Slips or Falls on Ice and Snow: Should you go to emergency, see a doctor, or consult a physiotherapist?

Winter is upon us, and with of all of this ice and snow, inevitably falls happen.  What should you do after a fall? See a doctor? Get an x-ray? Go to a physiotherapist?  There is no sure answer to that, but here are some guidelines to help you make a decision. 

When to go to the hospital emergency room (ER) after a fall

The most serious consideration after a fall is whether or not you hit your head. Smacking you head won’t always result in injury, but even a seemingly minor bump can suddenly turn into a life-threatening emergency. If you hit your head during a fall, go the ER immediately if you experienced one or more of:

     -  loss of consciousness

     -  seizure

     -  excessive bleeding that won’t stop with pressure applied for more than 15 minutes

     -  vomiting, especially if you vomit more than once, including several hours after the accident

     -  amnesia or memory loss

Symptoms may develop within the first 24-48 hours after your fall that should also be taken seriously. Go to the emergency room if you develop:

     -  an intense headache like you never had before

     -  difficulty breathing, have a feeling akin to a lump in your throat, or difficulty speaking or finding your words

     -  you start vomiting

     -  lose balance, coordination or control

     -  you lose or fade in and out of consciousness

There are reasons you should see a doctor if you fell and hit your head that do not require emergency medical attention, but more on that in the When to go to a clinic or see your family doctor after a fall section.

The most likely reason you will need to go to the hospital after a fall is if you have broken or fractured a bone.  Hospitals will do an x-ray and treat the break accordingly. Go to the ER if:

     -  you are unable to put weight on your injured side immediately after the fall

     -  your limb is obviously misshapen

     -  you have low bone density and are at high risk of fractures

     -  severe, unrelenting pain (this may not be indicative of a broken bone but it is best to rule it out after a fall)

     -  you are unable to move the injured body part

This is not an inclusive list.  When in doubt, error on the side of caution and go to the emergency room.

When to see your family doctor after a fall

There are lots of reasons you may require medical attention after a fall that aren’t medical emergencies.   Some reasons to go to a walk in clinic or see your family doctor will include:

     -  strong or lingering pain

     -  obvious swelling in a painful area

     -  dizziness, nausea, or vertigo

     -  headaches

     -  feeling weak, fatigued, unbalanced, or unsteady

     -  visual disturbances

     -  ringing in the ears

     -  if you hit your head and you are older than 65

     -  if you hit your head and are on blood thinners

Generally if you hit your head it’s a good idea to get check out by a family doctor within the first couple days.  A family doctor will examine you for signs of whiplash or concussion.  Family doctors will manage your incident and be your gateway to medication for pain management, imaging, and referrals to other health care providers. It is always a good idea to keep your family doctor in the loop. 

Do not underestimate the importance of pain management.  Fighting through excessive pain can alter the way your entire body perceives pain, and may contribute to difficulties with chronic pain.  Don’t be a hero, seek help if you are in pain.  And as always, error on the side of caution and consult a family doctor if you are unsure.

What you can do for yourself

In the absence of a medical emergency, much of the initial pain after a fall will be due to inflammation.  Treatment for acute or recent injuries is not overly complicated.  For the first few days:

     -  rest your body

     -  avoid any aggravating positions or activities

     -  ice the painful area 10 -15 minutes at a time for temporary pain relief.  You can ice often so long as you take an hour or two off between icing.  Ice or snow in a zip-lock bag will give you the best results.

     -  use a tensor to wrap, or brace or sling as required

     -  use a cane or crutches to avoid limping if you can’t put weight on your leg

     -  take pain medication or anti-inflammatories as required

When to see a physiotherapist after a fall

A week or two after a slip or fall is a good time to consult a physiotherapist. A physiotherapist can assess the injured areas and determine what has been aggravated and the extent of the damage. Your physiotherapist will use hands-on manual therapy and prescribe individualized exercises to help relieve pain, restore movement, and get you back to what you love doing.

As an important last point, any past injury can you put you at risk of re-injury.  Even if your pain was resolved, you may have residual weaknesses or imbalances from the experience which can put you at risk of injuring the same area again.  That’s why after any fall it is best to consult a physiotherapist to assess your strength, range of motion, and functional movements to help avoid any future issues.

So if you have experienced a slip or fall on the ice and snow, use the medical system and our knowledgeable health care providers to assist in your recovery.  We are here to help.