Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "

Case study ( 10212 views as of November 21, 2024 )

Irena a 22 women was involved in a rear-end motor vehicle collision three days ago. She was a seat-belted rear passenger in a taxi cab that was hit from behind by a food truck. Initially, she had some mild tightness in her shoulders and some stiffness in her lower back, but was able to walk around. She declined to go to the hospital with the paramedics who responded to the accident scene.

When she woke up the next morning, she felt much more stiff and had more severe pain between her shoulder blades and down her lower back. She took two days off of work to rest, hoping it would just improve on its own. On day three, the pain was radiating into her buttocks, and she could not bend to put on her shoes.

Irena could benefit from a visit to her Family Physician or Urgent Care Clinic. They may then refer her to a Physiotherapist, Chiropractor or an Acupuncturist. Irena may also receive information to aid in her rehabilitation from a Pharmacist and/or Personal Trainer/Athletic Therapist.

Author: Dr. Adam Lund

Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "

Case Introduction

Lower and Upper Back Pain

Presented by

Dr. Ramesh Sahjpaul

MD, MSc, FRCSC

Neurosurgeon

Treatments

How Exercise can Strengthen the Back and Help Reduce Back Pain

Practitioner help from:

Aaron English

Athletic Therapist
Yoga Can Help Treat Lower and Upper Back Pain

Practitioner help from:

Heather Greaves

Yoga Instructor
How a Chiropractor Can Help with Lower and Upper Back Pain

Practitioner help from:

Dr. Ashley Waggott

Chiropractor

Treatments

Treating Lower and Upper Back Pain With Massage Therapy

Practitioner help from:

Krista Mcconnell

Massage Therapist
Using Acupuncture to Treat Lower and Upper Back Pain

Practitioner help from:

George Taouil

Physiotherapist
How a Pharmacist Can Help With Conditions Including Lower and Upper Back Pain

Practitioner help from:

Tammy Maure

Pharmacist

Conversation based on: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "

Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "

Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 31 July 2018 Artus Health Centre

Poor posture stresses your spine. The soft tissue becomes overstretched, muscles tire and joints and nerves are put under pressure. Minor back muscle strains quickly improve on their own, but more severe strains will need physiotherapy treatment to relieve pain and promote healing.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 03 May 2022
  
  With the proper guidance from a physiotherapist and ergonomic adjustments to your work station, it is possible to significantly decrease the risk of another herniated disc in the future.
Dr. John Wade MD, FRCPC Rheumatologist, Vancouver, BC 31 July 2018 Artus Health Centre

More than 70% of back problems begin during routine daily activities. Accidents and other forms of trauma account for only 30% of back problems.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 03 May 2022
  
  Post surgically patients can experience some nerve pain but typically this can be treating with over the counter medications.
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 09 September 2016

Low and Upper back pain is crucial to everyday health and happiness. There are lots of studies around back pain and happiness and action should be taken.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Michelle Kaarto, BScK, CSEP CEP 08 October 2015

I was surprised to learn about my weak core strength being a big factor in my back pain when I visited a physiotherapist a few years ago. My physic told me it is common in young women who have had children to go back to strenuous exercise and don't really have their core strength back before they begin to work out hard. Having that weakness in core strength can really open your back up to strain and discomfort. I have since spent more time working on the core strengthening exercises I was given.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 09 November 2015
  
  I think that many people confuse the desire for a flat tummy with the need for a strong core. Having a strong core can definitely help with back pain and soreness.
- Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 09 October 2015
  
  That's a really good point Michelle that few people realize. Giving birth is a traumatic experience in a lot of ways in regard to muscle development and the process of getting back to a good level of strength. It could easily take up to a year to get back to normal levels.
Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 18 September 2015

A physiotherapist is really good option to help as well on treating back pain.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 08 October 2015
  
  My physiotherapist gave me a number of stretching exercises to do to help with my lower back pain. I do them on a regular basis
K. Michael 02 September 2015

I was in a car accident similar to Irene's 7 years ago. I also experienced back pain that was worse a few days after the accident. My chiropractor was beneficial in aiding my recovery. I still remember the release in pain when he was able to adjust my neck a week after my accident

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Dr. Ramesh Sahjpaul MD, MSc, FRCSC Neurosurgeon, Vancouver, BC 24 April 2015 Specialist Referral Clinic, Vancouver, BC

Well, understanding that most causes of back pain are fairly self-limited, and the pain resolves on its own within days to weeks. However, there are some situations in which a patient should see their family doctor if the back pain is persisting for more than a few weeks, if the pain is waking them up at nighttime, or if the back pain is associated with other symptoms, then definitely patients should consult their family physician.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 30 August 2015
  
  If the back pain is persistent, and not associated with an injury, a doctor can help to diagnose why the person is having the back pain. It could be the symptom of back arthritis or other conditions
- ShirleyG 23 August 2015
  
  If the back pain is ongoing what can a family physician do to help ?
Dr. Ramesh Sahjpaul MD, MSc, FRCSC Neurosurgeon, Vancouver, BC 24 April 2015 Specialist Referral Clinic, Vancouver, BC

MRI reports can sometimes be quite alarming, and that’s because they’re reflective of the normal wear and tear processes that occur in the spine with aging. And essentially everybody gets these changes on their MRI scan, and it’s important for patients to realize that they don’t need to be alarmed if their MRI report shows degenerative discs, bulging discs, bone spurs, and some degree of spinal stenosis.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Gordon Bohlmann Physiotherapist, Vancouver, BC 08 April 2015 Marpole Physiotherapy Clinic

Back pain after MVA is a common complain. the forces associated with moving vehicles, irrespective of the speed at which they collide are significant and can cause injuries to the human spine. Fortunately most of the time these injuries are to the soft tissue, which by no means implies they are less severe or debilitating. Soft tissues include tendons, ligaments, muscles, and nerves. All too often it is the subtle changes to the nervous system that drives many of the complaints and symptoms patients present with. In my experience, I have found IMS (Intramuscular Stimulation) to be very effective in treating patients who present with symptoms of nerve dysfunction following MVA - something called neuropathic pain or neuropathy. The signs and symptoms of neuropathy such as delayed onset described by Dr. Lund above, are often missed because they are not commonly looked for, but easily recognizable to the trained eye. If your symptoms of pain, stiffness, decreased range of motion, tingling numbness etc occurred days, or even weeks after an MVA, you may have developed a neuropathic pain syndrome, and IMS may be an option for you.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 09 July 2015
  
  Can you explain further about IMS ? How does this help with back pain ?
Romy Shapiro 06 April 2015

Something similar happened to me about 10 years ago. Turns out my back muscles were weak and they went into spasm. Perhaps doing back strengthening exercises can help

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 30 June 2015
  
  Improving your core muscle strength can not only help with back pain but also help prevent issues associated with normal aging. A strong body is generally a healthy body. A personal trainer can help create the best workout for you
- ShirleyG 07 April 2015
  
  When my husband went to the chiropractor he was given several back strengthening exercises to do. Since doing them he has found the back pain is reduced and his muscles feel stronger.
Joy 29 March 2015

It's always a good idea to seek medical attention after a car accident as the effects of pain and stiffness get worse with time. After an accident, adrenaline is coursing through your body, which masks the pain.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
ShirleyG 12 February 2015

When my husband is experiencing back pain (joint issue) he is told to ice the area, should he be alternating between hot and cold ?

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Mariana Paz Physiotherapist, Thornhill, ON 17 February 2015
  
  For an acute flare up (ie. pain right after vigorous exercise) I would recommend ice since there will be a small inflammatory reaction there. For all other times I would recommend heat as this will help the muscles relax. Any time there is a joint issue or joint restriction, the muscles surrounding the joint will become irritated and tense since they are trying to protect the painful joint. Tense muscles will respond well with heat.
ShirleyG 12 February 2015

A couple of years back my husband was lifting our son out of his bouncer and threw out his back. He went to physio for a bit and the therapist told him to continue home exercises and visit twice a week for the next month which he did. Since then twice a year he throws out his back with the simplest movement. He visited a chiropractor who told him it is a joint issue and he needs to strengthen his back through exercise. Is there someone else he should be seeing to ensure there is not an underlying issue with the back ?

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- ShirleyG 07 April 2015
  
  His doctor did testing and it was determined his back muscles are weak and need to be strengthened. He tried to do core exercises a few times a week. The doctor also reviewed the exercises the chiropractor gave him and agreed they were good stretching/strengthening exercises. He has been doing them for a while now and finds he has more strength and less sore/stiffness.
- Joy 29 March 2015
  
  My husband was experiencing the same thing. He was told to strengthen his core. He has been doing core strengthening yoga and daily stretching for over a year and hasn't had a back pain episode yet.
- K. Michael 08 March 2015
  
  He could see his family doctor to do additional tests to confirm the chiropractor's diagnosis. They would likely start with x-rays and possibly move up to an MRI. In the meantime he could start a core exercise program that would strengthen his back
Mariana Paz Physiotherapist, Thornhill, ON 06 February 2015

@Chantal- usually disc irritations will occur at the cervical (neck) and lumbar (low back) spine. The mid-back (thoracic spine) has more stability and less movement due to the attachments of the ribs and therefore the disc doesn't often get displaced or irritated. Pain in the mid-back and in the shoulder blade area is most often due to a disc irritation or bulge at the neck. The pain often radiates down to those areas. I would recommend getting your neck assessed (movement testing and repetitive movement testing) to see if it has any effect, positive or negative, on the mid-back pain you are experiencing.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Julianne Petersen Acupuncturist, Vancouver, BC 02 February 2015

Acupuncture and Cupping Therapy is very helpful for post motor vehicle accident/trauma. Cupping Therapy helps to detoxify the muscles while Acupuncture relaxes the body and calm the mind. Cupping Therapy goes into the deep muscle layers to lift the congestion (stagnation) out of the muscles and restore circulation flow. The muscle becomes stagnated due to the dumping of stress chemicals by the brain at the time of the trauma (fight or flight chemicals). Cupping Therapy and Acupuncture will help the body release the congestion and restore the natural flow of circulation, body fluids and electro-magnetic energy (Qi).

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Mariana Paz Physiotherapist, Thornhill, ON 31 January 2015

Back pain from a car accident is almost always the case. The soft tissues become very irritated and cause a lot of pain in the first 10 days after the accident. Pain that persists after the inflammatory phase (10 days) is most likely caused by a joint irritation in the low back (ie. intervertebral disc irritation.) In these cases, consulting a physiotherapist is extremely important so that they can address the joint issue through controlled movements and gentle exercises. Back pain from a car accident doesn't have to last forever! Consulting a physiotherapist or chiropractor to diagnose the problem is the fist step to a full recovery.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Joy 29 March 2015
  
  That is really interesting information regarding the inflammation phase.
- Chantal Sayers Vancouver, BC 05 February 2015
  
  Mariana, can you tell me if you can also get this intervertebral disc irritation in other parts of the spine due car accidents? I have had a bad back from a car accident but more mid back. Any recommendations would be helpful.
Mr. Tycson Boult Massage Therapist, Vancouver, BC 29 January 2015 Vitality Clinic, Downtown, Vancouver, BC

Great discussion! I have seen clients with very similar symptoms and it seems treatment of the anterior spinal muscles like psoas and iliacus has an equally large roll in recovery as the posterior lumbar spinal muscles. Including a stretch routine for the pelvis while incorporating ice for pain and heat for muscle relief has generally speaking, created relief for clients both in the short and long term.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
Healthymama 28 January 2015

A chiropractor really helped me after my car accident. But it's true that at first you don't feel so bad and then the next day you can wake up feeling horrible.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 28 January 2015
  
  And even worse the day after that. I found my pain increased the first 2-3 days after my accident.
K. Michael 04 January 2015

I think in general it's always best to be examined by a doctor after a car accident. As in Irena's case you don't often feel the full extent of the pain until a few days later

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- K. Michael 13 January 2015
  
  That is very true. Soft tissues injuries can linger long after the initial pain goes away
- Carrie Cooke 10 January 2015
  
  I agree, and also even if Irena was feeling better, back pain has a bad habit of coming back again, so it is good to follow the expert's advice so that when it comes back you can implement the therapy right away.
Bernadette van der Boom-Bebb 06 December 2014

I often use a heating pad for some temporary relief of back pain. There are some portable heating pad options that a pharmacist can suggest.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Joy 29 March 2015
  
  If your back pain is due to inflammation, ice would be better.
- Carrie Cooke 10 January 2015
  
  I tend to use a heating pad (alternating with ice) when my back is in spasm. It is very painful. I would like to try acupuncture, but am more hesitant to try Chiropractic therapy.
- Yuan Lew, MSc MBA 18 December 2014
  
  My magic bag is easy to use for my back pain. Just microwave and apply. I highly recommend one for back pain relief.
- stravers82 08 December 2014
  
  I always keep a magic bag on hand for when my back pain acts up. Also hot/cold can really help.
- K. Michael 06 December 2014
  
  I find one of the most effective "portable" heating pad is an old school hot water bottle. I keep one at work for bad days
stravers82 03 December 2014

Physiotherapy, prescription muscle relaxers, massage, chiropractor and acupuncture have all helped my back pain over the years.

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
K. Michael 03 December 2014

Back injuries can flare up for years. It is always in the patient's best interest to see a specialist ie) chiropractor, or physiotherapist

Reply to: Lower and Upper Back Pain " Irena a 22 year old women involved in a rear-end MVA "
- Joy 29 March 2015
  
  Even sleeping!
- K. Michael 10 December 2014
  
  It's amazing how many small changes we can make in our lives to help with back issues. From how you stand to wash dishes to how you take the laundry out of the dryer
- Yuan Lew, MSc MBA 05 December 2014
  
  So true. These specialists can really help with strategies to reduce flare ups in future. Sometimes it can be as simple as slight behavioural modifications.