Back Sprains/Strains

Most individuals at some point in their life will experience back pain to some degree. It is a painful injury that raises concern for most people, especially for the first time injured. The good news however, is that the majority of back pain resolves within six to eight weeks and rarely needs surgery.

Anatomy:
Protective bones called vertebrae encase the spinal cord and exiting nerves. These vertebrae form the spinal column. They are stabilized by ligaments and tendons. Ligaments bond vertebral bone to bone and tendons anchor muscle groups to bone. Together, the discs, muscles, tendons and ligaments work as a unit to handle the daily stresses placed upon the spine.

Function:
Normally, the muscles handle the stress and load placed upon the spine without difficulty. Sometimes the force exceeds the capabilities of the muscle and the ligament is forced to pick up the slack. The ligament is a tough fibrous rope that has limits as well and when these limits are exceeded, the ligament is injured as well as the muscle and joining tendons. When ligaments are injured, this is termed a sprain and when tendons or muscles are injured, these are termed strains.

Pain:
When these structures are injured, the surrounding soft tissue swells and muscles spasm in an attempt to stop motion and immobilize itself to protect against further injury. As the swelling and spasms decrease over a period of time, the pain begins to improve. Occasionally, the surrounding edema is great enough to cause pressure on the nerve structures, thus resulting in extremity pain, numbness, tingling or weakness.

Treatment:
The first 48 hours are aimed at ice treatment to reduce local swelling and decrease pain. The past thought process of prolonged bed rest has been altered. Now, most providers feel initial rest over 1-2 days is recommended and then begin gentle activities to increase blood flow and mobility.

• Anti-inflammatory medication will aid in decreasing swelling, thus reducing pain.
• Heat modalities are recommended after the first 2 days to help increase blood flow and begin to loosen muscle fibers, prior to attempting stretching/activities.
• Pain medication will help break the pain cycle and increase the comfort level.
• Physiotherapy modalities attempt to expedite return to activities by decreasing edema, spasm, gaining back early range of motion and strengthening collateral muscle groups to protect against early re injury.

Prevention:
After your recovery and return to function, you must be aware of the risk of future exacerbation.

• Routine exercises should be performed to insure adequate strength and mobility.
• Practice proper posture techniques.
• Stop smoking since nicotine constricts blood vessels and blocks nutrients from replenishing structures.
• Learn and always practice proper lifting techniques.