Feb 10, 2015

It is common to experience back and neck pain after a fall or an accident. Although it can take a few days to manifest, in most cases the pain resolves itself in several weeks. If it does resolve in a short period, it generally indicates a low level of injury.

When back and neck pain after an injury is associated with neurological symptoms such as pain down the arm or leg, numbness, tingling or weakness, it means there was a higher level of injury. It is possible for these symptoms to resolve on their own also, but it may take a little longer, anywhere from 4-8 weeks. If however, the neurologic symptoms do not improve or get worse, the injury needs to be evaluated more extensively by a specialist. A physical medicine specialist, a rehabilitation specialist trained in spine, an orthopedic spine surgeon or a neurosurgeon can perform these evaluations.

All falls and accidents are not the same. The extent of the injury and symptoms depend on the energy of the trauma and the amount of degeneration of the spine that is already present before the injury occurred. In other words, as our spine ages and discs degenerate, joints become arthritic, and the space for the nerves narrow. When this happens, the likelihood of not recovering from injury and accidents increases.

Extensive evaluations by a specialist can include x-rays, an MRI, or a CT scan. Depending on the severity of the symptoms and the lack of improvement, treatment may include physical therapy, injections, and possibly surgery.

CHRONIC LOW BACK AND NECK PAIN

Chronic low back and neck pain is typically defined as pain lasting for more than 6-8 weeks that does not show any sign of improvement. Causes include disc degeneration, spinal joints (facet joints) becoming arthritic, the spine moving too much and becoming unstable, or spinal deformity (kyphosis, scoliosis). There are many other causes outside of the spine that can result in chronic pain also.

Initial treatment options include time, physical therapy, activity modification, chiropractic care, and simple medications like NSAID’s (Advil, Aleve). When these initial attempts fail, it would be wise to consult a specialist. When spine pain is associated with neurologic complaints like pain, numbness, tingling or weakness down the arm, indicating cervical spine (neck) problems, then a more timely evaluation is indicated. When low back pain is associated with leg pain, numbness, tingling or weakness, then evaluation should be done quickly.

Warning signs of spine problems that constitute emergencies and require urgent attention include fractures, infection, paralysis, and bowel and bladder incontinence.