Can Spinal Injury from a Fall Cause Sciatica Symptoms?

Can hitting your spine on a table potentially cause sciatica?

Hello Doctor: My girlfriend accidentally slipped and hit her spine on the right side (approximately at the level of the navel) while out for a walk.
Pressing on that area causes a sensation like electric shock in her thigh and weakness in the injured area.
After the injury, she had an X-ray, and an orthopedic doctor confirmed that there were no bone injuries.
However, she still feels an electric sensation and weakness in the right thigh muscles when walking (she has been taking anti-inflammatory medication and muscle relaxants for a week with no improvement).
Currently, she has difficulty applying force with her right leg, and prolonged sitting causes pain.
Later, she found a chiropractor who discovered that she has a leg length discrepancy.
After adjusting her leg lengths back to normal, she is undergoing continuous massage therapy (the massage is focused on the right thigh and hip area).
There is significant improvement the day after the massage, but after a day or two, the original pain returns.
I would like to ask the doctor: 1.
Could hitting the spine potentially cause sciatica? 2.
Is an MRI necessary in this situation (I am a bit concerned about the possibility of a blood clot compressing the nerve, similar to the issue faced by the artist Zhang Shanwei)? 3.
Does treating sciatica also involve manipulating the nerves around the hip to alleviate the pain? Thank you.

Mr. Chen, 20~29 year old female. Ask Date: 2016/01/17

Dr. Shi Guozheng reply Orthopedics

Currently, there are symptoms of sciatica, but they are mild.
If you can still dorsiflex your foot, then an MRI is not necessary.
While chiropractic treatment may not be effective, muscle soreness can benefit from massage therapy.

Reply Date: 2016/01/17

More Info

Spinal injuries, particularly those affecting the lumbar region, can indeed lead to symptoms resembling sciatica. Sciatica is 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. When a spinal injury occurs, it can lead to inflammation, nerve compression, or irritation, which may manifest as pain, tingling, or weakness in the lower extremities.

1. Can spinal injury from a fall cause sciatica symptoms?
Yes, a spinal injury can cause sciatica-like symptoms. When the spine is impacted, it can lead to conditions such as herniated discs, spinal stenosis, or muscle spasms that may compress the sciatic nerve. In your girlfriend's case, the fall and subsequent symptoms of electric shock sensations and weakness in the thigh suggest that there may be some nerve involvement. The fact that pressing on the affected area elicits these sensations indicates that the injury may have affected the surrounding nerves or soft tissues.

2. Does this situation require an MRI?
Given the persistence of symptoms despite conservative treatment with anti-inflammatory medications and muscle relaxants, an MRI may be warranted. An MRI provides detailed images of the soft tissues, including nerves, discs, and muscles, and can help identify any potential issues such as herniated discs, nerve compression, or other abnormalities that may not be visible on X-rays. Your concern about a blood clot compressing a nerve is valid, as such conditions can lead to serious complications. An MRI can help rule out these possibilities and guide further treatment.

3. Is treating sciatica through hip manipulation effective?
Treatment for sciatica often includes physical therapy, which may involve manipulation or mobilization of the hip and lumbar spine. The goal is to relieve pressure on the sciatic nerve and improve mobility. If your girlfriend experiences relief after manipulation, it suggests that her symptoms may be related to musculoskeletal issues rather than purely nerve damage. However, the transient nature of the relief indicates that the underlying issue may still need to be addressed. Continued physical therapy, targeted exercises, and possibly a more comprehensive treatment plan may be necessary to achieve lasting results.

In addition to these points, it’s essential to consider other factors that may contribute to her symptoms. For instance, postural issues, muscle imbalances, or even psychological factors such as stress can exacerbate pain and discomfort. A multidisciplinary approach involving orthopedic specialists, physical therapists, and possibly pain management specialists may provide a more comprehensive treatment strategy.

In summary, spinal injuries can lead to sciatica-like symptoms, and further imaging such as an MRI may be necessary to assess the extent of the injury. Treatment may include physical therapy and manipulation, but it’s crucial to address any underlying issues to achieve long-term relief. If symptoms persist or worsen, seeking further evaluation and treatment is advisable.

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