Back Sprains and Strains
And How to Treat Them
About 80% of us experience back pain of some kind during our lifetime. In the majority of cases, pain occurs in the lumbar spine (the lower back), because this is the area that bears the most weight, especially when moving, twisting, and bending.
Back sprains are caused when ligaments—the tough bands of tissue that hold bones together—become overstretched or torn. Back strains involve a muscle and/or tendon.
However, many times the source of the pain can’t be clearly defined. Sometimes the condition or injury that triggered the pain may be healed, but the pain still persists.
How Back Sprains and Strain Can Happen
A back sprain or strain can occur when you lift too much weight, play a strenuous sport, or even bend or twist improperly during the course of a regular day. Whether it’s a sprain or a strain, the result is the same: Soft tissues become inflamed and cause pain, and often muscle spasms, which can be quite debilitating to a person’s movement and activities of daily living.
The pain may be aching, burning, stabbing, tingling, sharp, or dull. It can last for a couple of weeks, or go on for months, becoming chronic with more serious implications
There are three types of muscles that support the spine: Extensors (back and gluteal muscles), flexors (abdominal and iliopsoas muscles), and obliques or rotators (side muscles). Through a complex system of nerves, muscle pain or muscle stiffness may develop in the low back, which can restrict your range of motion. Muscle spasms may affect your normal posture or inability to stand up straight.
Is an X-ray or Other Diagnostic Test Necessary?
Diagnostic testing (eg, MRI) is usually not required unless the pain doesn’t go away. Of course, if pain and/or other symptoms suddenly or progressively worsen it’s time to call your doctor. At that point, your doctor will want to rule out any underlying causes of back pain like a disc injury or a pinched nerve. Your doctor may order an X-ray, CT scan, or MRI to examine the vertebrae, joints, spinal cord, and nerve roots. Early diagnosis and treatment may help prevent acute pain from becoming chronic.
First-Line Back Sprain or Strain Treatment
You may want to crawl into bed! However, bed rest should be limited because, when prolonged, it can lead to loss of muscle mass and strength. Your doctor may recommend a nonsteroidal anti-inflammatory drug (NSAID), pain medication and/or physical therapy (PT).
An organized program of PT may include pelvic traction, gentle massage, ice and heat therapy, electrical muscle stimulation, core strengthening and stretching. Your doctor may prescribe a combination of two or more treatments.
- Physical Therapy: This includes patient education and a variety of stretching and strengthening exercises, often focused on the core of the body, that the patient can continue at home.
- Medications: These can widely vary. NSAIDs are helpful to reduce pain associated with swelling (inflammation). Muscle relaxants can help calm spasms. In some cases, antidepressants and antiseizure medications may help reduce nerve-related pain. However, check with your doctor first because these medications may have side effects or interact with other medications you take.
- Coping Skills: Coping skills are very important when managing back pain—or, for that matter, any type of pain. Understand that pain can affect your mood and how you interact with others. Pain can bring on anxiety, depression, irritability, and frustration in many patients, who may be advised to seek out a psychologist or psychiatrist.
- Complementary Medicine: Acupuncture and biofeedback are common types of treatment in this category and might be recommended by your doctor.
Put Good Posture to Work
Since we spend so many hours at work, many back injuries can occur at a desk, especially if you sit at a computer for most of the day.
- Practice safe sitting, upright with your back and shoulders against the back of the chair, feet firmly on the floor
- Sit in a well-constructed, ergonomic chair with good back support
- Use a desk that is stable, with a top 28 to 30 inches above the floor
- Tilt your keyboard down and slightly away from you for better wrist posture
- Take breaks to stretch or go for a walk to get the blood flowing again
Here’s the Good News!
More than 90% of patients completely recover from lumbar muscle sprain or strain within a month. After that, heat and ice treatments are indicated as necessary to manage flare-ups, along with an anti-inflammatory medication.
- Keep in mind that low back sprain or strain can develop into a recurring condition unless you change the habits that cause or contribute to it.
- Talk with your doctor or physical therapist about specific exercises you can do to strengthen your core muscles—such as your abdominal muscles to help stabilize your spine.
- Yoga, swimming, stationary biking, and brisk walking are all beneficial to help keep your spine healthy.
- Aim to maintain a healthy body weight. Even five to 10 pounds can cause a change in back pain because your lumbar spine doesn’t have extra weight to move.
- If you smoke, quit! People who smoke heal more slowly and are at greater risk for back pain and degenerative disc disorders.
- Manage stress. Try to remove or reduce stressors in your life as best you can.