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pain after fall
9/26 8:50:56

Question
Hi, i slipped on a walkway that was covered in ice. I am 6ft 4" so i have a long way to fall!, my 2 feet gave way, and i landed extremely hard on the top half of my back. It happened so fast, i didnt have time to put my hands out! I was winded, and couldnt get a full breath for about 2 hours, and it was quite hard breathing for the first 20 mins, and i was very dizzy, and my vision was blurred. Anyway, i got it x-rayed, as it was very sore, but nothing is broken.
It has been 11 days now, and although the pain is minor throughout the day, at night I waken up after 4-6 hours sleep, and it is very sore, i struggle for even a small movement. I get up, take 2 pain killers, and after an hour or so, then i get back to sleep.
Do you know what could be wrong?
The pain is inside my chest, both at the front and back, in the lower half of my rib cage.

Do I need to wait this out for a longer period, or do I need to go and see someone now?
PS. a hot water bottle soothes the pain...

Kind regards.
Declan.

Answer
back pain, slip and fall, dizzy, vision blurred,


Hello Declan,

Sorry to hear that you slipped, fell and injured yourself.

".....Winded, couldn't breathe 2 hrs, dizzy, vision blurred....", given that severe a fall and complaints, you did go to the emergency department or family medical doctor immediately, correct?
"....Nothing is broken....", Xrays ONLY look at bones, not discs, not muscles, nerves, cartilage, etc.
Still very sore, taking pain killers, lower half rib cage pain, '...do I need to go and see someone now?...'.
Yes, I think you should see someone now.

It is not an emergency, you are mobile, breathing, getting around; but you are still sore, taking pain meds, and still have some difficulty breathing.

Another P- A chest xray could be a good thing to take, this will evaluate your heart/ lung fields, an possibly catch any anterior rib fractures which may have been missed.  A health professional auscultating (listening) to your lungs is a good idea.

A Doctor of Chiropractic could do that, and help you with adjustment (if indicated) as well as massage, adjunctive physiotherapy to help with the soreness.

When a patient is HURT and in pain (inflammed) I recommend ICE rather than heat.  Heat feels good when it is on, but can actually add to inflammation and pain.  People who have used heat over an injury often take twice as long to heal as those who use nothing.  People who smoke also take twice as long to heal.

In my Staten Island Chiropractic office I utilize the following two informational handouts on pain and p.r.i.c.e. :

++++++++++++

PAIN     

Pain  is a  憆ed light on the dashboard?

Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car- -- do you ignore it until the car breaks down, or do you get it checked and correct the problem?  

Pain, pain in your body- -- do you ignore it until your body breaks down, or do you get it checked and correct the problem?   Pain,  do you cover up the pain by taking a painkiller?  Take a painkiller, mask the pain, and allow a problem to progress in your body?

       NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  慥SC?,    憇ubluxation?  )
Vertebral Subluxation  is  actually  a  quite  common  condition.

  Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for 慡ubluxation? Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- 慡ubluxation??can be the cause of many symptoms and conditions.



Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.



The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.

       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
++++++++++++++++++

P.R.I.C.E. =    
P  protection.   R rest.   I  ice.   C  compression.   E  elevation.

Hurt  yourself ??  injury/ trauma/  bruise/ not even sure - - a broken bone ??
You should certainly get to the Doctor or trained health professional to be examined  if you think it  is  bad  enough.     BUT  in  the  meantime,  some  simple  steps  may  help.   

PRICE.


The  PRICE  protocol will usually help just about any musculoskeletal injury.

P = Protection;  protect the area from further injury- stop what you are doing, can you pad  or bandage the area ? Tape the area? Do something to protect the area !

R = Rest;  rest the area as much as possible, if a part is damaged, give the body time to repair the area

I = Ice;  ice is a potent anti-inflammatory; it will slow swelling, help with pain control (ice is analgesic), place ice over cloth over the injured area for 5, 10 minutes, off the injured area for 30 minutes; then back on again

C = Compression;  to help prevent swelling compression may be helpful- for example if it is an ankle, wrap the ankle with an ace bandage and ice the area.  Many body parts may not be applicable to compression.

E = Elevation; again to fight swelling and pain, raising the injured body part above the heart may be helpful- ie raise an ankle or knee, you lay down, raise the injured part


PRICE  may  help :    Sprains,  Strains,  musculo-skeletal injury,  bruise,  contusion

Sometimes  a slip, trip, fall, heavy lift, athletic injury, or a motor vehicle accident can cause a bump or bruise, sprain or strain.  Sometimes also involved with the injury is a vertebral subluxation (or other joint subluxation) (subluxation is a mechanical problem- of any joint- and requires a mechanical correction).  In the spine, a sprain/strain  is a misalignment,  a 慿ink?in the joint, a stretch of the muscles, tendons and/ or ligaments:- more properly termed a Vertebral Subluxation.   Sometimes symptoms can come immediately, sometimes days, weeks or even months later!- Well after the actual trauma !!!

         Spinal = Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?  ;   ( subluxation COULD be any joint )
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A  subluxation  interferes with the proper functioning of the nervous system  (the master system  which controls and coordinates all function within the body)  and may cause various other conditions, symptoms and problems.

This is a serious condition identified by its five parts:

    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

    Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.

         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.

          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.  Sprain/ strain/ bump/ bruise?= may result in subluxation of the nearby joint.  CORRECT the subluxation !!!!

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
++++++++++++++++++++++++++++++++++++++++


With difficulty breathing, dizziness, blurred vision, I hope you were checked and cleared by examination at your local Emergency Department.
Were you unconscious at all? Did you strike your head at all? - you may have suffered a concussion.  Any return of dizziness or vision changes signals a need for urgent evaluation by a health professional.

If that dizzy feeling and vision change is gone and stayed gone- thank goodness.

The difficulty breathing is still a concern.  I would have a licensed health professional listen to your lungs, perhaps get another chest series of Xrays.

Continued soreness?- no better place than the Doctor of Chiropractic.   Proper treatment now can prevent this problem from becoming more chronic and episodic from this injury.

For instance, with a severe fall, besides muscular soreness, it would not be unusual to cause malalignment in ANY of the joints in your body.  Proper alignment slows or stops progression of wear and tear- also known as OsteoArthritic degeneration.  A Doctor of Chiropractic can help now with the pain, and also evaluate the 'balance' in your body and joints- and help prevent developing problems later from this fall.

My Staten Island Back Pain patients also get an explanatory handout on OsteoArthritis and proper or improper alignment:



Degenerative    Disk     Disease

DDD = Degenerative Disc Disease; DJD = Degenerative Joint Disease; = similar/ same OsteoArthritis.

Degenerative Disc Disease  (old term =  DJD) is  actually  a  quite  common  condition.   However,  the course of the condition   is  highly variable.   Some patients with DJD literally cannot walk, yet other patients with similar X-ray/ MRI findings may be able to run marathons or lift heavy weights.   Some people suffer for only a few days with pain and symptoms, some people suffer for months. Although the course is highly variable, there are certain steps that are always helpful to follow:  Ice the area when painful-  10/ 15minutes on, 30/ 45 minutes off;  avoid certain postures and movements;  bend the knees when coughing or sneezing;  bend the knees when lifting anything;  do not extend legs straight out when sitting, laying down, lifting, or driving.   Avoiding certain movements and postures will prevent aggravation of the condition.   Practicing good postures and movement patterns will help the condition heal and be less painful.  DDD, DJD,  OsteoArthritis, -  deteriorating discs (disk)   is/ are  often caused by,  or often  concurrent with the Vertebral Subluxation Complex.  VSC is a misalignment which hastens deterioration of the joints involved.

         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is the underlying cause of many healthcare problems.

A subluxation interferes with the proper functioning of joints, and can cause osteo-arthritic degeneration, Degenerative Disk Disease, degenerative joint disease, etc.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:
    Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
    Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve  system  dysfunction  can  cause  symptoms  elsewhere  in  the  body.
    Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The  resulting  scar  tissue  changes  muscle  tone,  requiring  repeated  spinal  adjustments.
    Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation.   Inflammed  Discs can easily bulge,  herniate,  tear,  or  degenerate.   Other  soft tissues  may  also  suffer  permanent  damage.
    Pathophysiology:
         The VSC contributes to  OsteoArthritic  degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term  nerve  dysfunction  can  cause  other  systems  of  the  body  to  malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, Disk Degeneration,  or aggravate such conditions.

ONLY a Doctor of Chiropractic will evaluate for Vertebral Subluxation,  as well as other pathology.
  
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.     Subluxation- a neuro/skeletal/muscular-   mechanical-   problem  requires  a   mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
++++++++++++++++++++++++++++++++++++++++++

That pain in the lower rib cage- it may be just muscular soreness, possibly it could be a slight crack in the rib(s) (this sometimes is missed on initial Xrays-- sometimes best seen a couple of weeks later- when Xrays catch the healing reaction), or some residual lung problem; that is why I recommend another professional evaluation of the breathing complaint.

Hot Water Bottle??, I think you can see, that for pain (roughly correlating with inflammation) I recommend ICE (see PRICE above).  MOIST heat is okay on stiffness, maybe mild soreness, but not on pain. Heat will add to inflammation.

What could be wrong? In all likelihood you are sore, bruised, sprained, strained, contused.  It has been a while, and particularly if breathing discomfort continues I recommend evaluation by a licensed health professional.  For the best long-term recovery, I recommend an evaluation by your local Doctor of Chiropractic.

Keep me updated / or ask further at ALLExperts.com
http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC.htm

Thanks for the question, Good Luck, and I wish you-
Good Health, Naturally,



Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (email newsletter)
http://www.SIworkcomp.com
http://www.SIautoaccident.com  

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