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Arthritis (Expert Forum)
long-term problems after a fall
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
long-term problems after a fall
by PenguinPelvis, Jun 05, 2004 12:00AM
In November 1998, I fell hard onto a concrete ledge, when stepping down into a shower, falling onto my left buttock. I was 6 weeks post-partum and had recovered from symphysis pubis dysfunction which occurred three to four days after coming out of hospital following my daughter's birth. No pelvic problems during pregnancy or birth, however suffered with venous congestion in lower legs in last 4 months of pregnancy
After the fall, suffered throbbing in the pubic bone (which I didn't have during SPD), pain in the left buttock which bruised in a straight line (in line with the ledge that I fell on).
Still suffering pain in pubic bone, low back pain, clicking and grating in pubic bone and lower back, difficulty standing for long time and turning over in bed, mobility problems etc. and I still have constant pain/discomfort on site of fall after all 5 1/2 years.
If I have a slight trip or a jolt, or more recently, three times when I have had to lay completely flat for x-rays/MRI/CT scan, feel a click "underneath" or in lower backthen lose feeling in both feet moving gradually up my legs. They become ice-cold and I can track it moving up my legs. Although I can stand, I am unable to lift my feet to walk. In effect become "frozen", which usually lasts about 4-6 hours, when feeling gradually returns. I know when I am about to become mobile as I can start to feel that my bladder is full.
Most recently I was discharged by an Orthopaedic Consultant here in the UK when this had happened. He sent me for a CT scan on my skull (I was there about my pelvis and back!) and I became immobilised after laying flat. The consultant could offer no explanation as to why this happens, indeed was not interested.
I do not feel that I have been taken seriously and in fact have been made to feel that this is psychological in origin. I think I would have to be some sort of magician to imagine the coldness moving up my legs and not being able to walk!
This has happened at least 3 times now when I have been in a hospital environment however all they do is pack me into the car and send me home!
Lots of investigations have taken place but reveal very little compared to the symptoms I experience.
Various phrases used include:
"possible slight physiolgical hypertrophy on the upper surface of the pubic symphysis but not abnormal"
"some fact joint changes noted in the lower lumbar spine"
"mild myalgia paraesthetica on left side"
"bone scan showed some increased uptake over the SI joints of the back"
I have had to change my way of life completely and had to leave a job I loved as it involved lifting, carrying and a lot of getting up and down from my chair. It has caused marriage difficulties and I have no sex life and I feel I have lost out on my children's early years because of the difficulties this causes.
I feel a little let down by the medical community here in the UK.
Any comments and help would be gratefully received.
After the fall, suffered throbbing in the pubic bone (which I didn't have during SPD), pain in the left buttock which bruised in a straight line (in line with the ledge that I fell on).
Still suffering pain in pubic bone, low back pain, clicking and grating in pubic bone and lower back, difficulty standing for long time and turning over in bed, mobility problems etc. and I still have constant pain/discomfort on site of fall after all 5 1/2 years.
If I have a slight trip or a jolt, or more recently, three times when I have had to lay completely flat for x-rays/MRI/CT scan, feel a click "underneath" or in lower backthen lose feeling in both feet moving gradually up my legs. They become ice-cold and I can track it moving up my legs. Although I can stand, I am unable to lift my feet to walk. In effect become "frozen", which usually lasts about 4-6 hours, when feeling gradually returns. I know when I am about to become mobile as I can start to feel that my bladder is full.
Most recently I was discharged by an Orthopaedic Consultant here in the UK when this had happened. He sent me for a CT scan on my skull (I was there about my pelvis and back!) and I became immobilised after laying flat. The consultant could offer no explanation as to why this happens, indeed was not interested.
I do not feel that I have been taken seriously and in fact have been made to feel that this is psychological in origin. I think I would have to be some sort of magician to imagine the coldness moving up my legs and not being able to walk!
This has happened at least 3 times now when I have been in a hospital environment however all they do is pack me into the car and send me home!
Lots of investigations have taken place but reveal very little compared to the symptoms I experience.
Various phrases used include:
"possible slight physiolgical hypertrophy on the upper surface of the pubic symphysis but not abnormal"
"some fact joint changes noted in the lower lumbar spine"
"mild myalgia paraesthetica on left side"
"bone scan showed some increased uptake over the SI joints of the back"
I have had to change my way of life completely and had to leave a job I loved as it involved lifting, carrying and a lot of getting up and down from my chair. It has caused marriage difficulties and I have no sex life and I feel I have lost out on my children's early years because of the difficulties this causes.
I feel a little let down by the medical community here in the UK.
Any comments and help would be gratefully received.
Doctor's Answer
by Kevin Pho, MD, Jun 07, 2004 12:00AM
, Jun 07, 2004 12:00AM
It seems like many tests have already been performed, including MRI, CT scan and bone scan without a clear diagnosis. The bone scan shows increased uptake of the SI joints in the back - which can be caused by the trauma itself.
You can always consider another orthopedic opinion - but in light of negative testing, it may not be helpful. You can also consider a referral to a rheumatologist - who can do various tests to evaluate for a rheumatological cause (i.e. for ankylosing spondylitis).
Tests to consider would be an HLA-B27 level, rheumatoid factor, CRP, ESR, ANA level and blood count. These tests can be discussed with your personal rheumatologist.
If everything is negative, you can consider a referral to a physiatrist (rehabilitation specialist) who can help manage the discomfort.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
You can always consider another orthopedic opinion - but in light of negative testing, it may not be helpful. You can also consider a referral to a rheumatologist - who can do various tests to evaluate for a rheumatological cause (i.e. for ankylosing spondylitis).
Tests to consider would be an HLA-B27 level, rheumatoid factor, CRP, ESR, ANA level and blood count. These tests can be discussed with your personal rheumatologist.
If everything is negative, you can consider a referral to a physiatrist (rehabilitation specialist) who can help manage the discomfort.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
www.4life.com
www.transferfactor.com
If you want more detail about TF email me at
***@****
and I will send more information