How Are Back Strains And Sprains Treated
The treatment for strains and sprains is similar, and often takes place in two phases.
The goal of the first phase is to reduce the pain and spasm. This may involve rest, and the use of ice packs and compression , especially for the first 24 to 48 hours after the injury. An over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen , may be recommended to help reduce pain and swelling.
After the first 24 to 48 hours, returning to normal activities, as tolerated, is advisable. Extended bed rest or immobility simply prolongs symptoms and delays recovery.
Most people with lumbar strain/sprain symptoms improve in about 2 weeks. If symptoms continue for more than 2 weeks, additional treatment may be required.
What Causes A Back Strain Or Sprain
Twisting or pulling a muscle or tendon can result in a strain. It can also be caused by a single instance of improper lifting or by overstressing the back muscles. A chronic strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.
A sprain often occurs after a fall or sudden twist, or a blow to the body that forces a joint out of its normal position. All of these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.
In addition, several factors can put a person at greater risk for a back strain or sprain, including:
- Curving the lower back excessively
- Being overweight
- Having weak back or abdominal muscles, and/or tight hamstrings .
Playing sports that involve pushing and pullingsuch as weightlifting and footballalso increases the risk of a low back injury.
Conditions Of Bone And Joint Causes Lower Back Pain
Bone and joint conditions: Bone and joint conditions that lead to low back pain include those existing from birth , those that result from wear and tear or injury, and those that are due to inflammation of the joints .
Congenital bone conditions: Congenital causes of low back pain include scoliosis and spina bifida. Scoliosis is a sideways curvature of the spine that can be caused when one lower extremity is shorter than the other or because of an abnormal architecture of the spine . Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit from support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with the absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.
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Should I Rest If I Have Sciatica
Some rest and change in your activities and activity level may be needed. However, too much rest, bed rest, and physical inactivity can make your pain worse and slow the healing process. Its important to maintain as much activity as possible to keep muscles flexible and strong.
Before beginning your own exercise program, see your healthcare provider or spine specialist first to get a proper diagnosis. This healthcare professional will refer you to the proper physical therapist or other trained exercise or body mechanics specialist to devise an exercise and muscle strengthening program thats best for you.
What Are Some Less Invasive Or Noninvasive Back Pain Treatments
Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.
Medications. When over-the-counter pills and topicals dont do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:
- Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain
- Muscle relaxants, such as baclofen or carisoprodol
- Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen
- Opioids, such as oxycodone or hydrocodone, on a short-term basis.
Physical therapy . PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:
- Exercise
- Transcutaneous electrical nerve stimulation
- Ultrasound
Injections. An epidural steroid injection or a selective nerve block may provide short-term pain relief when lower back pain causes sciatica symptoms, such as leg pain.
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Medical Definition Of Low Back Pain
- Medical Editor: Charles Patrick Davis, MD, PhD
Reviewed on 10/15/2021
Low back pain: Pain in the lower back area can relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area. Lumbago is another name for low back pain.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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What Is The Outlook For People With Lower Back Pain
The outlook depends on the cause of pain. Most people with back strains and sprains recover and do not have long-term health issues. But many people will have another episode within a year.
Some people have chronic back pain that doesnt get better after several weeks. Older people with degenerative conditions such as arthritis and osteoporosis may have symptoms that get worse over time. Surgery and other treatments are effective at helping people with a range of injuries and conditions live pain-free.
Back Pain Culprit: Chronic Conditions
Several chronic conditions can lead to low back pain.
- Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
- Ankylosing spondylitis inflames the joints of the spine, and sometimes the shoulders, hips, ribs, and other areas too. It causes chronic back pain and stiffness. In serious cases, spinal vertebrae start to fuse .
- Fibromyalgia causes widespread muscle aches, including back pain.
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You’re Having Problems With Your Bowels Or Urination
If your back pain is paired with a loss of control over your bowels or urination, then it’s time to seek help immediately at a local emergency room. These symptoms point to cauda equina syndrome, where the nerves in the lower spine have become paralyzed. While rare, this syndrome can be permanently damaging to the nerves if left untreated. If you experience these symptoms, especially accompanied by numbness in the legs, then you may need surgery to decompress the nerves and preserve their overall function.
When To Contact A Medical Professional
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also call if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
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Causes Of Labor Back Pain
During labor, the most common source of back pain is from the babys head exerting pressure on the lower back, which happens when the babys head is down and facing forward.
Some underlying health conditions, such as scoliosis and exaggerated swayback, or lordosis, may also cause lower back pain during labor.
Having a small waist can exacerbate back pain as this may cause the babys head to exert more pressure on the lower back when giving birth.
Straight Leg Raising Test
With the patient in the supine position, each leg is raised separately until pain occurs. The angle between the bed and the leg should be recorded. Pain occurring when the angle is between 30 and 60 degrees is a provocative sign of nerve root irritation . Bending the knee while maintaining hip flexion should relieve the pain, and pressure in the popliteal region should worsen it .11 If placing the knee back in full extension during straight leg raising and dorsiflexing the ankle also increase the pain , nerve root and sciatic nerve irritation is likely.
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The result of straight leg raising is positive in 95 percent of patients with a proven herniated disc at surgery, but it is also positive in 80 to 90 percent of patients without any form of disc protrusion at surgery.12 In contrast, crossed straight leg raising is less sensitive but much more specific for disc herniation. In the crossed straight leg raising test, the contralateral, uninvolved leg is raised . The test result is positive when pain is produced.
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What Type Of Doctor Should I See For Back Pain
This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.
Mechanical Lower Back Pain
Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:
- Muscle strain.
- Spondylolisthesis .
- .
- Osteoarthritis .
- Spinal stenosis .
Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.
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Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
When To Go To The Hospital
Lower back pain on its own does not necessarily mean that labor is imminent. However, a person should call their obstetric care provider if they notice other symptoms of labor, such as new onset back pain and cramping that occurs about every 10 minutes and lasts for 4050 seconds.
The ACOG recommend that a person go to the hospital if:
- fetal movement is less frequent
- the water has broken, and no contractions are occurring
- there is heavy vaginal bleeding
- they experience severe pain with minimal relief between contractions
Back pain symptoms from pregnancy and labor can be similar, so in some cases, it can be difficult for a person to tell the difference between the two.
However, although lower back pain during labor is
If a person experiencing intense back pain thinks that they might be going into labor, the ACOG recommend paying attention to the following signs:
- regular contractions that are increasing in frequency
- a feeling that the fetus has dropped lower in the pelvis
- the water breaking
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How Do Health Care Professionals Diagnose Low Back Pain
The diagnosis of low back pain involves a review of the history of the illness and underlying medical conditions as well as a physical examination. It is essential that a complete story of the back pain be reviewed including injury history, aggravating and alleviating conditions, associated pain symptoms , as well as the duration and progression of symptoms. Aside from routine abdomen and extremity evaluations, rectal and pelvic examinations may eventually be required as well. Further tests for diagnosis of low back pain can be required including blood and urine tests, plain film X-ray tests, CAT scanning, MRI scanning, bone scanning, and tests of the nerves such as electromyograms and nerve conduction velocities .
Complete Guide To Low Back Pain
This article might ease your mind, but what about your back pain? If your pain is becoming chronic , or if you just keep having flare-ups, you may want to dive much deeper into the topic. There arent any easy answers for stubborn back pain, but there is evidence-based hope, and the PainScience.com back pain tutorial explores the topic extremely thoroughly. The main text is written for patients, but its also extensively referenced for keen readers and healthcare professionals. Read the introduction.
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Lower Back Pain Caused By Infection
Infections of the spine are not common, but they do occur. The doctor will ask about the usual signs and symptoms of infection, especially when back pain is accompanied by fever and/or chills. Dialysis patients, IV drug users, and patients who have recently had surgery, trauma, or skin infections are at risk for infections of the spine. Infections of the spine can be caused by a number of agents, most commonly bacteria. Doctors will first test for the presence of bacteria, then give antibiotics.
What Clinical Trials Are Being Conducted At Cleveland Clinic Relating To Spine Tumor Surgery
Researchers at Cleveland Clinic are involved in ongoing studies that investigate new drugs and treatment approaches for managing disease. Participants in these clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. There are currently more than 1,700 active clinical studies underway.
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What Are The Symptoms Of Adult Scoliosis
Most cases of adult scoliosis dont cause symptoms, though pain may develop. Back pain occurs for many reasons including arthritis, inability to stand upright, and/or due to weakness of the core musculature and loss of conditioning. Leg pain/numbness/weakness may develop if there is pressure on the nerves in the lumbar spine.
In some cases, changes in the body may include:
- Height loss
- Uneven alignment of the pelvis and hips
When Should I Contact My Healthcare Provider About A Back Strain Or Sprain
- You have severe pain and cannot walk more than a few steps.
- You have numbness in the area of injury or down your leg.
- You have injured your lower back several times before.
- You have a lump or area with an unusual shape.
- You have pain that interferes with sleep.
- You have obvious weakness in an extremity after an injury.
Last reviewed by a Cleveland Clinic medical professional on 11/09/2018.
References
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