It is a common scenario, whether sitting or standing, when we need to bend down or forward, and suddenly there is a sharp sting on one side of the low back. The sensation can cause the knees to buckle. So we stand up slowly to assess the condition and realize it is almost impossible to stand completely straight and even harder to bend forward. So we sit back down to try and relieve the pressure. It helps a little, but the injury has caused the back muscles to spasm and get tighter and tighter. When we try to get up, there can be one big or several mild to severe electrical shock sensations traveling through the back. A severely over-rotated vertebrae could be the cause and require chiropractic care, massage, and/or decompression therapy. 

Over Rotated Vertebrae

The spinal column is made of 26 interconnected vertebrae. When in motion, each vertebra moves, and as the torso rotates, the spine must rotate as well. The spine can move in several ways, including:

• Bending
• Rounding forward.
• Extending or arching backward.
• Twisting
• Tilting sideways uses some of the same muscles when twisting.

Although the spine can move in various directions, there are limits to how far it can and should go. For example, when bending forward to lift an object, an individual can unknowingly over-extend and over-rotate vertebrae. This is where the risk of injury increases. A rotational injury of the spine occurs when the torso turns too far, and the spinal cord can’t handle it. This can stretch the ligaments in the spine to the point of snapping, causing the facet joints to dislocate. Ligament strains and facet dislocations are two of the most common rotational spine injuries.

Complications

An over-rotated vertebrae injury can also lead to complications that include.

Chronic Pain

• Spinal nerve damage can lead to chronic pain conditions.

Mobility Problems

• Mobility problems are common following an injury of the spine.
• This comes from damage to the nerves that innervate the legs, causing weakness and coordination problems.

Pressure Ulcers

• Numbness following a spine injury can cause individuals not to notice pressure ulcers developing.
• These can lead to infections and could require hospitalization.

Individuals accumulate tension and/or weakness in the oblique abdominal muscles and other trunk muscles that can lead to chronic tightness and weakness, affecting movement and decreasing the range of motion.

Chiropractic Treatment Plan

Depending on the time and severity of the injury, a personalized treatment plan may consist of the following:

• Wearing a back brace.
• Non-surgical decompression.
• Muscle stimulation.
• Soft tissue massage.
• Chiropractic mobilization to release the spasms and reset the spine.
• Rest

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Facet Syndrome Treatment

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References

Janssen, Michiel M A, et al. “Pre-existent vertebral rotation in the human spine is influenced by body position.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 19,10 (2010): 1728-34. doi:10.1007/s00586-010-1400-3

Kruger, Erwin A et al. “Comprehensive management of pressure ulcers in spinal cord injury: current concepts and future trends.” The Journal of spinal cord medicine vol. 36,6 (2013): 572-85. doi:10.1179/2045772313Y.0000000093

Passias, Peter G et al. “Segmental lumbar rotation in patients with discogenic low back pain during functional weight-bearing activities.” The Journal of bone and joint surgery. American volume vol. 93,1 (2011): 29-37. doi:10.2106/JBJS.I.01348

Shan, X., Ning, X., Chen, Z. et al. Low back pain development response to sustained trunk axial twisting. Eur Spine J 22, 1972–1978 (2013). doi.org/10.1007/s00586-013-2784-7