Lumbar Compression Fracture: One cause of pelvic muscle pain

Lumbar Compression Fracture: One cause of pelvic muscle pain

The highly qualified biomechanics therapists at Bodyharmonix can alleviate your pain and provide effective rehabilitation for your lumbar compression fracture. The lumbar region of your spine has the 5 (occasionally 6!) vertebrae that are large and strong. Your lower back begins at the thoracolumbar junction, also known as the lumbar curve and ends at your sacrum. Muscles groups compensating for the dysfunctional lumbar region groups can result in sore muscles in the pelvis area.

lumbar-compression-fracture-spine-bodyharmonix-brunswick

image of spine and vertebrae

Causes of Lumbar Compression Fracture

Trauma of your lower back (e.g., a fall on the buttocks) can result in a lumbar compression fracture; wedge, flexion-distraction or burst fractures are common diagnoses. We know that a fracture usually occurs when your spine is bend with great force. When trauma affects neurophysiological functioning then the treatment plan is much more diverse. Including the pelvic area muscles which will be carrying more load, and will require additional functional training and manual therapies.

Spine, Posture, Muscle and Your Stability

Muscle groups that are largely responsible for postural stability attach to the vertebrae of the lumbar spine. Because of your lumbar spine you can walk upright. When posture changes due to trauma of the lumbar region normal curves of the spine also change. For example, the lumbar curve may decrease or increase in magnitude. Also, the surrounding soft tissue, muscles and joints must compensate for the postural load changes. This can lead to muscle tension of the pelvic girdle for example.

Pressure, Trauma, Fractures and Pain

When the lumbar vertebrae are compressed, at least one, sometimes more, are shortened. When the trauma is caused by high velocity force it is usually the posterior of the vertebrae that cracks from the pressure. A burst-type fracture can result in fragments of bone pressing on the spinal canal, incurring intense pain. The trauma can result in mild to severe pain at the time. Sometimes the pain may radiate to the pelvis and legs.  

Postural Assessments and Manual Therapy

Following healing, lumbar fractures tend to be tender near the area of trauma. The therapist at Bodyharmonix will manually palpitate the area around your injury (with great gentleness) to determine the site/s of pain and injury (these may not be in the same place). Part of your personalised postural assessment will require you to move in a variety of directions to help pinpoint the source of pain, and to identify areas of other muscle soreness and tenderness, if any. Active motion that mimics your daily functioning can also aid in evaluation of secondary symptoms. We will observe your range of motion (ROM) to see if it’s restricted and measure your restriction too. Your muscle strength will also be tested. And you will be asked to keep a Pain Diary to better tailor your training regime.

Muscles, Tendons, Cartilage and Musculoskeletal Biomechanics

Evaluative attention will also focus on the musculoskeletal structure of your hips and pelvis area, as the muscle groups, tendons, cartilage and joints of these regions contribute a lot to the biomechanics of your lumbar spine.

A key symptom our therapists look for in a lumbar compression fracture is midline back pain. It tends to be identifiable: with a single finger, in that you can point to or touch the area (i.e., axial pain); by non-radiating pain; and sensations of aching and stabbing that can be intense requiring extended periods of rest and immobility. Most people experiencing a compression fracture of the lumbar spine do not require surgery. The crack can heal with rest, rehabilitative functional training, pain alleviation medicine when necessary and at times a special brace to immobilise the spine. Rest and minimal movement can also aid with pain relief.

Functional Training and Rehabilitation

The rehabilitation process from traumatic lumbar fractures tends to be long and slow. You may need to be in rehabilitation therapy for several months, and a total recovery can take over 12 months in some cases. WE cannot begin rehabilitation with you though, until your specialist has confirmed that your lumbar spine compression fracture has stabilised.

After taking your complete medical history, and determining the site/s of pain and the intensity of your pain, management of your inflammation will begin. Manual therapies such as massage (Remedial and Swedish), dry needling and lymphatic draining will be used to move toxic wastes due to inflammation. These therapeutic techniques will also aid to alleviate the pain caused by tension and overcompensation of your muscles.

You can use gentle forms of traction provided by massage and complement them using ice or heat to decrease your pain symptoms. As your treatment program begins you’ll be asked to keep a Pain Diary to help track activities that aggravate or ease your pain. This diary will help you and your therapists get a better idea of your ROM functioning as well.

Physical Conditioning and Strengthening

The next stage of biomechanical therapy will focus on strengthening your lumbar spine through extensor exercises, abdominal and lumbopelvic conditioning, and taping (Papa, 2012). Forward flexion of the spine will be avoided as much as possible, and self-management training will target developing habits that adopt a neutral spinal position. Forward flexion will aggravate your condition when there are cracks in the posterior of the vertebrae. Enhancing your ROM through functional training will aid you in returning to daily activities that use these movements. The overall goal of your rehabilitation at Bodyharmonix will be to return your posture and stability to functional levels and increase your performance conditioning to avoid the risk of further injury. 

 

References:

Papa, J. A. (2012). Conservative management of a lumbar compression fracture in an osteoporotic patient:
            A case report. Journal of Canadian Chiropractic Association, 56(1), 29-39.

Sherman, A. L., & Razack, N. (2017). Lumbar compression fracture workup. Retrieved from,

http://emedicine.medscape.com/article/309615-overview

Charmayne Paul, Bodyharmonix Associate, of Psych and Stats Tutor ~ Chart your course to success~

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