Do you wince every time you twist or bend? Do you get a sharp pain in your back that keeps you off work? Back pain is rather common and because it is so common, you might neglect it or resort to painkillers for immediate relief.
But if it’s an injury and you neglect it now, it will become a source of chronic pain over a period of time and affect your daily activities. Also, when we say injury, we don’t necessarily restrict it to a fall, a sports injury, or a vehicle accident. Many back injuries are actually caused by incorrect lifting and material handling, as seen in a 15-month analysis analysis of 900 injuries in a company of 3,958 employees.1
So to find out which injuries are really serious and need immediate attention, read on.
Spinal Cord Injury
If a motor accident or a violent fall causes severe pain or pressure in your neck, back, or head; weakness; numbness; or even a loss of ability to move or feel a part of the body (paralysis), it is possibly an indication that your spinal cord has sustained an injury and that you need to visit the doctor right away. It could end up confining you to a wheelchair.
The injury could be to any or several of your vertebrae or to the spinal cord itself, the bundle of nerves in this long tube-like structure, which carries response signals throughout the body. It could lead to additional damage over days or weeks in and around the spinal cord through bleeding, swelling, inflammation, and/or fluid accumulation. When the injury affects the spinal cord, it gives rise to a condition known as myelopathy, which can affect your motor function.
Because spinal cord injury (SCI) disrupts nerve signals, day-to-day activities like walking or even sleeping become difficult. About 60 percent SCI patients report chronic pain long after the injury happened, and of these, 25–30 percent report back pain. Most patients characterize the pain as burning, aching, stabbing, and sharp and claim that it interferes with their daily activities and sleep.
Apart from chronic pain, SCI could also be a “complete injury” that results in the paralysis of the area below the level of injury. But patients have complained of pain, which is caused by false signals the injured nerves send to the brain. This type is called neuropathic pain, and it can only be managed, not cured.2
Spinal fractures result mostly from great force to the spine, such as a fall from a height, sports accidents, or any violent accident. The most vulnerable location is the junction between the middle and the lower back or the thoracolumbar junction. These fractures range from severe and painful compression fractures called burst fractures to fracture dislocations where both bone fracture and dislocation take place simultaneously.
Spinal fractures may even be caused by osteoporosis, in which case they are called compression fractures. Compression fractures make either the front part of the vertebra or both the front and the back collapse. In a mild compression, you will face minimal deformity. However, if the compression is severe, you will face severe pain, and it could result in kyphosis or a hunchback-causing deformity. In fracture dislocation, however, the vertebra shifts from its position and frequently causes spinal cord compression.
If you have a spinal fracture, in most cases, you will be confined to a plaster bed for 8–12 weeks and then given a back brace or a corset to keep your fractured bone from moving at all.3 In very severe cases, surgery is recommended.
Severe Back Injuries
Spondylolysis is a stress fracture, or a crack in one of the bones or vertebrae in the spinal column, caused mainly during sports activities, especially when the activity is increased suddenly. It mostly affects the fifth lumbar vertebra and, sometimes, even the fourth lumbar vertebra. It might not be very painful, but it can often lead to a more severe condition, known as spondylolisthesis.
Spondylolisthesis occurs when a vertebra, especially the fifth lumbar vertebra, slips forward and stays out of place causing spinal dysfunction and pinching a nearby nerve root, a condition known as radiculopathy, which causes all the pain. It could be either degenerative (age-related wear and tear), isthmic (spondylolysis-induced), or congenital (present since birth).
The incidence of nerve compression is found to be highest in degenerative spondylolisthesis, and severe degrees of slip are found in congenital spondylolisthesis.4 Spondylolisthesis often results in severe pain in the lower back, especially while standing, walking, and bending backward and can be accompanied by leg pain and cramping.
Early treatment can cure this condition, but if you neglect it now, there can be several complications. A couple of days of bed rest, followed by some restrictions in activities, and physiotherapy will help. Studies have found herbal medicines to be effective, too.5
Slipped disc, also called herniated disc, is a common cause of lower back pain. The discs of the spine act as shock absorbers for the spine and keep it flexible. But, when it is damaged or injured, the disc herniates, i.e., it bulges and breaks open. The herniated disc is often the result of wear and tear of the disc, mostly due to the natural aging of the spine, which depletes its water content, making it more susceptible to injuries. Various other reasons could lead to the injury—from improper lifting and physical work to obesity and smoking.
Herniated discs that press on nearby nerve roots, a condition known as radiculopathy, cause pain in the legs and buttocks.
It is also observed that people whose job requires driving motor vehicles are at the most risk of acute lumbar herniated disc than those who do not need to drive.6 The common symptom of herniated disc is sciatica—a pain that extends from your lower back to the leg.
Treatment would require you to pause your daily activities such as lifting and bending, take bed rest at regular intervals, take anti-inflammatory medicines, and undergo physiotherapy. In a few cases, surgery is recommended.
Radiculopathy arising from both spondylolisthesis and herniated discs, which occur mostly in the lumbar region where the spinal cord is not present, is not as severe as a spinal cord injury and does not affect motor function entirely.
Soft Tissue Injuries
Strains And Sprains
An awkward fall, a sports injury, lifting heavy weight, or overuse of the muscles without proper rest are reasons for a back sprain or strain. As these involve stretching or twisting the ligaments and muscles in the lower back or the lumbar region beyond the normal limit, they either tear the ligament, causing a sprain, or injure the muscle or tendon, causing strain. The subsequent swelling causes stiffness, pain, and tenderness and restricts some movements in that area. It might even be difficult for you to maintain healthy postures once you have been affected by lower back sprain and strain. While these are not often severe, some cases might need surgery.
In case of an injury, it is best to avoid painkillers because of their adverse side effects. Ice packs are a good alternative, but ensure that the ice does not come in direct contact with the skin. A turmeric poultice made by mixing turmeric with lemon juice and a little water and boiled into a paste can also be applied to the affected area to reduce the inflammation. After the injury has healed, yoga can be used as a part of rehabilitation therapy, even for people with SCI.7 See the alternative treatments available here. Seek medical advice if the pain persists or seems to get worse.
Adopt correct posture while sitting, standing, and lifting heavy weights. If your work involves repeated lifting or bending, find out about proper lifting techniques and use them. It is also important to know and work within your body’s limitations. Lifestyle changes like eating nutritious food, performing regular exercise, back stretches, and yoga to strengthen the back, and staying away from habits like smoking will also go a long way in ensuring a healthy and injury-free back.
|↑1||Bigos, Stanley J., Dan M. Spengler, Nancy A. Martin, Judith Zeh, Lloyd Fisher, Alf Nachemson, and M. H. Wang. “Back Injuries in Industry: A Retrospective Study: II. Injury Factors.” Spine 11, no. 3 (1986): 246-251|
|↑2||Cruz-Almeida, Yenisel, and Eva G. Widerström-Noga. “Chronic pain after spinal cord injury: what characteristics make some pains more disturbing than others?.” Journal of rehabilitation research and development 44, no. 5 (2007): 703.|
|↑3||Holdsworth, Frank. “Review article fractures, dislocations, and fracture-dislocations of the spine.” J bone joint surg Am 52, no. 8 (1970): 1534-1551.|
|↑4||Newman, P. H., and K. H. Stone. “The aetiology of spondylolisthesis.” Bone & Joint Journal 45, no. 1 (1963): 39-59.|
|↑5||Tsuji, Kazuyuki, Hideki Koizumi, and Tetsuro Okabe. “Successful treatment of spondylolisthesis with medicinal herbs.” Geriatrics & gerontology international 8, no. 2 (2008): 126-129.|
|↑6||Kelsey, Jennifer L., and Robert J. Hardy. “Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc.” American Journal of Epidemiology 102, no. 1 (1975): 63-73.|
|↑7||Zwick, Dalia. “Integrating Iyengar yoga into rehab for spinal cord injury.” Nursing2015 36 (2006): 18-22.|