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Hi, About 2 Weeks Ago I Had A Minor Fall

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Posted on Wed, 21 Aug 2019
Question: Hi, about 2 weeks ago I had a minor fall down some steep stairs. I mainly bounced on my butt down 4 steps. I got up and did not feel any pain at the time. I now can barely move my left leg. I went to the doctor but they are saying possible strain. I am wondering why I am not getting better. any suggestions?
doctor
Answered by Dr. Dariush Saghafi (3 hours later)
Brief Answer:
Blunt trauma can weeks-months to heal with nerves/spinal column

Detailed Answer:
So sorry you take that fall and can understand why you are concerned.

I believe it would be a good idea to get some imaging studies to look for at least some level of damage such as either a PINCHED NERVE or CONTUSION to either the bony elements of the spinal column or the spinal cord.

Sometimes in falls people's bodies and limbs go in all sorts of uncanny directions and it's hard to say why you wouldn't've felt any pain upon getting up UNLESS you were so hyped up from the sudden loss of balance and traumatic strikes to the successive stairs that you were simply in one of those "adrenalin states of mind" which didn't allow you to feel much pain....or whether the amount of damage was that minimal such that no fracture occurred.

Whatever the case, by bouncing down the stairs one possible thing to have injured very easily would've been the TAILBONE or COCCYX and often times this is where much pain emanates and can take a long, long, time to resolve. However, in your case...I'm not certain how much pain is actually present since your PRIMARY COMPLAINT seems to be that of not being able to move your LEFT LEG very well.

And so, if it is MOVEMENT that is mainly compromised in your case then, I think it less likely to be a fracture and more likely that the problem is that of a CONTUSION (bruise) to some part of either nerve roots that control leg movements OR there may be a couple of levels where nerve roots are being pinched from soft tissue swelling of back muscles overlying the affected nerve roots that were affected.

If it is a contusion or blood clot that is simply causing pressure on the nerve roots then, I would expect to be a convalescent time of weeks to even months depending on the severity for full recovery.

Aside from an imaging study such as MRI, CT, or PLAIN FILMS it would be helpful to get someone from PHYSICAL THERAPY to assess EXACTLY WHAT PART of the leg is not moving or "barely" moving and that will help locate where in the nerve plexus or at which spinal/vertebral level there may be a problem which can then, help whoever orders the imaging study to focus there attention to see if they can see anything.

Another study that may be very useful to get since it's been a couple of weeks since the accident would be that of an EMG/NCV which is an electrical type of examination that uses needles that are placed in muscles of the back, hip, and leg that can TEST the INTEGRITY or FUNCTIONALITY of the muscles, nerves, and spinal cord in that area to tell whether the process is really something akin to a sprain/strain of tendons/ligaments or muscles....OR whether nerves and electrical transmission circuits have become involved.

My guess is that you will be getting better little by little with CONSERVATIVE therapy including PHYSICAL THERAPY, ULTRASOUND/DIATHERMY treatments, ELECTRICAL STIMULATION using something like a TENS unit, massage, symptomatic medication for pain or feelings of tingling and so forth.

But remember that with BLUNT TRAUMA some times the healing times can be very protracted...much more so than in something that is fractured, broken, or something of that nature. You've heard the saying that sprains can be worse than fractures?

Well, this may be kind of what they mean.

If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in being kept in the loop with how things progress so please drop me a line whenever you get some testing done or a treatment plan in place. I'm happy to give you opinions on those issues as well.

This query has utilized a total of 45 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

If they are able to get a clinical idea of approximately what level everything is happening then, a better determination can be made that either tells you that watchful waiting will be the preferred approach vs. something more invasive and/or proactive to get the leg moving again. Anyways, getting physical therapy involved at this time I believe would also be to your benefit.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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Hi, About 2 Weeks Ago I Had A Minor Fall

Brief Answer: Blunt trauma can weeks-months to heal with nerves/spinal column Detailed Answer: So sorry you take that fall and can understand why you are concerned. I believe it would be a good idea to get some imaging studies to look for at least some level of damage such as either a PINCHED NERVE or CONTUSION to either the bony elements of the spinal column or the spinal cord. Sometimes in falls people's bodies and limbs go in all sorts of uncanny directions and it's hard to say why you wouldn't've felt any pain upon getting up UNLESS you were so hyped up from the sudden loss of balance and traumatic strikes to the successive stairs that you were simply in one of those "adrenalin states of mind" which didn't allow you to feel much pain....or whether the amount of damage was that minimal such that no fracture occurred. Whatever the case, by bouncing down the stairs one possible thing to have injured very easily would've been the TAILBONE or COCCYX and often times this is where much pain emanates and can take a long, long, time to resolve. However, in your case...I'm not certain how much pain is actually present since your PRIMARY COMPLAINT seems to be that of not being able to move your LEFT LEG very well. And so, if it is MOVEMENT that is mainly compromised in your case then, I think it less likely to be a fracture and more likely that the problem is that of a CONTUSION (bruise) to some part of either nerve roots that control leg movements OR there may be a couple of levels where nerve roots are being pinched from soft tissue swelling of back muscles overlying the affected nerve roots that were affected. If it is a contusion or blood clot that is simply causing pressure on the nerve roots then, I would expect to be a convalescent time of weeks to even months depending on the severity for full recovery. Aside from an imaging study such as MRI, CT, or PLAIN FILMS it would be helpful to get someone from PHYSICAL THERAPY to assess EXACTLY WHAT PART of the leg is not moving or "barely" moving and that will help locate where in the nerve plexus or at which spinal/vertebral level there may be a problem which can then, help whoever orders the imaging study to focus there attention to see if they can see anything. Another study that may be very useful to get since it's been a couple of weeks since the accident would be that of an EMG/NCV which is an electrical type of examination that uses needles that are placed in muscles of the back, hip, and leg that can TEST the INTEGRITY or FUNCTIONALITY of the muscles, nerves, and spinal cord in that area to tell whether the process is really something akin to a sprain/strain of tendons/ligaments or muscles....OR whether nerves and electrical transmission circuits have become involved. My guess is that you will be getting better little by little with CONSERVATIVE therapy including PHYSICAL THERAPY, ULTRASOUND/DIATHERMY treatments, ELECTRICAL STIMULATION using something like a TENS unit, massage, symptomatic medication for pain or feelings of tingling and so forth. But remember that with BLUNT TRAUMA some times the healing times can be very protracted...much more so than in something that is fractured, broken, or something of that nature. You've heard the saying that sprains can be worse than fractures? Well, this may be kind of what they mean. If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined? Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in being kept in the loop with how things progress so please drop me a line whenever you get some testing done or a treatment plan in place. I'm happy to give you opinions on those issues as well. This query has utilized a total of 45 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement. If they are able to get a clinical idea of approximately what level everything is happening then, a better determination can be made that either tells you that watchful waiting will be the preferred approach vs. something more invasive and/or proactive to get the leg moving again. Anyways, getting physical therapy involved at this time I believe would also be to your benefit.