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Suggest treatment for lower back injury following a car accident

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Posted on Mon, 5 May 2014
Question: ,53 yr old female. 5 ft 10 in 210wt. history hbp, depression aniexity , poor spelling, short term memory , migraines, chest pain, leg theigh pain skeletal pain. lumbar back,injury new, life stress- mom and dad died , marriage of 27 years divorced... bullied at work , quit not working,, 7 years of Trichotillamania, PMDD, still having periods every other mo. Meds. klonapin 1 mg bid for 25 years,, Effexor xr 150, trazadone 100 mg bed, toperal hbp. imatrex prn drs seen , cardio stresss cardio w XXXXXXX . test passed . calcium 0 DX mvp rhum test for connective tissue disease mixed= yes 2nd rheumatologist blood work esr =7 vit D=17 serologyRF=< 10 very concerned , cardiac risk ?? IMMUNOLOGY ANAscreen ccpAb IgG = Positive A <0.50 ANA, IFA = Negative Primary Dr, fibromyalgia, migraines, chest pain, stress, fatigue chronic, depression, does not feel well 50 %, hx sore throat, Taken off work in November 2013. Dr . Phyciatrist. aniexty, depression, stress/ divorce family deaths. panic disorder. pain management Klonapim Effexor continued. DR Gyn, mammo good , abnormal pap 3 years, diag hvp polposcopy, inflammation repeat after next pap. DR at urgent care.. 2 x, car accident w big rig , ran over debrie in the road ,,, whiplash L Lumbar sprain ,, pain, taken 2 flexural. what would your diag, and treatment include? Thank you,
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Answered by Dr. Karl Logan (5 hours later)
Brief Answer: Further investigation required Detailed Answer: Hello, From what I can understand your question is that you have a lower back injury following a car accident and your are asking for a diagnosis and possible treatment. I also see from your past medical history that you have a connective tissue disorder. I hope that you Dr did a thorough physical examination following your injury? This would include a full neurological assessment to ensure no nerve or spinal cord damage. It is unusual but not impossible to 'sprain' your lower back. If the mechanism of the accident involved a rapid deceleration then I would be concerned that you may have sustained a fracture in your lumbar spine that could be diagnosed most of the time on an X-ray. Depending on the pattern of the fracture an MRI or CT scan may be used to further clarify the situation. If your XR's were normal then this is reassuring but you may in these circumstances if your symptoms are ongoing and localized to one particular region organize an MRI scan of your spine. If this is normal again it is more reassuring but it does not help your symptoms. In the absence of abnormal finding in the painful part of your spine on Xray and MRI scan then I would institute treatment with anti-inflammatory medication, physiotherapy and massage. A lumbar corset may be helpful. I hope this information is of benefit to you. Best wishes
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Karl Logan (28 hours later)
Dear Dr. XXXXXXX Thank you for the information and suggestions from the car accident. I would have appreciated your opinion on the lab results from the Rhumatologist, which was included in my original letter. Having mixed connective disease, I would like to know if that is diagnostic on the results I provided for you.
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Answered by Dr. Karl Logan (12 hours later)
Brief Answer: CT disorders not diagnosed on blood work Detailed Answer: Hi, Connective tissue (CT) disorders cannot be diagnosed on blood work. Some CT disorders can be diagnosed on genetic testing such as Ehlers Danlos syndrome but the majority are diagnosed on physical signs alone. From your previous letter I can see no blood work that would be concerning for a rheumatological disorder. Best wishes
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Karl Logan

Orthopaedic Surgeon

Practicing since :1999

Answered : 705 Questions

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Suggest treatment for lower back injury following a car accident

Brief Answer: Further investigation required Detailed Answer: Hello, From what I can understand your question is that you have a lower back injury following a car accident and your are asking for a diagnosis and possible treatment. I also see from your past medical history that you have a connective tissue disorder. I hope that you Dr did a thorough physical examination following your injury? This would include a full neurological assessment to ensure no nerve or spinal cord damage. It is unusual but not impossible to 'sprain' your lower back. If the mechanism of the accident involved a rapid deceleration then I would be concerned that you may have sustained a fracture in your lumbar spine that could be diagnosed most of the time on an X-ray. Depending on the pattern of the fracture an MRI or CT scan may be used to further clarify the situation. If your XR's were normal then this is reassuring but you may in these circumstances if your symptoms are ongoing and localized to one particular region organize an MRI scan of your spine. If this is normal again it is more reassuring but it does not help your symptoms. In the absence of abnormal finding in the painful part of your spine on Xray and MRI scan then I would institute treatment with anti-inflammatory medication, physiotherapy and massage. A lumbar corset may be helpful. I hope this information is of benefit to you. Best wishes