Last weekend I fell on a sport climb just above the first bolt. I swung sideways into my belayer who was slightly lifted off the ground. The side of my lower back impacted my belayer's knee HARD. His knee hit me so hard I went into shock and nearly blacked out. I eventually was able to be carried to the car. I was put into bed and thought I'd sleep it off. It was a LONG night. The next morning I went to the ER. X-rays were fine and it's not a spinal injury..good news. They discharged me with a heavy prescription of painkillers.

It's only been two days, but my movement is still severely limited. I can't bend over or from side to side at all. Any torque movement feels like a knife in the localized area from the impact.

I'm worried. Anybody else deal with something like this?

Back injuries just take a long time to heal.... sucks, but there are no real shortcuts. The tendons, ligaments and muscles you likely tore/pulled/bruised will probably hurt for a few weeks, and you may not feel "normal" for months. The good news is that even disk problems usually resolve themselves on their own without surgical intervention. I fell 30 feet from a roof and broke 2 vertebrae at the end of November and have just gotten back into climbing in the past 2 weeks. There's stuff in my back and pelvis that is still not aligned the way it used to be, and I've been hearing this could take a year or so... as dangerous as my spine injuries were, the most intense pain has been from the tendon and ligament damage around it, and I'm still in pain, though not nearly to the degree I was. I think patience is key- you'll want to get the blood flowing in the area you hurt, but not overdo it for a good long while.

Apply heat to the area that was injured. You want the blood to flow to the injured area. You dont have to get anything special. I`d also recommend taking some Aleve.

How good was the hospital? My husband had a bad snowboarding fall. He eventually stood back up and snowboarded down to the medical services building. They didn't want to call an ambulance as he was standing, but he pressed the issue and they eventually did.

At this point, the shock had worn off and he was in so much pain he was having trouble breathing.

We go to the ER, they do the x-rays and say he is fine, give him strong meds, and tell me to do the hot/cold compress thing.

After a few days with no real improvement, we go back to a good hospital we trust, and new x-rays, the attending said they couldn't even see the ones the other hospital used, showed FIVE FRACTURED VERTEBRAE!

The idiots at hospital one didn't take the time to get a clear x-ray and let him actually walk around with a broken back. He was in a full body brace for months.

If it is not a doctor you trust, and the pain is sticking around, get another opinion would be my suggestion.

Did they do a physical exam for a herniated disk? If not, might want to get that check out, as an X-ray will not show it. Until you know it is not a disk injury, do not use heat. Just ice and anti-inflammatories.

It sounds like you may have broken vertebrate. The bad news (as if that isn't bad enough) is that there really isn't any treatment...they're probably not going to do surgery unless there's a risk of spinal cord damage, so you're just going to be left with trying to manage the pain and immobilizing for 3-4 months.

Is there a chance you injured a kidney or something like that?

Yes - there are physical exams for a herniated disc.
A clinically significant herniated disc will cause either radicular pain in an extremity or radiculopathy ( weakness or loss of tendon reflexes or loss of sensation) in the distribution of the nerve root the herniation has affected. An astute orthopedic surgeon or neurologist or physiatrist can usually accurately diagnose the location of the herniated disc based on a physical exam without resorting to an $$$ MRI scan. An MRI scan is needed only in an operation is being considered, which as others have noted, is usually not necessary as most herniated discs resolve given enough time with no specific therapy.
Pain localized only in the back and with no radiation to the leg is almost aslways due to localized trauma to the back muscle, tendon and/or vertebrae.

As others mentioned your pain is probably coming from your back muscles and not a bone. I fractured my lower back a few years ago and stretching really helped. Try stretching out your hamstrings and lying down on the floor as if you were going to do a crunch and lowering your legs side to side. Also make sure that the drugs they gave you are anti-inflammatory. If your pain doesn't go down in the next week or so I would think about getting an mri. Back pains the worst hope everything turns out alright.

Thanks for all the info, I appreciate it. I guess I'll wait a week and get a second opinion if there's no improvement. I just woke up and I still have the same pain. Time for more hydrocodone and anti-inflammatories.

The only thing the doctor did was test my urine for blood, x-ray my back and test all my reflexes. Everything was fine.

To make matters more complex..I'm an American living in Australia, but I'm moving back to the States two weeks from today. I have full health cover here, but I'll be screwed back home. I also had plans to go bouldering in the Virgin Islands on June 2nd then off to Flagstaff in late June. I'll keep my fingers crossed.

I should've chosen a less competent belayer who would've just dropped me. Sore ankles would've been much easier to deal with.


Thanks again.

Have you considered seeing a Chiropractor regarding this injury? Last year I feel on a slab climb, slid over a bulge, and landed on a ledge below. Hitting my lower back directly above my hip to the left of my spine. I couldn't work or do much for a week. I made 3 Chiropractic appointments within 2 weeks, and noticed results immediately. Muscle stimulation, localized massage therapy, and skeletal adjustments made a huge difference in my recovery time.

Since you are currently in Australia, you might consider going to a physiotherapist - they can perform a good physical exam, and should be able to rule out any red flags (such as fracture). The Aussie PTs have a great reputation worldwide for being excellent manual therapists. There are so many factors that need to be considered, and honestly, not every back injury is the same. So, while stretching hamstrings might have worked great for one person, for another that may only seriously aggravate an irritated nerve root. I would be cautious about taking specific advice about what to do from a web forum.

I would guess that it might be unlikely to have access to MRI in Aus as freely as you would in the US (I may be wrong about that - but I know from living in Canada that diagnostic imaging was not nearly as widely used). That can be a good thing as the clinicians might be much more proficient at their physical examination if they do not rely as heavily on imaging.

Good luck!

A study was done several years ago in which people with NO symptoms of back or leg pain had an MRI scan of their lumbar spine. A significant number ( I have forgotten what percentage exactly but seem to remember approximately 30%) of these scans done on people with no back/leg pain showed a herniated disc. ( The study was published in the New England Journal of Medicine sometime in the 90's. ) It is clear that a herniated disc seen on a MRI scan may be asymptomatic. Thus the clinical exam of the patient must correlate with the MRI scan. For example, a
herniated disc on an MRI scan in someone who has no back-leg pain is not significant. A clinically significant herniated disc presses on a nerve root in the foramen which causes pain in the nerve root distribution. Someone with back pain ( from trauma or other reasons) but no radicular pain or evidence of radiculopathy can have an MRI scan done which shows a herniated disc with no compression of the nerve root - this finding of a herniated disc is simply coincidence.
This does not mean that only people with radicular symnptom/signs should have back MRI scans - other causes of back pain such as tumors, infections cand be diagnosed with the scan.

Just my 2 cents, but if you've got the time and can get in to see a physio while you're still there do that. If the ER doc cleared you and you don't have any "serious", immediate problems the physio will be able to assess how well you're able to move and do more qualitative evaluation that emergency medicine isn't really interested in.

Also like TW mentioned, there is a poor correlation between disc derangement as show on MR and back pain. You can have significant back pain and have a totally clean MR. And really the only time that disc injury comes into the picture for treatment is if there is clear evidence of neurological impairment due to disc herniation... if so then surgery, if not (regardless of what it is) then any sane ortho is going to recommend at least some conservative care (manual therapy of some kind) to see how the injury responds.

Good luck w/ getting this sorted out. And since no one else has mentioned it, one of the easiest and best things you can do is simply go for a walk. Don't think hiking, more like wandering around window shopping, it's a lot better than sitting or lying around to keep your back happy while it heals up.
BA

You would not believe how many significant injuries the ER has "cleared" me for. Experience has taught me to always follow up with a Dr. who specializes in the body part/type of injury and can spend a bit of time with you.

My point exactly, all the ER cares about is whether or not you're going to die in the next 24hrs. He hasn't died, so go see someone who'll do a more qualitative assessment of how well things are functioning.

I have had similar back injuries, but they weren't caused by someone kneeing my back. Instead an overweight luggage in the overhead bin on a certain flight from the old continent fell on me and I was paralyzed for a day in the hospital.

During my recovery period, I had to ice my back and do very light stretching. Since I had a lower back injury, doing light stretch workouts for the muscles in the hip and butt area helped lessening the pain and for quicker recovery.

Since then, I have the occasional a stiff lower back. The muscles there tends to stay tight, so I regularly do PT and stretching. Because the muscles stay tight, I've been careful making sudden moves when I start to feel the tightness without proper stretching or the next morning I can't get out of bed...even roll off the bed.

It took me about 3 months before I could walk without pain. Then another 3 months to feel confident enough to get back into some light climbing activity. Then another 6 months before I felt like I can exert myself without injuring my back.

Good luck!