Back injury: is there such a diagnosis as far as it isSeriously? How to avoid bad consequences with a bruised back than histo treat

Чт, 21 апр 2016 Автор: врач Артём

Bruising is one of the most common domestic injuries.

Everyone in his life has met with bruises, but not everyone knows what
bruises are different from fractures. What is a bruise and what is it
different from fracture?

A bruise is a traumatic tissue injury.
the cause of which is the mechanical effect on one or another

The main difference of contusion from fractures and other types of injuries.
is the lack of violation of the anatomical integrity of the tissue.

Although bruises are widespread in medical practice,
the diversity of their species is so great that talking about danger or
safety of such an injury can only be based on localization
damage. Fortunately, for the most part bruises are not dangerous and
relatively easy to treat.

Об ушибе спины говорить можно лишь условно.
Officially, such a diagnosis is not made, because it does not exist.
From the anatomical point of view, the back is the back
torso that originates in the area of ​​the first cervical
vertebra and ends with the loin. It is clear that this
огромная анатомическая region. Located in the back area
a huge amount of soft tissue. On this basis, diverse and
types of back injuries.

In most cases we are talking about injuries to the muscles of the back. They
least dangerous. In addition, in this area there are:

• Spinal injuries. They, в свою очередь, подразделяются

– bruises of the cervical spine;

– bruises of the thoracic spine;

– bruises of the lower back and sacrum.

• Rib bruises (technically, bruise a bone, including a rib
impossible, the damage concerns the periosteum rich in nervous

There are also more detailed classifications taking into account
or no damage to the vertebrae, spinal cord.

Back injury: causes

The causes of back injuries are manifold. Due to the fact that in the area
There are many muscles in the back, and the spine and back
rib sections are injured relatively infrequently. therefore
It is possible to isolate a number of specific causes, such as the most
often contribute to injury.

• Traffic accidents. Most often as a result
Accidents occur cervical and lumbar spine bruises
(when hitting his head on the steering wheel, etc.).

• Fight (in domestic conditions or during sparring).

• Blow to the back with blunt objects. When hitting along
spine bruises are most often observed and
fractures of the posterior rib sections, whereas when struck across
spine picture is reversed. Similar effects cause
impact shock wave.

• Falls from a height. In this case, we can talk about falls
from a low height to the back, and landing on the feet when jumping from
height (the so-called spinal compression injury). In the second case
the risk of severe damage is higher because the compression
injury requires more thorough diagnosis. No less dangerous and
fall on your back flat.

• Violation of the technique of sports exercises. In this
In this case, it is not bruises that are more likely to occur, but sprains.

• T.K. bruises “plunger”. Occurs when hitting his head on a solid
bottom surface of a shallow reservoir. Accompanied by dangerous
injuries, including bruises of the cervical spine
moderate and high severity, fractures and dislocations

In all cases, a back injury may be a single injury, or
be collateral damage.

At risk, according to medical statistics,

• Women of any age (due to anatomical features
skeleton structures).

• Athletes (especially dangerous in terms of injury contact, water,
extreme sports).

• Drivers of passenger vehicles.

• Persons whose professional activities are associated with high
level of physical activity.

Back injury: symptoms

Symptoms in case of back injuries are pronounced. Intensity as well
also the nature of the manifestations depend on two factors:

• Localization of injury.

• The extent of injury.

Nevertheless, it is possible to isolate the symptoms, which in one way or another
will be present necessarily, regardless of location and strength
bruised back. These manifestations include:

Болевой синдром. Pain intensity
syndrome depends not so much on the degree as on the localization
injuries. The most painful injuries of the cervical spine, and
also ribs. In all other cases, the strength of the pain can be
different. The pains are dull aching in nature. In some cases, may
to be burning Often, pain radiates along the entire vertebral
pillar. If the ribs are damaged, pain spreads to the area.

Отечность места ушиба. Edemas are not formed.
immediately and several hours after injury (on average,
It takes from 2 to 12 hours). Puffiness occurs due to congestion
fluid in the area of ​​damaged tissues.

Развитие гематомы. When a back injury occurs
destruction of surrounding blood vessels (capillaries). Blood from
vessels coming out in the extracellular space of the skin layers.

In addition to the symptoms described, there are local manifestations. They
play an important role in the diagnosis and contribute to the formulation of the correct

With bruises of the cervical spine
a picture of acquired neurological deficit develops,
reduced motor activity of the upper and lower extremities.

Symptoms include:

• Humming in the ears (tinnitus).

• Visual disturbances (flickering in the eyes of the photopsy flies,
increase in the number of floating haze, loss or contraction
visual fields).

• Lack of coordination, uncertain walk.

• Decreased motor activity of the arms and legs until development
paresis or paralysis.

Somewhat less common:

• Respiratory failure.

• Impaired reaction of pupils to light.

Most neurological symptoms are due to compression.
the basilar and vertebral arteries that feed the brain (primarily
the occipital lobe and cerebellum are affected).

Back injury in the thoracic spine
accompanied by:

• Violations of the motor activity of the hands.

• Numbness of the upper limbs.

• Incontinence of feces and urine (rarely).

• Decreased sex drive.

In case of damage to the lumbosacral
spine to the forefront:

• Violations of the excretory system.

• Reduced motor activity of the lower extremities.

In all three cases we are talking about extremely dangerous injury.

For bruises in the posterior ribs, the main symptom is
intense pain. In addition to pain, problems develop with
breathing, which is often also caused by pain, forcing
patient to restrain a normal breath.

Back injury: diagnosis

Diagnosing back injuries is not an easy task.
The doctor has several tasks at once:

First, accurately determine the location of the injury (pain – unreliable
diagnostic sign, it may be located far from the place

Second, exclude the presence of more serious injuries to the ribs and
spine and lungs (fractures of the ribs are often fragments
bones damage lung tissue).

The standard diagnostics strategy consists of several

1) The first is a survey of the patient (history taking).
The doctor specifies his points of interest regarding the patient’s condition,
circumstances of injury, etc.

2) Врач производит осмотр места damage. At this stage
it is important to determine the presence of deformities, the presence and size of the edema and

3) In the next step, the specialist produces palpation.
damaged places and conducts a series of functional tests (for
assessment of tendon reflexes, sensitivity of the skin over
местом bruise).

After conducting primary diagnostic measures, the doctor may
establish a preliminary diagnosis. The following steps are
confirmation of the findings of a specialist and the exclusion of more severe

4) Radiography of the spine, chest in two projections.
Allows you to visually assess the condition of the bone structures and eliminate
partial or complete fractures of the vertebrae and ribs.

5) Magnetic resonance imaging (MRI) – designed for
fine evaluation of the soft tissues of the back, organs of the chest cavity,
blood vessels. Especially important for examining the condition
intervertebral discs, spinal cord.

6) Computed tomography (CT) – assigned as
alternatives to x-rays or in combination with it. Intended for
fine assessment of bone structures.

In rare cases, lumbar puncture is prescribed (to exclude
the presence of blood in the cerebrospinal fluid).

Back injuries, regardless of location and severity taken
considered potentially dangerous injuries, because the diagnosis
fit in a complex. Diagnosis and treatment of back injuries

  • Surgeon (neurosurgeon).

  • Neurologist (neuropathologist).

  • Orthopedist.

  • In case of damage to the lungs – pulmonologist.

Back injury: treatment

Tactics of treatment of uncomplicated bruise of the back, as well as soft bruise
the tissues of the back (muscles) is to relieve pain. For
these purposes are used nonsteroidal anti-inflammatory
drugs in the form of ointments (Ketorol, Diclofenac) and
analgesic drugs (Baralgin and others). In addition, it is prescribed
observance of the sparing mode of physical activity.

Much more difficult is the case with complicated bruises and bruises.
spine and ribs. In this случае помимо противовоспалительных
and pain medications are prescribed hormones. They all serve
goals to remove pain, swelling, inflammation.

Also, “complex” bruises require mandatory course
rehabilitation. After the end of drug treatment with
stabilization condition is assigned to physiotherapy (magnet and
electrophoresis) and exercise therapy.

Thus, the contusion of the back is a collective concept and exists
it is for convenience only. In most cases we are talking about
relatively harmless muscle damage, but exclude more
severe injuries cannot be done until specialized
diagnostic activities. In all cases, make a diagnosis
It is not possible on your own, a visit to the doctor is necessary.

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