Back pain after a fall from a ladder

Patient

Q: My husband fell off a ladder from about 15 feet 6 days ago. He feel backwards and landed on the metal ladder and bent couple of the steps. He went to hospital and they did MRI's, Cat scans and tons of xrays including labwork. They did say that they found nothing on the results. He has severe bruising on both upper and lower arms and the whole lower half of his back to basically the end of his buttocks. They gave him pain medication and muscle relaxers. He went again to doctor the other day because pain was worse in his back. All they did was give him more pain medication. The last couple days he has been moaning every time he moves or sits. Last night he woke up with severe leg cramps and tightening of the muscles in his back. He is in constant severe pain. Could something have been overlooked with the test results or could something else have messed up since those tests? He is 58 yrs old.

Doctor

A:   In the view that you were checked out at the hospital and everything was normal, the most likely diagnosis would be: Mechanical low back pain (LBP) which is the second most common reason for seeing a physician in the United States. The conservative treatment of the mechanical lower back pain is basically relative rest, avoiding all the activities that produce pain or discomfort, such as weight lifting. Also very important is to keep a good posture at all times and sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.   Control of the pain and inflammation with Ice, transcutaneous electrical nerve stimulation (TENS), Physical Therapy and anti-inflammatory drugs (“Aleve”). Try to keep a consistent exercise routine with stretching and extension-flexion which may reduce tension and stress to the spinal joints. After your visit to the hospital for back pain, it is recommended that you follow your doctor's instructions as carefully as possible. This includes taking the medications and performing activities as directed.

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