Should I Visit the Emergency Department?
I’m a 37-year-old woman currently on a daily regimen of 100 mg of fluoxetine to manage my borderline personality disorder (BPD). I also take tramadol as needed to alleviate back pain. Earlier this year, I underwent an MRI to eliminate the possibility of Cauda Equina Syndrome after experiencing severe back pain coupled with numbness and weakness in my legs, as well as some urinary incontinence. During a follow-up with my spine specialist, I received the assessment that there were degenerative alterations in my cervical spine due to a disc bulge; however, there was no evidence of neural impingement in the sagittal images. The axial view showed some degree of narrowing around my spinal cord, though it remained uncompressed and exhibited no signal changes. In the lumbar region, there were degenerative changes observed at L5-S1, along with bulging and alterations in the facet joints at L4-5 and L5-S1. There is some foraminal narrowing surrounding the L5 nerve root on both sides, although it’s not compressing the nerve. Causative factors for CES appeared to be ruled out. I have benefitted from physiotherapy, successfully lost six stone, and have been managing relatively well. There are times, however, when I overdo it and experience heightened pain, at which point I have some effective pain relief on hand. Recently, I encountered an incident at work that left me reconsidering my situation. My foot unexpectedly caught on a carpet while I was walking, causing me to jolt forward violently. This triggered sharp pain in my lower back that prompted tears and made mobility challenging. After resting for an hour, I found myself unable to walk home due to recurring numbness and weakness in my legs, accompanied by a tingling sensation in my arms. Now that I’m back home, I’m uncertain whether I should seek treatment at the emergency department for my back given the potential risk of developing nerve compression following today’s mishap. I’m hesitant to take up time there unnecessarily, but I also worry about the possibility of further injury occurring as a result of the incident.
Answers (1)
3/26/2025, 3:20:47 PM
OpenHealth AI
Based on your description, it’s very understandable to feel uncertain about whether to visit the emergency department (ED) after your recent fall and the subsequent symptoms you experienced. Here’s a structured response to help you evaluate your situation:
Key Points:
- Recent Fall and Symptoms: The jolt from your fall has led to sharp pain in your lower back, difficulty walking, and recurring numbness and weakness in your legs, along with tingling in your arms.
- Concerns About Nerve Compression: Given your previous issues with back pain and the potential for nerve-related complications, it’s crucial to assess the seriousness of your current symptoms.
Explanation:
Your symptoms of sharp pain, numbness, and weakness after experiencing a fall are concerning, especially considering your medical history of degenerative spinal changes. These symptoms could indicate nerve involvement, which can be serious and may require immediate evaluation.
Next Steps:
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Immediate Evaluation: Given that you are experiencing new and worsening neurological symptoms (numbness and weakness in your legs and tingling in your arms), it is prudent to seek care in the emergency department. Do not delay, especially since these symptoms can indicate potential nerve compression or irritation, even if prior imaging showed no direct compression.
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Monitor Symptoms: While heading to the ED, pay attention to any worsening of symptoms, such as increased pain, difficulty moving your legs or arms, or any changes in bowel or bladder function. Document these changes as they may be helpful for the healthcare team.
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Transportation: If ambulatory, consider having someone accompany you for safety, or use an ambulance service if you're unable to move effectively.
While it's understandable to hesitate before seeking emergency care, ensuring your safety and health is the top priority. You deserve to have your symptoms properly assessed and to gain clarity on your condition. Please take this step seriously for your well-being.
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