Back Strains and Sprains

The back constitutes a intricate structure composed of bones and muscles, supported by cartilage, tendons, and ligaments. It is nourished by a network of blood vessels and nerves. Particularly, the lumbar, or lower back region, carries a substantial portion of the body’s weight during activities like walking, running, lifting, and other physical tasks. Consequently, it is not surprising that injuries to the lower back, such as strains and sprains, are frequently encountered.

What does the term “strain” refer to?

A strain is an injury affecting either a muscle or tendon. Tendons are the resilient, fibrous bands of tissue that establish connections between muscles and bones. In the context of a back strain, the muscles and tendons responsible for supporting the spine undergo twisting, pulling, or tearing.

And what about a “sprain”?

A sprain entails the stretching or tearing of a ligament. Ligaments are fibrous bands of tissue that connect two or more bones at a joint and serve to limit excessive joint movement.

How prevalent are occurrences of back strains and sprains?

Strains and sprains are exceedingly common injuries and rank second only to headaches as the most frequently reported complaints to healthcare professionals.

SYMPTOMS AND CAUSES

What are the contributing factors to the onset of a back strain or sprain?

A back strain can be the outcome of the twisting or pulling of a muscle or tendon, often arising from improper lifting techniques or overexertion of the back muscles. Chronic strains, which persist over an extended period, typically result from repetitive, prolonged movements that place stress on the muscles and tendons.

In contrast, a sprain typically occurs following a fall, sudden twisting motion, or a forceful impact on the body that forces a joint out of its usual position. In all these situations, one or more ligaments are stretched beyond their normal range, leading to injury.

Additionally, several factors can heighten a person’s risk of experiencing a back strain or sprain, including:

1. Excessive arching of the lower back
2. Being overweight
3. Having weak back or abdominal muscles, as well as tight hamstrings (muscles located at the back of the thighs)
4. Engaging in sports that involve pushing and pulling, such as weightlifting and football, which increase the likelihood of sustaining a low back injury.

What signs and symptoms characterize a back strain or sprain?

Symptoms of a strain or sprain encompass:

1. Aggravation of pain with movement
2. Muscle cramps or spasms (involuntary, sudden muscle contractions)
3. Reduced joint function or range of motion (difficulty walking, bending forward or sideways, or maintaining an upright posture)
4. In certain cases, a sensation of popping or tearing at the time of the injury.

DIAGNOSIS AND TESTS

How are healthcare providers able to diagnose back sprains and strains?

Mild strains and sprains can typically be diagnosed through a comprehensive medical history review, which includes an assessment of symptoms and the circumstances surrounding the injury, as well as a physical examination conducted by a healthcare provider. In instances of more severe strains and sprains, especially when accompanied by weakness or a loss of function, X-rays may be taken to exclude the possibility of a fractured (broken) or herniated (bulging) disk as the underlying cause of the back pain.

MANAGEMENT AND TREATMENT

How are back strains and sprains typically managed and treated?

The approach to treating strains and sprains is often similar and generally occurs in two phases.

The initial phase aims to alleviate pain and muscle spasm. This phase may entail rest, the application of ice packs, and compression (pressure), especially within the initial 24 to 48 hours following the injury. Over-the-counter nonsteroidal anti-inflammatory drugs, such as ibuprofen (Motrin®), may be recommended to help reduce pain and swelling.

After the initial 24 to 48 hours, it is advisable to gradually return to normal activities as tolerated. Prolonged bed rest or immobilization only serves to prolong symptoms and hinder recovery.

Most individuals with symptoms of lumbar strain or sprain show improvement in approximately two weeks. If symptoms persist beyond this period, additional treatment may be necessary.

Are there any complications associated with back strains and sprains?

The most common complication that arises from a back strain or sprain is a reduction in physical activity, which can lead to weight gain, decreased bone density, and a decline in muscle strength and flexibility in other parts of the body.

PREVENTION

What measures can be taken to prevent back sprains and strains?

Although it is impossible to prevent all back injuries, there are steps that can be taken to reduce the risk of strains or sprains:

1. Maintain a well-balanced, healthy diet to promote strong bones and muscles.
2. Manage your weight within a healthy range, as excess weight places added stress on the structures of the lower back.
3. Engage in regular exercise, including stretching, to maintain joint flexibility and muscle health.
4. Practice safety precautions to prevent falls, such as wearing properly fitted shoes and keeping walkways and stairs free of clutter.
5. Employ proper body mechanics when sitting, standing, and lifting, including maintaining good posture, avoiding overreaching, and refraining from twisting movements. When lifting objects, bend your knees and utilize the strong leg muscles to distribute the load.
6. Quit smoking, as nicotine can interfere with blood flow to the muscles.

OUTLOOK / PROGNOSIS

What is the outlook or prognosis for individuals with back strains and sprains?

In most cases, individuals experiencing back strains and sprains can expect a complete recovery with treatment within a two-week timeframe.

LIVING WITH

When should individuals contact their healthcare provider regarding a back strain or sprain?

It is advisable to reach out to your healthcare provider if:

1. You experience severe pain and are unable to walk more than a short distance.
2. You notice numbness in the area of the injury or down your leg.
3. You have a history of multiple lower back injuries.
4. You observe a lump or an area with an unusual shape.
5. Pain disrupts your sleep.
6. You experience obvious weakness in an extremity (hands or feet) following an injury.