Expert: Dr. J. Shawn Leatherman - 9/16/2008

Question
I have had mid back pain for about 2 years now. I think I had this pain long before I gave birth to my son in March of 2006 but it wasn't as bad until Oct. of 2006 when I slipped and fell on our front porch and landed on my butt bone. Which frankly felt like someone took a sledge hammer to my lower back at the time. I didn't go and see a doctor or anything because I thought I just bruised my spine or something of that nature. So it took about a year for it to feel a little better but I still have pain today and everyday. I am 25 years old and I do not exercise. I do practice some yoga every once in a while and I do stretch before bed and in the morning if I remember. But nothing seems to help. I have gone and gotten massages but that is very temporary relief. Some days are okay and bearable and other days are just painful. I also have had horrible posture my whole life. I try to sit up straight in my car and at work at my desk and lately I have been trying to stand straight to help but my back isn't used to that so it hurts when I try to do that. I am pretty sure that my pore posture is the main cause of why this is happening but if you could please advise me on what you think my problem is or what I should do that would be great... Thank you for your time.. Angela

Answer
Dear Angela,

The fall you have described is a common injury mechanism for the low back and sacrum/coccyx, but does not usually cause pain higher up in the mid back.  It is possible that you could have experienced a compression fracture of the vertebra where the vertebral body actually crushes under the compressive force of falling.  

Although this is not a common fracture in healthy young women, I have seen it in a young patient of mine a few years back, she was 14 years of age.  Compression fractures are not like the fractures of long bones like in the legs, and often people don't even know that they fractured the vertebra until it is found on an incidental x-ray examination years later.  However, some of them can be pretty bad.  If you did sustain a compression fracture then, it probably has healed by now, but it is worth looking into further.  

Even if you did sustain a compression fracture and it has healed, the resultant structure of the spine will be changes, and rehab exercises will be helpful.  Most of them would consist of extension types of back exercises, and yes you should be concerned with your posture and try to improve it.  Maintaining an upright spinal presentation will decrease the gravitational and positional loads on the spine which should help to alleviate pain.

Find yourself a good local chiropractic physician and have them do an examination of the area of complaint as well as a postural assessment so that you can be properly educated on the correct exercises for stability and postural control.  Further have them take an x-ray of the lumbar and thoracic spine to rule out compression fracture and look at your standing spinal structure.  It is important to gain control over these issues while you are young before this progresses to a bigger or permanent issue...this has been going on long enough.  Often specific exercise protocols along with a few spinal adjustments will give you quick pain relief.  Realize that the exercise protocols will need to be continued until you can maintain proper posture and stability.

Good Luck Angela,

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net