People come to the Doctor’s office because they have concerns that they caused a major low back problem with a minor traumatic event. Luckily, the research shows that Minor Trauma does not lead to a permanent change to the spine.
The study was performed at Stanford University by Carragee et al. There were 200 volunteers. The average age was 39 years. 27% were smokers. 76% had disk degeneration findings on MRI. 13% had moderate to servere spinal stenosis. All had no know prior history of back pain.
Major Injuries were defined as back pain episodes associated with high-energy trauma that resulted in visceral injury (bowels, bladder, etc), long bone fractures, or pelvic or spine fracture or dislocation.
Minor Injuries, or Minor Trauma was injuries that report a pain scale of >2/10, lasting more than 48 hours, but not meeting the criterion for a Major injury, outlined above. Minor Trauma examples included lifting injuries, falls, sports injuries, and road traffic accidents that did not meet the Major Injury catagory.
The study identified people who were at risk for degenerative lumbar disk disease, but had no history of low back pain episodes. All study volunteers were then examined with x-rays, MRI’s and physical examinations. All volunteers were followed every six months to see if these people who were at risk for have lumbar disk disease would have a significant change in there spine with minor trauma. After the traumatic episode, the spines were again examined, and MRI’ed.
By definition, a serious back pain episode was defined as having a pain scale >6/10 lasting at least a week with disability from the usual occupation.
The results showed minor trauma was NOT associated with a significant adverse Low back pain event. For each 6 months in the study, the volunteers demonstrated a 2.1% risk of developing a serious low back pain episode without any trauma. After a minor trauma, 2.4% developed a serious low back pain episode.
Followup MRI’s evaluating new serious low back pain rarely demonstrated any significant structural changes in the MRI.
The study concluded that Minor Trauma does not appear to increase the risk of serious low back pain episodes or disability. Over all good news! Even with an episode of increased back pain, minor trauma does not cause a significant structural change to a spine.
- Carragee E, Alamin T, Cheng I, Franklin T, Hurwitz E. Does minor trauma cause serious low back illness? Spine (Phila Pa 1976). 2006 Dec 1;31(25):2942-9. PubMed PMID: 17139225