Back contusion

A back bruise is one of the most dangerous injuries, since there is little soft tissue in the back area that takes the blow. The spine is most often subject to bruises, and the severity of the injury depends on which area of the spine is damaged.

A back injury can be divided into five zones - injury to the cervical, thoracic, lumbar, sacral and coccygeal regions. The nature of the injury can also vary in severity - from a simple, minor injury to a concussion and a fracture of the vertebrae.

The spinal cord after injury can be completely restored in case of mild damage, or partial or complete disruption of its functions is possible.

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What causes a back bruise?

• Mechanical impact from outside (by an object, blast wave, etc.);
• A typical “diver’s” injury is a blow to the head on the bottom of a body of water followed by a cervical injury, or a blow to the flat of the back;
• Automobile, transport accidents;
• Fall - injury from falling on the back or landing on the feet (compression injury of the spinal column).

What are the symptoms of a back injury?

Symptoms of a back injury depend on the severity of the injury and may include the following:

Simple back injury:

• Pain at the site of injury;
• Swelling, bruising or hematoma at the site of the injury;
• Pain spreading along the spine, down the back.

Back contusion accompanied by trauma to the cervical vertebrae:

• Respiratory dysfunction;
• Muscle paresis, impaired sensitivity, decreased muscle tone;
• Muscle spasm may occur due to damage to the nerve endings of the spinal cord (spastic tension);
• Paralysis.

Back contusion that injures the thoracic region:

• Loss of sensitivity in the limbs;
• Impaired coordination of limb movements;
• Localized pain in the sternum area, radiating to the left, to the heart area;
• Impaired respiratory function, painful sensations when inhaling and exhaling.

Back contusion with damage to the lumbar region:

• Paresis of the lower limbs, up to paralysis;
• Loss of sensation in the legs;
• Decreased all reflexes;
• Urinary retention (incontinence);
• Erectile dysfunction.

How is a back injury classified?

Back contusions can be classified by severity, depth of injury and type:

• Back contusion without spinal cord injury;
• Back contusion accompanied by spinal cord injury;
• Back contusion with damage to the skin and soft tissues;
• Back contusion without penetrating wounds;
• Simple back bruise;
• Back contusion with dislocation of vertebrae;
• Back contusion with fractured vertebrae.

Why is a back injury dangerous?

A back contusion should be differentiated by its severity, preferably immediately after the injury. Even with weak clinical manifestations, an X-ray is necessary to exclude possible serious consequences. These include remote neurological manifestations that sometimes do not manifest themselves in the first weeks after the injury. This is a decrease in muscle tone (paresis), sudden situations of paralysis of the limbs, which can be transient and recurrent. Remote spastic manifestations, loss of sensitivity and periodic pain in the spine are also often observed. Any injury to the soft tissues surrounding the spinal column is accompanied by bruises of the bone structure, which is filled with nerve endings. Also, a spinal injury, even the most minor, often leads to instability of the spinal column and, as a result, to compression deformation.

How is a back injury diagnosed?

In traumatology, it is believed that any mechanical impact on the back can be potentially dangerous for the spine. Therefore, in addition to a visual examination, anamnesis, and reflex testing, an X-ray (spondylography) is mandatory, and possibly CT (computer tomography). Differential diagnosis is made by excluding the risks of pathological injuries.

What to do if you have a back injury?

If the symptoms determine that the bruise is minor, the algorithm of actions is similar to standard measures for bruises:

• Immobilization – ensure immobility with the exclusion of axial load;
• Moderately tight bandage, fixation of the injury site;
• Apply cold during the first 24 hours, periodically changing the compresses to avoid heating;
• Monitoring the dynamics, reactions and condition of the victim.

A back injury may not show serious symptoms on the first day, so you should be extremely careful, avoid stress, and preferably maintain a horizontal position for a week. At the slightest threatening signs listed above, you should seek help from a traumatologist.