Question
I fell down about 5 or 6 stairs about a week ago. I bounced down each one and landed on my buttock. On the way down I hit my right side and then my left side. It took the wind out of me and the only parts of me that hurt were my sides and the back of my arm. My mother-in-law (who happens to be a nurse practitioner) asked me a couple of questions and then said I should be fine. Well, it is a week later and my lower back is causing me great pain and discomfort. It is stiff and hurts whenever I stand up straight.  Only when I am hunched over does it not hurt so bad. I find it hard to get comfortable and it hurts when I sneeze or cough.  Could my back pain be associated with my fall from a week ago?

Answer
low back pain , herniated disc , trauma , hunched over , antalgic posture , antalgic gait , (+) Dejerine ,

Hello Rachele,

Sorry to hear of your Low Back Pain.

You bounced down the stairs, certainly trauma enough to sprain/ strain, subluxate your back- possibly even herniate a disc.

Why do I mention a herniated disc with your low back pain?- You mention it hurts when you cough or sneeze; this could be a sign of a herniated disc (HNP = herniated nucleus pulposis).  You mention a hunched over comfortable posture or movement pattern; this is an antalgic posture or an antalgic gait; this could be a sign of a herniated disc.

It is not uncommon to injure ourselves, yet not feel the full extent of the aches and pains for several days.  Have you ever 'hurt' yourself, and said to yourself "... oooooooops, that hurts a little now, but I know this is going to hurt a lot tomorrow...", I know I have.  Sometimes after a 'pulled muscle', I feel the worst even three/ four days AFTER the trauma.  Everyone that comes to my Staten Island Chiropractic office has had similar experiences.  I think you are in that type of situation now.  Ever bang/ hit a part of your body?- sometimes it takes days for the full bruise to appear.

The same with our back.  The body is made of bones, ligaments, cartilage, muscles, nerves, organs; all of these go through the same process: inflammation.  Inflammation is the bodies response to irritation, injury trauma.  Your back is inflamed.  Perhaps a disc is inflamed.  Perhaps a disc is bulging or herniated.  Your back is sprained/ strained/ bruised.  Sprains and strains of the spinal joints allow those joints to become dysfunctional.  Ligaments and muscles that are out of balance allow our joints to become out of balance.  Actually, if our joints are not guided EQUALLY from both sides, the joint will not only be allowed to become out of balance- the stretched, dysfunctional ligaments or muscles will pull the joints out of balance (spinal joint imbalance = vertebral subluxation complex, more on that later).


You have pain, let me give you some cautionary information on utilizing pain medication- which covers up the problem, but does not get to the cause of the problem.  I utilize this information handout in my Staten Island Chiropractic office:



PAIN

Pain is a 'red light on the dashboard'.

Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car- -- do you ignore it until the car breaks down, or do you get it checked and correct the problem?

Pain, pain in your body- -- do you ignore it until your body breaks down, or do you get it checked and correct the problem? Pain, do you cover up the pain by taking a painkiller? Take a painkiller, mask the pain, and allow a problem to progress in your body?


NOTICE ON PAIN RELIEVERS:

Label changes ORDERED by FDA; the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news 206- 207; 12-9-06) ;

The American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement 2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse. These medications cover up the pain, and cause the problem to worsen.


Pain can often be the result of the Vertebral Subluxation Complex.

Vertebral Subluxation ( 'VSC',  'subluxation' )
Vertebral Subluxation is actually a quite common condition. Doctors of
Chiropractic look for pathological conditions which may require referral to other specialties, and also look for 'Subluxation'. Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system (the master control system- ALL health disciplines learn this). VSC- 'Subluxation'  can be the cause of many symptoms and conditions.



Only a Doctor of Chiropractic will evaluate and treat for VSC, as well as other
pathology.



The course of VSC is highly variable. Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights. Some patients immediately develop symptoms related to the VSC, some patients take years to develop symptoms. Some people suffer for only a few days with pain and symptoms, some people suffer for months. Some
people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position. When subluxated, joints are in a stressed, vulnerable, compromised condition. Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.

Vertebral Subluxation cannot be corrected through chemicals
(medicine), stretching, yoga, vitamins or physical therapy alone.
Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction- - - a manipulation, best performed with
the chiropractic adjustment.
++++++++++++++++++++++++++++++


Another informational handout for my Staten Island Low Back Pain patients:



Lower Back Pain (LBP):

Low Back Pain can be caused by many different things.

Big, BAD, catastrophic things like a tumor or a cancer can cause low back pain (only a proper exam by a licensed doctor, like your Doctor of Chiropractic, or your family Doctor of Medicine, can evaluate your signs and symptoms, and perhaps refer for testing).

Big, bad things like a Herniated Disc, sciatica, possible fracture or
dislocation can cause LBP (again, best evaluated by your DC or MD, and perhaps referral).

Bad things, like - Sprains, Strains, contusion, or Vertebral Subluxation Complex (all very efficiently diagnosed and treated by your Doctor Of Chiropractic. LBP can come from a motor vehicle accident, sport injury, slip, trip, fall, arthritis, lifting improperly, or even bad posture in standing, sitting or sleeping. All of these things often have a Lumbar (Low Back) Vertebral Subluxation involved.


Vertebral Subluxation Complex (a.k.a. 'subluxation')

The vertebral subluxation complex is the underlying cause of many healthcare problems. A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.



This is a serious condition identified by its five parts:

Spinal Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their
normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate
nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and
go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

Histopathology:
A rise in temperature from an increase in blood and lymph supplies
result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

Pathophysiology:
Bone spurs and other abnormal bony growths attempt to fuse
malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.



The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.

Workers Compensation Injury, Automobile accidents, improper lifting,
improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
Vertebral Subluxation cannot be corrected through chemicals
(medicine), stretching, yoga, vitamins or physical therapy alone.

Subluxation-
a neuro/skeletal/muscular- mechanical- problem requires a mechanical
correction- - - a manipulation, best performed with the chiropractic
adjustment.

Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST Chief of Chiropractic in a  Hospital in New York State (DHSI); As Seen in PREVENTION Magazine
*********************



Herniated disc in the lumbar spine can often result in Sciatica. Sciatica is an irritation or inflamation of the sciatic nerve.  HNP may or may not include sciatica, leg pain, muscle weakness.

Again, my Staten Island Herniated Disc patients usually find this information helpful:




Disk   Herniation

Herniated  disk  is  actually  a  quite  common  condition.   However,  the course of the condition is highly variable.   Some patients with a herniated disk literally cannot walk, yet other patients with similar MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.
Disk  Herniation  is often caused by, or often  concurrent with the Vertebral Subluxation Complex.

        Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:

   Spinal Kinesiopathology:
        This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

   Neuropathophysiology:
        Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

   Myopathology:
         Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

   Histopathology:
        A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

   Pathophysiology:
        The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.

The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.   
         Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
+++++++++++++++++++++++++++++++++++

I recommend you see a local Doctor of Chiropractic for an evaluation. The above discussion should give you an idea as to what the Doctor would be looking for.

I hope this information helps.


If you need to re-contact me, please do so: ALLEXPERTS.com
( http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm )

Thanks for the question, Good Luck, and I wish you-
Good Health, Naturally,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.SIworkcomp.com
http://www.SIautoaccident.com