breathing in her left lung, as well as pain in her coccyx when lying flat.
She cannot sleep on her back and must sleep on her side.
She requires assistance to get up from bed, sit in a chair, and stand.
It seems she has weakness in her coccyx area, which is painful, and she struggles with stairs.

Due to her discomfort, it has been challenging for her to travel to various hospitals for consultations, so I would like to clarify a few things before taking her to see a doctor.
Which department should I schedule an appointment with? Should it be orthopedics? Would an MRI be necessary? Are there MRI machines that are less enclosed? My mother mentioned that she had a previous MRI at Taoyuan Provincial Hospital, which was very enclosed, and she had difficulty breathing and could not move.

Now, with her coccyx pain, she cannot lie flat for an extended period for the examination.
She also mentioned that at St.
Paul’s Hospital, there was a less enclosed MRI machine.
Are the functions of both machines the same? Is it possible to perform the examination without lying flat, perhaps in a standing position?
I would appreciate any advice on which department to visit and what specific examinations to consider.
What symptoms should we monitor to rule out other potential issues? Since the accident on October 15th, today being the 20th, it has been about five days.
She has not experienced nausea, vomiting, or dizziness.
Her bowel movements have been somewhat irregular today, and she continues to have significant pain in her coccyx and discomfort in her left chest when breathing.

Thank you for your guidance.

Li Shifa, 20~29 year old female. Ask Date: 2005/10/20

Dr. Chu Baijun reply Orthopedics

Hello, I apologize for the delay in my response, but I would like to share some of my thoughts.
Generally, severe internal organ injuries are rarely unnoticed by patients while they are conscious; typically, there is immediate pain and discomfort following the injury.
The delayed onset of pain in the left lung and pain in the coccyx while lying down certainly warrants further examination, and I recommend visiting an orthopedic clinic.
As for which imaging studies are necessary, that decision should be made by the physician, as advanced imaging does not necessarily provide answers to all questions for both the physician and the patient.
Sincerely, Dr.
Chubao County.

Reply Date: 2005/10/20

More Info

I'm sorry to hear about your mother's situation following her accident. Given the complexity of her symptoms and her medical history, it's crucial to approach this carefully. Here’s a comprehensive response to your questions and concerns.

Seeking Medical Guidance
1. Specialist Consultation: Given your mother's symptoms, it would be advisable to consult with an orthopedic specialist. They can evaluate her spine and any potential injuries related to her tailbone (coccyx) and other areas affected by the accident. If her pain is severe and involves nerve-related issues, a neurologist may also be beneficial.
2. Imaging Studies: Considering her ongoing pain and difficulty with mobility, an MRI (Magnetic Resonance Imaging) could provide detailed images of her spine and surrounding soft tissues. This imaging can help identify any soft tissue injuries, disc herniations, or nerve compressions that may not be visible on X-rays.
3. MRI Equipment: Regarding your concerns about the MRI machine, there are indeed open MRI machines that are less confining than traditional closed MRI machines. These open machines can be more comfortable for patients who experience anxiety or claustrophobia. However, the imaging quality may vary, and not all facilities have them. It's best to inquire directly with the imaging center about the type of MRI machines they use and whether they have options that are less enclosed.

4. Positioning During MRI: Unfortunately, MRIs typically require the patient to lie down for the duration of the scan. There are no standard protocols for performing an MRI while standing. If lying flat is too painful for your mother, discuss this with the medical staff at the imaging center; they may have alternative solutions or suggestions to make the process more comfortable.

Symptoms to Monitor
Given your mother's recent accident and her existing health conditions, it’s essential to monitor for any worsening symptoms, including:
- Increased pain: If her pain escalates significantly or becomes unmanageable.

- Neurological symptoms: Such as numbness, tingling, or weakness in her legs, which could indicate nerve involvement.

- Respiratory issues: If her breathing difficulties worsen or if she experiences chest pain that intensifies.

- Changes in bowel or bladder function: Any new or worsening issues with bowel or bladder control should be addressed immediately, as they can indicate serious complications.

Follow-Up Care
After the initial evaluation and imaging, your mother's healthcare provider may recommend a treatment plan that could include:
- Physical Therapy: To help strengthen the muscles around her spine and improve mobility.

- Pain Management: This may involve medications, including anti-inflammatories or muscle relaxants, to help alleviate her discomfort.

- Activity Modification: Encouraging her to avoid activities that exacerbate her pain while gradually increasing her mobility as tolerated.

Conclusion
In summary, your mother should see an orthopedic specialist for her spine pain and related injuries. An MRI may be necessary to assess her condition further, and it's important to monitor her symptoms closely. Open MRI options are available, and discussing her comfort with the medical staff can help facilitate a smoother experience. Always prioritize her safety and comfort, and don't hesitate to seek immediate medical attention if her symptoms worsen.

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