Relative mild car accident-i have been hit by a car on the pedestrian walk and ended up in the hospital with back pain. They have done a radiography and ct on my spine, resulting in no trauma-related damages to the spine. They let me go home, and recommended I will take dexamethasone once a day for five days, and doreta as a painkiller, but I figured I should not take such a strong painkiller unless the pain is really bad, which it was not, it was manageable with just paracetamol. My question is, why did the doctor prescribe the dexamethasone? It is a pretty serious medication, which made me hiccup the whole day when I took it, and also gave me insomnia.

Dr. Dev Anand RamanathanPhysiotherapist19yrs exp

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Regards Lybrate user. Appreciate your detailed note & observation, as well as your query. To answer your query, road traffic accidents have the potential to injure any structure in the body depending on the mechanism of the injury. It is often difficult for the clinicians to find out which exact issues were affected, immediately after the injury, especially if the injury is subtle (not much of prominent symptoms). Major injuries like fractures or joint sprains or dislocations could be easily identified. Radiology reports may sometimes not show subtle structural damages & may necessitate the clinician to follow a sequence of tests to find out exact disorder (s), if symptoms persist. As you had mentioned back pain, it could range from a mild spasm of the back muscles that might have occurred to protect your back when the sudden injury occurred. However, sometimes (hypothetically & not necessarily) the spasm could mask a ligament or capsular damage of spinal joints too, which may not be found out on the same day of examination. So the role of the clinician demands a broad thought to anticipate & address multiple concerns, during the treatment. As a physiotherapist, it is beyond my scope to answer "why did the doctor prescribe dexamethasone? However, logically reasoning, the medication would potentially control inflammation that could occur from the injury. Medications have effects & side effects as well. If side effects persist, it is recommended to consult a physician.  

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