Understanding Your Spinal Fractures
A comprehensive guide to your L1-L3 transverse process fractures, recovery expectations, and what lies ahead on your healing journey.
Your Medical Journey at a Glance
01
The Incident
November 28, 2025: Fall down stairs resulting in impact to lower back on sharp rock
02
Emergency Assessment
CT scan revealed mildly displaced fractures of left lateral processes at L1, L2, and L3
03
Current Status
Stable fractures with conservative management plan focused on pain control and gradual recovery
04
Looking Forward
Expected healing timeline of 4-8 weeks with physiotherapy and activity modification
What Are Transverse Processes?
Understanding the Anatomy
Think of your vertebrae like an airplane viewed from above. The thick, round part at the front is the vertebral body—the main weight-bearing column. The bony bump you can feel on your back is the spinous process (the tail of the plane).
The transverse processes are the two bony "wings" that stick out on the left and right sides of each vertebra. These wings serve as attachment points for muscles and ligaments but don't support your body weight.
Why This Matters
You've fractured three of these "wings" on your left side at L1, L2, and L3. The good news: these bones aren't responsible for supporting your body weight, nor do they protect the spinal cord.
This is why doctors call this a "stable fracture"—unlike a crushed vertebral body, this injury typically doesn't put your spinal cord at risk or require surgery to stabilize the spine.
Why Does It Hurt So Much?
Muscle Attachment Points
The transverse processes are major attachment points for your back and hip muscles, including the psoas muscle (which helps you lift your leg) and muscles that keep your back upright.
Constant Movement
Every time you move, twist, or even breathe deeply, those muscles pull on the broken fragments, causing pain and preventing healing.
Protective Spasms
Your large back muscles often go into protective spasm, tightening up like a rock. This muscle spasm is often more painful than the fracture itself.
The "Sharp Rock" Detail Matters
Direct Impact Injury
The emergency department report notes you hit your "left flank on a sharp rock." This crucial detail explains why your fractures are so specific to L1-L3 on the left side.
Transverse process fractures are often caused by a direct blow—like falling onto a hard edge or stone step. You didn't just twist your back; you took a direct impact to the bone.
Visible Signs
The report notes "erythema" (redness) and swelling on your left flank, confirming significant soft tissue trauma (bruising) on top of the broken bones.

Key Finding: The combination of direct trauma, visible bruising, and specific fracture pattern confirms this was a high-impact injury requiring careful management.
Understanding Your CT Scan Results
Alignment: Normal
Unremarkable alignment of the lumbar spine—your vertebrae are properly stacked and stable
Fractures: Three Levels
Mildly displaced fractures of the left lateral process of L1, L2, and L3—broken but not severely separated
Compression: None
No acute compression fracture—the main weight-bearing parts of your spine are intact
Spinal Canal: Clear
No significant spinal canal stenosis—adequate space for your spinal cord and nerves
The Mystery of Right Leg Pain
Why Does Moving My Right Leg Hurt My Left Fractures?
This is one of the most interesting findings in your physical exam. The report notes: "Pain worsens in the left flank with passive and active right hip flexion."
You might wonder: "Why does moving my right leg hurt my left fractures?"
The Cross-Bracing Effect
Your core works like a suspension bridge. When you lift your right leg, the muscles on your left side (specifically the Quadratus Lumborum and the Psoas) have to instantly contract to act as an anchor so your body doesn't tip over.
Since those left-side muscles are anchored to your broken transverse processes, that stabilizing contraction pulls directly on the fracture, causing pain.
Why Right Hip Flexion Strength Was Reduced

Clinical Finding: Your right hip flexion strength was rated "4 of 5" (slightly weak)—not because the leg is weak, but because your body stopped you from pushing harder to prevent the pain in your back.
This explains why your right hip flexion strength was rated "4 of 5" (slightly weak) in the emergency department—not because the leg is actually weak, but because your body instinctively stopped you from pushing harder to prevent the excruciating pain in your back.
This is a protective mechanism, not true weakness. As your fractures heal and pain decreases, this strength will return to normal.
The Straining Pain: Valsalva Maneuver
1
What Happens
The report mentions you had worsening pain when "straining to have a bowel movement"
2
The Mechanism
When you bear down, you increase pressure inside your abdomen, pushing outward against your spine and back muscles
3
The Result
This internal pressure causes the fracture sites to move slightly, triggering sharp pain

Action Item: You definitely want to avoid constipation. Pain medications and reduced activity will slow your digestion. Start taking a stool softener or increase fiber and water intake immediately to prevent the need to strain.
Kidney Concerns: Ruled Out
Your Concern Was Valid
You were rightly concerned about your kidneys ("renal injury"), as they sit right next to the L1-L3 vertebrae where your fractures occurred.
The Evidence
  • No hematuria: No blood in the urine
  • No abdominal distention: Your belly isn't swollen or hard, which would happen if there was internal bleeding
  • CT scan findings: While focused on bones, a significant kidney laceration or bleed usually shows up on the scan

The Verdict: The doctors effectively ruled out kidney injury through multiple lines of evidence. Your kidneys are safe.
Blood Pressure Spike Explained
155/96
Your ED Reading
Elevated compared to normal range
100%
Pain Response
Almost certainly due to acute pain
Your blood pressure was high (155/96) in the emergency department. Given your history of hypertension (controlled by medication), this spike is almost certainly a pain response.
Pain causes the body to release adrenaline, which tightens blood vessels and raises blood pressure. As your pain comes under control with medication and healing, this should settle down. However, it's worth monitoring, especially given your history of hypertension.
Summary of Your Current State
The Injury
Direct impact (sharp edge/rock) resulted in 3 broken "wings" on the spine and significant muscle bruising
The Pain
Purely mechanical—hurts when you sit up, sit down, or use your core to stabilize your legs
The Safety
Neurological function (sensation in legs) is normal, spinal cord is safe, kidneys are uninjured
The Timeline
Bones generally take 4-8 weeks to heal, but soft tissue pain may linger longer
The Additional Finding: L5-S1 Narrowing
What Was Found
At the L5-S1 level (lower down near your tailbone), you have "moderate right neural foraminal narrowing" and "severe left neural foraminal narrowing".
What This Means
The "neural foramen" is the bony tunnel where nerve roots exit your spine to travel down your legs. "Narrowing" (stenosis) means this tunnel has become tight due to age-related degenerative changes.
Current Impact
The report notes you are "neurologically intact" with "normal sensation" in your lower legs. This means that despite the "severe" narrowing, the nerve is currently functioning perfectly and is not being pinched.

Important: This is a pre-existing condition, not caused by your fall, but worth monitoring.
Understanding Neural Foraminal Narrowing
1
How It Develops
Age-related degenerative changes gradually narrow the bony tunnels where nerves exit the spine
2
Current Status
Despite severe narrowing on the left, your nerve is functioning normally with no symptoms
3
Future Risk
Less margin for error—swelling from your new fractures could potentially irritate this area
4
Watch For
Shooting pain, burning, or numbness traveling down your left leg would indicate nerve irritation
Why This Matters for Your Recovery
The Connection
Because the tunnel is already tight on the left side, you have less margin for error. The swelling from your new fractures (which are also on the left, though higher up at L1-L3) could potentially trickle down and irritate this area.
What to Watch For
If you start feeling shooting pain, burning, or numbness traveling down your left leg, it likely means this narrowed area is being aggravated by inflammation from your acute injuries.

Action Required: Report any new leg symptoms immediately to your healthcare provider. Early intervention can prevent complications.
Your Recovery Roadmap
Immediate Phase (Weeks 1-4)
Pain Management: Take Acetaminophen (1000 mg) regularly every 6-8 hours and Celecoxib (200 mg) twice daily to manage inflammation
Movement: Follow "activity as tolerated"—walk frequently but avoid movements that hurt, especially sitting upright for long periods
Recovery Phase (Weeks 4-8)
Physiotherapy: Start when pain is better managed—crucial for rebuilding strength in muscles that were bruised and strained
Gradual Progression: Slowly increase activity levels as pain permits
Long-Term Monitoring
Follow-up: Regular check-ins with Dr. Kotalik for symptom management
Warning Signs: Return immediately if you develop new neurological signs (leg weakness, numbness) or difficulty with bladder/bowel function
Pain Management Strategy
1
Acetaminophen
1000 mg every 6-8 hours, taken regularly (not just when pain is severe)
2
Celecoxib
200 mg twice daily as needed to reduce inflammation
3
Ice/Heat Therapy
Alternate as needed for comfort and muscle relaxation
4
Positioning
Find comfortable positions that minimize strain on fractured areas

Pro Tip: Taking pain medication regularly (around the clock) is more effective than waiting until pain becomes severe. Stay ahead of the pain curve.
Activity Guidelines: What to Do
Walking
Walk frequently—this is your best therapy. Start with short distances and gradually increase as tolerated.
Position Changes
Change positions regularly to prevent stiffness. Don't stay in one position too long.
Gentle Movement
Keep moving within your pain tolerance. Complete bed rest is not recommended as it weakens muscles.
Listen to Your Body
Let pain be your guide. If something hurts significantly, modify or stop that activity.
Activity Guidelines: What to Avoid
Prolonged Sitting
Avoid sitting upright for extended periods—this puts maximum strain on your fractures
Twisting Motions
Minimize twisting at the waist, which pulls on the fractured transverse processes
Heavy Lifting
No lifting anything heavy—this engages core muscles that attach to your fractures
Straining
Avoid straining during bowel movements—use stool softeners to prevent this
Sleeping Positions for Comfort
Best Positions
  • Side-lying: With a pillow between your knees to maintain spinal alignment
  • Semi-reclined: In a recliner or with pillows propping you up at 30-45 degrees
  • Fetal position: Curled slightly on your side with knees bent
Positions to Avoid
  • Flat on back: Can increase pressure on fractures
  • Stomach sleeping: Requires twisting neck and arching back

Sleep Tip: Use multiple pillows to support your body and maintain comfortable positions. Don't be afraid to experiment to find what works best for you.
Getting In and Out of Bed Safely
01
Log Roll Technique
Move your body as one unit—don't twist at the waist. Roll onto your side first.
02
Use Your Arms
Push up with your arms while swinging your legs off the bed simultaneously.
03
Sit at Edge
Pause at the edge of the bed before standing to prevent dizziness.
04
Stand Slowly
Use your leg muscles to stand, keeping your back straight and core engaged gently.
Preventing Constipation
Why This Matters
Pain medications (especially if you need stronger ones) and reduced activity will slow your digestion. Straining during bowel movements causes the Valsalva maneuver, which significantly increases pain at your fracture sites.
Prevention Strategies
  • Stool softeners: Start immediately, don't wait for constipation
  • Hydration: Drink plenty of water throughout the day
  • Fiber: Increase dietary fiber gradually
  • Movement: Walking helps stimulate bowel function

Recommended: Docusate sodium (Colace) 100-200 mg twice daily, or as directed by your doctor. This is preventive, not just for treatment.
When Physiotherapy Begins
1
Timing
Start physiotherapy "when pain is better managed"—typically around weeks 2-4
2
Initial Focus
Passive range of motion and gentle stretching to prevent stiffness
3
Progressive Strengthening
Gradually rebuild strength in muscles that were bruised and strained
4
Long-term Prevention
Core strengthening and posture training to prevent future back problems
Expected Healing Timeline
Week 1-2
Acute pain phase—focus on pain management and gentle movement
Week 3-4
Pain begins to improve—start physiotherapy when ready
Week 5-8
Bone healing progresses—gradual return to normal activities
Week 8+
Most healing complete—continue strengthening and prevention

Remember: Everyone heals at their own pace. These are general guidelines—your actual recovery may be faster or slower.
Warning Signs: When to Seek Immediate Care
New Leg Weakness
Sudden inability to lift your foot or toes, or difficulty walking
Numbness or Tingling
New numbness in legs, feet, or "saddle area" (groin/buttocks)
Bladder/Bowel Changes
Loss of bladder or bowel control, or inability to urinate
Severe Pain
Pain that suddenly worsens dramatically or doesn't respond to medication
Dark Urine
Blood in urine or very dark-colored urine (could indicate kidney involvement)
Understanding the Medical Reports
The CT Scan Report
This report provides the "picture"—the actual structural damage to your spine. It shows exactly where the fractures are located and confirms that the main weight-bearing parts of your spine are intact.
The Emergency Department Report
This report provides the "story"—why you're feeling specific pains and confirms that doctors were thorough in ruling out organ damage.

Key Point: Together, these reports paint a complete picture of your injury, its severity, and the expected course of recovery.
Key Physical Exam Findings Explained
Tender to Palpation
Pain when pressing on L4/L5 vertebrae and paraspinal regions bilaterally, more pronounced on the left—confirms fracture location
Erythema and Swelling
Redness and swelling noted over the left flank—visible signs of trauma and inflammation
Pain with Positioning
Pain with sitting upright and sitting down, manageable at rest—typical of transverse process fractures
Cross-Body Pain Pattern
Pain in left flank with right hip flexion—demonstrates the cross-bracing effect of core muscles
Why Three Fractures Indicate Significant Impact
Having three fractures (not just one) indicates you took a fairly hard hit. The force required to break three transverse processes suggests significant trauma.
What This Means
  • More extensive soft tissue damage
  • Longer recovery time likely
  • Greater need for vigilance regarding complications
  • More important to follow activity restrictions

Silver Lining: Despite the significant impact, the structural integrity of your spine remains intact. The main weight-bearing column is undamaged.
Why No Surgery Is Needed
Stable Fractures
The transverse processes don't support body weight, so the fractures don't compromise spinal stability
No Spinal Cord Risk
These "wings" don't protect the spinal cord, so there's no risk of cord damage
Natural Healing
Bone will heal naturally over 4-8 weeks with conservative management
Surgery Wouldn't Help
Surgical fixation of transverse processes is technically difficult and wouldn't speed healing
The Spinal Surgery Consultation
What They Said
The emergency department team consulted with Dr. Yi at Saint Michael's Hospital spinal surgery department. His assessment was clear:
"For transverse process fractures there is no specific management that is indicated other than ongoing symptom/pain control, and activity as tolerated. No specific follow-up is required."
What This Means
This confirms that your injury, while painful, is not dangerous and doesn't require surgical intervention. The treatment plan is straightforward: manage pain, stay as active as you can tolerate, and let nature take its course.
Why You're Neurologically Intact
Normal Sensation
You have normal sensation in both lower legs, indicating no nerve damage
Preserved Strength
5/5 strength in most muscle groups (4/5 in right hip flexion due to pain inhibition, not true weakness)
Normal Gait
Able to walk normally when pain allows, indicating intact motor pathways

Excellent Sign: Being neurologically intact means your spinal cord and nerves are functioning normally. This is the most important indicator of a good prognosis.
Understanding "Mildly Displaced"
What "Displaced" Means
The term "mildly displaced" means the broken pieces have shifted slightly from their original position but are not scattered or floating far away.
Why This Matters
Mild displacement is actually common and not concerning. The pieces are still close enough together that bone will bridge the gap during healing. If the displacement were severe, surgery might be considered, but that's not the case here.

Key Point: "Mildly displaced" is much better than "severely displaced" or "comminuted" (shattered into many pieces).
The Role of Inflammation
Initial Injury
Fractures and soft tissue damage trigger inflammatory response
Acute Inflammation
Swelling, redness, pain—body's natural healing response
Healing Phase
Inflammation gradually decreases as tissue repairs
Recovery
Bone strengthens, soft tissue heals, function returns
Celecoxib (an anti-inflammatory medication) helps manage this inflammatory response, reducing pain and swelling while allowing natural healing to proceed.
Why Muscle Spasms Occur
Protective Mechanism
When your spine senses injury, the large back muscles automatically tighten up to "splint" the area and prevent further damage. This is called protective muscle spasm.
The Problem
While this is a natural protective response, the constant muscle tension can become more painful than the fracture itself. The muscles essentially lock up, creating a vicious cycle of pain and spasm.
Breaking the Cycle
  • Pain medication reduces pain signals
  • Gentle movement prevents muscles from staying locked
  • Heat therapy can help relax tense muscles
  • As fractures heal, spasms naturally decrease
The Importance of Movement
Prevents Stiffness
Gentle movement keeps joints and muscles from becoming rigid and painful
Maintains Circulation
Movement promotes blood flow, bringing nutrients to healing tissues
Preserves Strength
Staying active prevents muscle atrophy (wasting) from disuse
Improves Mood
Activity releases endorphins and prevents the depression that can come with prolonged inactivity
Why Bed Rest Is Not Recommended
Old Thinking vs. New Understanding
Decades ago, doctors prescribed strict bed rest for back injuries. We now know this actually slows recovery and can cause complications.
Problems with Prolonged Bed Rest
  • Muscle weakness and atrophy
  • Increased stiffness
  • Blood clot risk
  • Bone density loss
  • Depression and anxiety
  • Slower overall recovery

Modern Approach: "Activity as tolerated" means staying as active as your pain allows, with frequent rest breaks. This promotes faster, more complete recovery.
Managing Daily Activities
Dressing
Sit down to put on pants and shoes. Avoid bending at the waist—bring your foot up to you instead.
Bathing
Use a shower chair if standing is difficult. Avoid baths that require getting down to floor level.
Driving
Wait until you can sit comfortably and react quickly. Pain medications may impair driving ability.
Household Tasks
Ask for help with tasks requiring bending, lifting, or prolonged standing. Pace yourself.
Nutrition for Bone Healing
Key Nutrients
  • Calcium: 1000-1200 mg daily (dairy, leafy greens, fortified foods)
  • Vitamin D: 800-1000 IU daily (sunlight, fatty fish, fortified milk)
  • Protein: Essential for tissue repair (lean meats, fish, beans, eggs)
  • Vitamin C: Supports collagen formation (citrus, berries, peppers)
Hydration
Drink plenty of water—at least 8 glasses daily. Proper hydration supports healing and helps prevent constipation.

Consider: Discuss with your doctor whether calcium and vitamin D supplements would be beneficial for your recovery.
The Psychological Impact of Injury
Normal Reactions
Frustration, anxiety, and mood changes are normal responses to injury and pain
Loss of Independence
Needing help with daily tasks can be emotionally challenging
Fear of Re-injury
Anxiety about falling again or making the injury worse is common
Coping Strategies
Stay connected with others, maintain routines when possible, focus on small improvements
If you experience persistent low mood, anxiety, or difficulty coping, discuss this with your healthcare provider. Mental health is an important part of physical recovery.
Support System and Resources
Your Healthcare Team
  • Dr. Kotalik: Your family doctor for ongoing management
  • Dr. Deketele: Emergency physician who managed your initial care
  • Physiotherapist: Will guide your rehabilitation when ready
When to Contact Them
  • New or worsening symptoms
  • Questions about medications
  • Concerns about recovery progress
  • Need for work or activity restrictions documentation

Don't Hesitate: Your healthcare team is there to help. It's better to ask questions than to worry unnecessarily or risk complications.
Work and Activity Restrictions
1
Immediate (Weeks 1-2)
Likely need time off work, especially if job involves physical labor, prolonged sitting, or driving
2
Transitional (Weeks 3-4)
May return to light duty or modified work if available and pain allows
3
Progressive (Weeks 5-8)
Gradual return to full duties as healing progresses and strength returns
4
Full Recovery
Return to all normal activities including heavy lifting and strenuous exercise
Discuss specific work restrictions with your doctor. They can provide documentation for your employer if needed.
Understanding Your Medications
Acetaminophen (Tylenol)
How it works: Reduces pain signals in the brain
Dosing: 1000 mg every 6-8 hours (max 4000 mg/24 hours)
Important: Avoid alcohol; can cause liver damage if exceeded
Celecoxib (Celebrex)
How it works: Reduces inflammation and pain
Dosing: 200 mg twice daily as needed
Important: Take with food; may increase cardiovascular risk with prolonged use
Your Other Medications
Lipitor: Continue as prescribed for cholesterol
Antihypertensives: Continue as prescribed for blood pressure
Important: Don't stop any regular medications without consulting your doctor
Potential Medication Side Effects
Acetaminophen
  • Generally well-tolerated
  • Liver damage if overdosed
  • Check other medications for acetaminophen content
Celecoxib
  • Stomach upset (take with food)
  • Increased blood pressure (monitor)
  • Fluid retention
  • Increased cardiovascular risk with long-term use

Report Immediately: Black or bloody stools, severe stomach pain, chest pain, shortness of breath, or signs of allergic reaction.
Alternative Pain Management Strategies
Ice Therapy
Apply ice packs for 15-20 minutes several times daily during the first 48-72 hours to reduce inflammation
Heat Therapy
After 72 hours, use heat to relax muscle spasms and improve blood flow to the area
Relaxation Techniques
Deep breathing, meditation, and guided imagery can help manage pain and reduce stress
Gentle Massage
Light massage of surrounding muscles (not directly over fractures) may help reduce tension
Monitoring Your Progress
01
Pain Levels
Track your pain on a scale of 0-10. You should see gradual improvement over weeks.
02
Function
Note improvements in activities: walking distance, sitting tolerance, ability to perform daily tasks.
03
Sleep Quality
Better sleep often indicates improving pain control and healing.
04
Mood
Improving mood and reduced anxiety are positive signs of overall recovery.

Keep a Journal: Tracking your progress can help you see improvements that might not be obvious day-to-day and helps your healthcare team adjust your treatment plan.
What "Good Recovery" Looks Like
1
Week 1
Severe pain, limited mobility, need for regular pain medication
2
Week 2
Pain begins to ease, can walk short distances, still need pain medication
3
Week 4
Noticeable improvement, longer walking distances, less frequent pain medication
4
Week 6
Significant improvement, most daily activities manageable, occasional pain medication
5
Week 8
Near-normal function, minimal pain, rare need for pain medication
Realistic Expectations
What to Expect
  • Recovery is gradual, not linear—some days will be better than others
  • You may have setbacks—this doesn't mean you're not healing
  • Some residual discomfort may persist beyond 8 weeks
  • Full return to pre-injury function may take 3-6 months
Factors Affecting Recovery
  • Your age (66) may mean slightly slower healing
  • Overall health and fitness level
  • Adherence to activity guidelines
  • Consistency with pain management
  • Quality of physiotherapy
The Pre-existing L5-S1 Narrowing: Long-term Implications
Current Status
Severe left neural foraminal narrowing at L5-S1, but nerve is functioning normally with no symptoms
Why It Matters
This is a degenerative condition that may progress over time, potentially causing symptoms in the future
Monitoring
Watch for new symptoms: shooting pain, numbness, or weakness in the left leg
Prevention
Maintaining core strength and good posture may help prevent symptom development
Understanding Neural Foraminal Stenosis
What Causes It
Age-related changes including disc degeneration, bone spurs, and ligament thickening gradually narrow the space where nerves exit the spine.
Why You Have No Symptoms
The nerve can tolerate a certain amount of narrowing before symptoms develop. You're currently in that "compensated" phase where the nerve is compressed but still functioning normally.
Future Considerations
If symptoms develop in the future, treatment options include:
  • Physical therapy
  • Anti-inflammatory medications
  • Epidural steroid injections
  • Surgery (if conservative measures fail)
Preventing Future Back Problems
Core Strengthening
Once healed, focus on building core strength to support your spine and prevent future injuries
Proper Body Mechanics
Learn correct lifting techniques, maintain good posture, avoid prolonged static positions
Weight Management
Maintaining healthy weight reduces stress on your spine
Regular Exercise
Stay active with low-impact activities like walking, swimming, or cycling
Ergonomics
Ensure your work and home environments support good spinal health
Fall Prevention Strategies
Home Safety
  • Remove tripping hazards (loose rugs, clutter)
  • Improve lighting, especially on stairs
  • Install handrails on both sides of stairs
  • Use non-slip mats in bathroom
  • Keep frequently used items within easy reach
Personal Strategies
  • Wear proper footwear with good traction
  • Take your time—don't rush
  • Use assistive devices if needed
  • Stay physically active to maintain strength and balance
  • Have vision checked regularly
Understanding Your Risk Factors
Age
At 66, you're at increased risk for falls and slower bone healing, but most people your age recover well from these injuries
Hypertension
Well-controlled with medication, but monitor blood pressure during recovery
Dyslipidemia
Continue Lipitor as prescribed; good cardiovascular health supports healing
Pre-existing Spinal Changes
Degenerative changes at L5-S1 require monitoring but aren't currently causing problems
Questions to Ask at Follow-up Appointments
About Recovery
Am I healing as expected? When can I return to specific activities? Do I need follow-up imaging?
About Medications
When can I reduce or stop pain medications? Are there any interactions with my other medications?
About Activity
What exercises should I do? What activities should I still avoid? When can I drive?
About Prevention
What can I do to prevent future injuries? Should I have bone density testing? Do I need calcium/vitamin D supplements?
Understanding Medical Terminology
Key Terms from Your Reports
  • Transverse process: Bony wing projecting from vertebra
  • Mildly displaced: Broken pieces slightly separated
  • Neural foraminal narrowing: Tight space where nerve exits spine
  • Erythema: Redness of skin
  • Paraspinal: Alongside the spine
More Terms
  • Neurologically intact: Nerves functioning normally
  • Stenosis: Narrowing of a space
  • Degenerative changes: Age-related wear and tear
  • Acute: Recent, new
  • Conservative management: Non-surgical treatment
Resources for Additional Information
Medical Information
UpToDate patient education materials on spinal fractures and back pain management (provided in your documents)
Pain Management
Discuss with your doctor about referral to pain management specialist if needed
Physiotherapy
Ask for recommendations for physiotherapists experienced in spinal injuries
Support Groups
Consider connecting with others recovering from similar injuries for emotional support
Your Care Team Contact Information
Primary Care
Dr. Thomas Kotalik, MD
Your family doctor for ongoing management and follow-up care
Emergency Care
Dr. Serena E. Deketele, MD
Emergency physician who managed your initial assessment and treatment
Hospital
Collingwood General and Marine Hospital
459 Hume Street, Collingwood, ON L9Y 1W9
Phone: (705)445-2550
Key Takeaways: What You Need to Remember
Your Injury
Three stable fractures of transverse processes at L1-L3 on the left side—painful but not dangerous
No Surgery Needed
Conservative management with pain control and activity modification is the appropriate treatment
Expected Timeline
4-8 weeks for bone healing, with gradual improvement in pain and function
Stay Active
Movement is medicine—stay as active as pain allows, don't stay in bed
Watch for Warning Signs
New leg weakness, numbness, or bladder/bowel problems require immediate medical attention
Good Prognosis
Most people recover well from these injuries with proper management
Your Recovery Checklist
Daily Tasks
  • ☐ Take pain medications as prescribed
  • ☐ Take stool softener
  • ☐ Walk several times throughout the day
  • ☐ Apply ice or heat as needed
  • ☐ Practice good posture and body mechanics
  • ☐ Stay hydrated
Weekly Goals
  • ☐ Gradually increase walking distance
  • ☐ Track pain levels and function
  • ☐ Practice relaxation techniques
  • ☐ Maintain social connections
  • ☐ Follow up with healthcare providers as scheduled
Looking Forward: Life After Recovery
1
Complete Healing
Most patients achieve full or near-full recovery within 3-6 months
2
Return to Activities
Gradual return to all pre-injury activities including work, hobbies, and exercise
3
Prevention Focus
Implement strategies to prevent future falls and maintain spinal health
4
Ongoing Monitoring
Regular check-ups to monitor the pre-existing L5-S1 narrowing and overall spinal health
You've Got This: Final Encouragement
Recovery from spinal fractures can be challenging, but you have every reason to be optimistic. Your fractures are stable, you're neurologically intact, and you have a clear treatment plan.
Remember that healing takes time, and progress isn't always linear. Some days will be better than others, and that's completely normal. Be patient with yourself, follow your treatment plan, and don't hesitate to reach out to your healthcare team with questions or concerns.

Remember: You didn't just twist your back—you took a significant impact and your body is working hard to heal. Give yourself grace, follow the plan, and trust the process. Most people recover well from these injuries, and there's every reason to believe you will too.
Wishing you a smooth and complete recovery!