The Anatomy and Injuries of the Low Back
One of the most common injuries suffered as a result of a motor vehicle accident is one to the low back or what is called the lumbar region. The lower back consists of five vertebrae, known as L1- L5 in the lumbar region which help to support the weight of the upper body. The spaces between the vertebrae are filled with round, rubbery cushions known as intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place and tendons attach the muscles to the spinal column. There are 31 pairs of nerves that are rooted to the spinal cord and they control body movement and transmit signals from the body to the brain.
The injuries that often occur as a result of a motor vehicle collision can be
Strains and Sprains, Herniated or Ruptured discs, Radiculopathy, Sciatica, Spondylolisthesis, Spinal Stenosis and in rare instances, Cauda Equina Syndrome
. A
Sprain
is caused by overstretching or tearing of the ligaments and
Strains
are tears in the tendon or muscle.
Herniated or Ruptured
discs can occur when the intervertebral discs become compressed and bulge outward (i.e. herniated) or rupture, causing low back pain.
Radiculopathy
is the condition caused by compression, inflammation and/or injury to a spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that travels or radiates to other areas of the body that are served by that nerve.
Radiculopathy
may occur when
Spinal Stenosis
or a
Herniated or Ruptured
disc compresses the nerve root.
Sciatica
is a form of radiculopathy caused by compression of the Sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. Disc compression can cause shock like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot.
Spondylolisthesis
is a condition in which a vertebrae of the lower spine slips out of place pinching the nerves exiting the spinal column.
Spinal Stenosis
is a narrowing of the spinal column that puts pressure on the spinal cord and nerves and can cause pain or numbness with walking and over time leads to leg weakness and sensory loss.
Cauda Equina Syndrome
is a very serious condition that can arise from a ruptured disc. It occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots causing loss of bladder and bowel control.
When investigating lower back complaints, a physician will often have a patient undergo X-rays of the lumbar spine which are used to look for broken bones or an injured vertebrae. X-rays show the bony structures and any vertebral misalignment or fractures. Additionally, a CT scan might be ordered, which is used to see spinal structures that cannot be seen on conventional X-rays such as disc rupture or spinal stenosis. An MRI is used to create a computer generated image of soft tissues such as muscles, ligaments, tendons and blood vessels. Additionally, a doctor might order electrodiagnostics if a person is complaining of radiculopathy. These electrodiagnostics could be EMG, Nerve Conduction studies, and Evoked Potential studies. EMG assesses the electrical activity in a muscle and can detect if muscle weakness results from a problem with the nerves that control the muscles. Nerve conduction studies are used to exclude conditions that can mimic radiculopathy.
Different forms of treatment are used to treat low back pain. The simplest forms of treatment are application of hot or cold packs to the injured areas, stretching and strengthening exercises, the taking of medication, and physical therapy. In addition to these forms of treatment a person might also have to undergo spinal manipulation and spinal mobilization, traction, acupuncture, nerve block therapies, epidural steroid injections, transcutaneous electrical nerve stimulation (TENS) and if all else fails, surgery.
If you suffer from low back pain as a result of a motor vehicle accident, contact your physician immediately for guidance on the treatment of this type of injury. If you have any questions concerning a low back injury from a motor vehicle accident please contact our office.
We are always here for you.
Chuck
