You have fractured a transverse process. There are two transverse processes that extend off each vertebra in the spine, one on each side. This is where some muscles and ligaments of the back attach to the spine. One of these muscles is the psoas muscle, which controls the forward bending motion of the upper body and thighs. This muscle attaches to the transverse processes of the lumbar vertebrae and the 12th thoracic vertebra.
During a fall, car accident, or other forceful injury, the psoas muscle can contract strongly as the body tries to protect itself. The contraction can be strong enough to pull off a chip of bone from the transverse process.
This fracture does not cause any injury to the spinal cord or nerves. However, the forces that cause this fracture can also cause internal bleeding or other injuries that might not be clear at the time of your first exam. Be sure to watch for the symptoms listed under "When to seek medical advice."
This injury will take 4 to 6 weeks to heal. It can be treated at home with rest and medicine for pain and swelling. A back brace (called TSLO) or abdominal binder may be prescribed to reduce pain by limiting motion at the fracture site.
After the healing time, you will be advised to gradually return to normal activities over the next 3 or 4 weeks.
Stay in bed if advised for the first few days. As soon as your healthcare provider says it is OK, begin sitting up and walking. This helps you prevent problems from prolonged bed rest (like muscle weakness, worsening back stiffness and pain, or blood clots in the legs).
During bed rest, lie flat on a firm mattress with pillows under your knees. You can also try lying on your side with your knees bent up toward your chest and a pillow between your knees.
Avoid prolonged sitting. This puts more stress on the lower back than standing or walking.
During the first two days after injury, apply an ice pack to the painful area for 20 minutes every 2 to 4 hours. This will help reduce swelling and pain. Don't put the ice pack directly on your skin. Wrap it in a towel before applying.
Heat from a hot shower, hot bath, or heating pad can help relieve muscle spasm. Don't use heat for the first two days. Some people feel best alternating ice and heat treatments. Use the method that feels the best to you.
Take any medicine as prescribed. Talk with your healthcare provider about using over-the-counter anti-inflammatory medicine.
If you were prescribed opioid pain medicine, take it only as directed. (Don't drive a car or use power tools or other machinery while taking this medicine.) Call your healthcare provider if your pain is not well controlled. A dose change or stronger medicine may be needed.
Don't lift anything over 15 pounds until all the pain is gone. Use a back brace if prescribed. When you do lift, use safe lifting technique.
Follow up with your healthcare provider in one week or as advised.
Call your healthcare provider right away if any of the following occur:
Increasing back or abdominal pain
Weakness, dizziness, or fainting
Blood in your urine (pink, red, or brownish color)
Weakness or numbness in one or both legs
Pain and swelling in either leg
Loss of control over bowels or bladder, or numbness in the groin (or genital area)
Chest pain or shortness of breath
Back pain that spreads to one or both legs