Lumbar Sprain and Strain

What is it?

Muscular or ligamentous injuries to the lumbar spine can cause significant pain and or disability in the individual which could lead to pain in the legs. Understanding the extent of tissue damage depends on the grade to which damage has occurred.

Grade 1: can take approximately 7days to 4 weeks for full recovery

  • Simple sprain/strain with minimal dysfunction
  • Minimal fibre damage
  • Minimal loss of function and pain
  • Reduced range of motion

Grade 2: can take approximately 2 weeks to 1 year for full recovery

  • Moderate sprain/strain, partial tear
  • Moderate fibre damage, approximately half of fibres may be torn
  • Loss of function and significant pain
  • Typically as a result of sports injury, trauma or faulty lifting movements

Grade 3: may take 8 weeks to over a year to recover

  • Significant damage, complete rupture
  • Severe fibre damage
  • Significant function loss and pain
  • May need to consider surgical consultation

Sprains are classed as ligament injuries which are typically painful during active and passive range of motion, and generally exhibit little to no pain during muscle contraction. In strains muscles are usually painful during active range of motion and muscle contraction, passive range of motion is typically not painful unless stretching to end of range.

Causes

  • Direct trauma as a result of injury following a fall, impact during sport or car accident
  • Overuse: repetitive movements and sustained postures can weaken structures in the spine leading to possible tissue damage.
  • Postural: poor working postures can also cause structural imbalances which can lead to weaknesses which when performing daily or sporting activities may increase risk of injury.
  • Sudden unguarded movement: bending down to pick something up without using knees and core can increase the pressure on the spine, increasing the risk of spinal injury.
  • Muscle imbalance can predispose muscle/ligament injury due to poor movement patterns.
  • Previous injury can leave weakness in the area if correct rehabilitation protocols were not adopted.
  • Poor core musculature

Signs and symptoms

  • Pain in the lumbar spine with possible referred pain into the legs, pain can be unilateral or bilateral. Muscle spasm may be present as part of the bodies protective mechanisms. Pain may be a dull ache with sharp pain during movement.
  • Reduced mobility: stiffness in the lumbar spine as well as hip stiffness may be present.
  • Guarded movements: movement may be restricted, especially turning, twisting, getting into and out if a chair. Guarded movements typically occur due to pain, however these altered movement patterns can increase risk of muscle imbalance and further injury.
  • Local swelling
  • Tenderness on palpation

Management

Early management of this condition is essential, initial reduction of the aggravating activity is important to reduce further stress on the lumbar spine. The following are self-management strategies, which can be adopted.

  • In the initial stages when pain is present you may benefit from ice application (15mins every 2 hours) and some non-steroidal anti-inflammatory medication (NSAIDS). Once initial inflammation has subsided heat may be more beneficial to facilitate movement.
  • Initiation of flexibility and strengthening programmes for the core musculature as soon as the initial pain has subsided and movement is no longer guarded.
  • Hydrotherapy may be an option in the early stages to facilitate correct movement patterns without too much impact on the joints of the spine.

What can Sports Injury Scotland Do?

Sports massage and mobilisations have been found to be an effective method of reducing the pain associated with lumbar spine sprains and strains, increasing the mobility at the joints and improving the muscles flexibility, will enable the individual to perform the necessary strengthening exercises which are essential to ensure a safe return to activity. Postural education will help individuals with reducing the likelihood of recurrence. Sports Injury Scotland will provide diagnosis and treatment of any musculoskeletal injury offering advice on not only the management of pain, but direction on how to avoid recurrence.