Strain and Sprain FAQ

1. What’s the difference between a “back sprain” and a “back strain”?

To understand sprain and strain injuries, it helps to know a little anatomy. Tendons are the tough, rope-like tissues that connect your muscles to your bones. A back strain refers to an injury to either a muscle or to one of these tendons. When you strain your back, you’ve twisted, torn or pulled the tendons or muscles that support your vertebrae. A sprain is an injury that occurs when a ligament is stretched too far or is torn. Ligaments are tough and fibrous too, but they connect bones at the joints; keeping them from moving too far in one direction or another.

2. What are the symptoms of back strain or sprain?

If you’ve twisted or pulled the muscles or tendons in your back you’ll probably experience:

• Pain in your back that gets worse when you move
• Cramps or spasms in the muscles of your back
• Difficulty standing up straight, walking or bending over or to the side

Some people actually feel a tear or “pop” when a strain occurs.

3. What causes back sprain or strain?

Pulling or twisting your back repeatedly can cause a muscle or tendon strain. A back strain can also result from only one incident of over-stressing your back. Chronic strains are usually caused by repetitive or prolonged movement of the tendons and muscles. Sprains result from many times with falls or sudden twisting motions, or when sudden blows to the body force a joint out of alignment. Any of these conditions cause injury by stretching ligaments further than their normal range.

Factors that increase your risk of back strain or sprain include:

• Being overweight increases your risk of sprains or strains of your back
• Having weak abdominal or back muscles
• Having tight muscles in the back of your thighs (hamstring muscles) can cause sprains or strains
• Participating in sports that involve pulling and pushing (football and weightlifting)
• Having excessive curves in the lower back can make  you more likely to experience sprains or strains

4. How common are back strains and sprains?

Sprains and strains are extremely common problems. They are second only to headaches as the most common reason people see their health care provider.

5. How will my doctor diagnose a back strain or sprain?

Minor sprains and strains can often be diagnosed by your health care provider based on a physical examination and your medical history (which includes how you were injured and your symptoms). If your injury is more severe, especially if you experience loss of function or severe weakness, your doctor may order x-rays to make sure there are no broken bones (fractures) or bulging (herniated) discs causing your symptoms rather than a simple strain or sprain.

6. How are back strains and sprains treated?

Sprains and strains are usually treated in much the same way and are managed in two phases. In the first step of treatment, the goal is to decrease pain and relieve spasms caused by the strain or sprain. For up to 48 hours, ice packs, rest and pressure (compression) is usually recommended. A medication such as ibuprofen is often recommended. Ibuprofen is a non-steroidal, anti-inflammatory drug that can be purchased without a prescription. It will help to reduce pain and inflammation (swelling) caused by the back strain or sprain. After 48 hours, it’s best to resume normal activities. Staying immobile for too long after a sprain or strain can delay recovery and lead to complications. Improvement is usually noted within two weeks of a strain or sprain. If pain or spasms continue beyond 14 days after a sprain or strain, additional treatment may be needed.

7. Are complications associated with back strains and sprains?

Inactivity is the most common adverse complication of a back strain or sprain. It leads to:

• Weight gain
• Decreased bone density
• Loss of muscle strength
• Loss of muscle flexibility in other parts of the body

8. What is the prognosis for people with back strain and sprain?

In most cases, people with back strains and sprains fully recover within 2 weeks.

9. How can back injuries be prevented?

Not all back strains and sprains can be prevented all the time, but you can reduce your risk of suffering a back injury. Try to incorporate these tips for taking care of your back into your daily lifestyle:

• Eat a well-balanced diet every day: This will keep your muscles and bones strong and healthy.
• Watch your weight: Your low back is stressed by carrying excess body weight.
• Stretch and exercise. This helps keep your joints flexible, your vertebrae in good alignment and less susceptible to a strain or sprain.
• Practice safety: At home and away. Shoes must fit. Clutter must be cleared to avoid falls, especially on stairs and in hallways. Falls and near-falls can lead to sprains and strains
• Practice your posture: Always be mindful of how you’re sitting, standing and lifting. Keep your shoulders back and keep your back straight. Don’t cross your legs or your feet. Never lift with your back, bend your knees and lift with your legs. Improper lifting can cause sprains and strains.
• Give up cigarettes. Smoking interferes with circulation to the muscles and may make you more likely to sprain or strain your back.

10. When should I call my physician?

Notify your doctor if you have:

• Severe pain and are unable to take more than a few steps.
• Numbness in your back or traveling down your leg.
• Suffered multiple sprains or strains to your lower back.
• Any type of lump or bulge that is unusually shaped.
• Pain from a strain or sprain that makes it hard for you to sleep.