Doctor, I had an accident in 2014, after taking x-ray, I got l1 compression. After taking 2 months bed rest, it got reduced. Again, I got pain for 3 to 4 times but it got reduced. Recently, the pain has coming from two years and it has not reduced. Lower back pain and middle of the shoulders pain. I took whole spine mri scan in september. Recently I fell in the bathroom one month back and since then my lower back is getting more pain, both my legs have numbness. A doctor said again take lumbosacral mri but I have doubt about it can I take lumbosacral mri or drugs lumbar mri. Thank you doctor.

Dr. Julie Mercy J DavidPhysiotherapist26yrs exp

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Physical examination a thorough physical examination reveals much about the patient's health and general fitness. The physical part of the exam includes a review of the patient's medical and family history. Often laboratory tests such as complete blood count and urinalysis are ordered. The physical exam may include: ?palpation (exam by touch) determines spinal abnormalities, areas of tenderness, and muscle spasm. ?range of motion measures the degree to which a patient can perform movement of flexion, extension, lateral bending, and spinal rotation. ?a neurologic evaluation assesses the patient's symptoms including pain, numbness, paresthesias (e.g. Tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes. Particular attention may be given to the extremities. Either a ct scan or mri study may be required if there is evidence of neurologic dysfunction. Physical therapy which teaches the patient to strengthen the paravertebral and abdominal muscles which lend support to the spine. General exercises which help build flexibility, increase range of motion and strength. A corset or a brace could be used to provide support; cervical collars may be used to alleviate pain by restricting movement. Hot or cold packs on the affected area, ultrasound and electric stimulation are some of the other treatments which are used. Management of acute symptoms rest and support- with acute joint symptoms, a lumbar corset may be helpful to provide rest to inflamed facet joints. When acute symptoms decrease, discontinue corset by gradually increasing the time without the corset. Often the most comfortable position is flexion, esp. If there are neurologic signs due to decrease in the foraminal space from joint swelling or osteophytes. Education of posture- head, neck and shoulders should be supported by the back rest of chair with a small pillow in the lumbar spine, the feet supported and the arm resting on arm rests or on a pillow in the lap. Modalities- hot or cold packs on the affected area, ultrasound and electric stimulation are some of the other treatments which are used to decrease pain and reduce muscle spasm. Relaxation- by soft tissue techniques. Teach self relaxationtechniques, e.g like deep breathing exercises and physiological relaxation (laura mitchell method) and hydrotherapy. Traction- gentle intermittent joint distraction and gliding techniques may inhibit painful muscle responses and provide synovial fluid movement within the joint for healing. Gentle rom within the limits of pain. Management of subacute and chronic phase increase rom- free active exercises of lumbar spine. Pelvic tilting forward, backward in crook lying, quadriped, sitting and standing. Mobilization- restoration of intersegmental mobility by accessory pressure enables the patient to regain full functional painfree movement. Stretching exercises. Strengthening exercises.Posture correction.  

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