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Lump in the lower back after a fall. Is it an inflammed muscle? History of Muscular dystrophy

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Orthopaedic Surgeon
Practicing since : 1994
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Boyfriend, who has mild Muscular Dystrophy since a kid, fell off low scaffling at work, backside down onto a ladder laying on the ground. He didn't want to see a doctor, had a knot on his head and a sore lower back. Within days knot on head went away and a swelling lump developed on the right side of his lower back that was getting bigger. No visible bruising or color at all. Seemed a soft lump at first and now seems to be getting harder, is about the size of a large lemon. Seems it's more "irritating" than "hurt" to touch it. It has now been 12 days. Never iced it or used heat when he initially fell. Is it inflammed muscle as he continues to work 6 days a week?...will it eventually heal or is something more?
Posted Tue, 17 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 16 hours later

Thanks for posting your query.

Presence of a lump on the lower right back after a fall is suggestive of hematoma formation. However it is important to rule out any hair line fractures in the spine. Hence it is important to get an x-ray and a MRI scan of the area done. X-rays are very sensitive for picking up any fracture and MRI is one of the best tests for ruling out and identifying soft tissue injuries in the area of fall. His primary doctor can help streamlining these tests.

Mean time, I suggest you to apply cold compresses on the lump; avoid any activity till proper diagnosis is made and take some like Ibuprofen or Tylenol after prescription from your doctor.

I hope this answers your query effectively. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.

Wish you good health.

Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Lump in the lower back after a fall. Is it an inflammed muscle? History of Muscular dystrophy 11 hours later
Thank you for your answer, however trying to get him to go in is near impossible. Wouldn't a hematoma appear as a bruise?...the lump still has no color whatsoever. The lump is just to the right of his spine, above his tailbone. He also has not taken anything for pain or swelling. No ibuprophen or anything since the injury, and he lives with me so I know this as I have tried to get him to take ibuprophen. He also has not stopped working 6 days a week, renevating a bar/restaurant currently, so I know he is up and down ladders, painting, laying flooring, moving appliances, etc. If something were broke/fractured wouldn't it hurt or impede movement? Is it possible to be a muscle issue?...torn, extended, or something, and it will eventually heal itself?
Answered by Dr. Praveen Tayal 9 hours later

Thanks for writing again.

A hematoma is not necessarily associated with overlying skin color changes. A collection of blood inside can get infected or may resolve on its own.

It can be a swelling also.

A hairline un-displaced fracture does not cause pain but may get displaced and cause complications if adequate rest is not provided.

Proper investigations are necessary for management and to avoid any delayed complications.

Hope my answer is helpful. Please accept my answer in case you do not have further queries.

Wishing you a trouble free early recovery.

Dr. Praveen Tayal.
Above answer was peer-reviewed by
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