Low Back Sprains and Strains

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Low back pain is one of the most common medical complaints. Lumbar (low back) sprain or strain is a common diagnosis.  Sprains and strains often result from excessive physical demand on the spine’s ligaments or muscles.  Although pain can be severe, and even temporarily disabling, most low back sprains and strains are easy to treat and do not require spine surgery.

How Low Back Sprains and Strains Occur

The low back (lumbar spine) is the body’s primary weight-bearing structure.  The lumbar spine’s large vertebral bodies and inward curve (lordosis) make it uniquely designed to carry and distribute stress during movement and at rest.

Sprains and strains are soft tissue injuries.  Soft tissues include tendons, ligaments, and muscles. Sprains are limited to tendons and ligaments, whereas strains affect muscles.  Injury can occur when these tissues are stretched beyond their normal limits.  Examples are:

• Excessive flexion (bending forward)
• Excessive extension (bending backward)
• Excessive force to the spine (e.g., fall)

Symptoms

Symptoms include sharp pain, difficult and painful movement, swelling, and stiffness.  Pain may be so severe you suspect something is broken.

Diagnosis

Diagnosis of back sprains and strains should be made by a physician with special expertise in spinal conditions.

• Medical History 
  The doctor asks about your symptoms, how the injury occurred, and treatments you tried.

• Physical Examination
  The physical and neurological examination evaluates movement limitations, potential balance problems, reflexes, muscle strength, sensation, and signs of neurologic dysfunction.

• Diagnostic Tests
  An x-ray may be ordered to rule out a serious diagnosis, such as herniated disc or spinal fracture.

Non-operative Treatment

Surgery to treat a sprain or strain is rarely necessary. Medications may include an anti-inflammatory, muscle relaxant, and pain killer (non-narcotic or narcotic). A narcotic may be prescribed if pain is severe or the non-narcotic agent fails to relieve pain.  Chiropractic and acupuncture can be effective too.

Physical therapy is often recommended and may include ultrasound, massage, ice / heat, and electrical stimulation.  Active therapies include stretching and strengthening exercise.  During physical therapy, you learn about posture and how to apply proper biomechanics to walking, standing, working at a desk, and other activities.

Lifestyle changes may be recommended, such as maintaining a healthier body weight and stop smoking.

Reminder

Not every episode of back pain is a sprain or strain. If back pain is acute, persistent, or worsens, consult with a physician who has expertise in the care of spinal problems.