Lumbar sprains are often considered a generic term to explain low back pain that originates from the muscles or ligaments. It is usually just in the low back and buttock area, and does not spread into the legs. Lumbar strains and sprains are not serious injuries, they do not involve damage to lumbar discs, lumbar nerves, the vertebrae, or joints. Pain is localized to the back and will resolve with conservative treatment.
What is a Lumbar Sprain?
Technically, sprains are tears of ligaments. In the lumbar area, these ligaments hold the bones in alignment with the help of muscles. Strains occur to muscles when they are overstretched. Most lumbar pain is related to injuries to the muscles, and thus are more correctly considered strains.
Mobility of the lumbar region is dependent on the action of both very large and very small muscles along the spine. The lumbar spine can bend forward and back, rotate and twist. Lifting and twisting can put excessive forces through the spine and muscles causing a strain. Pain usually appears after doing any of the following:
- Performing too much lifting
- Staying in a bent position
- Performing repetitive lifting and twisting
Performing activities without the proper body mechanics, obesity, and poor conditioning are all contributing factors.
Treatment of lumbar strains is typically conservative. Ice initially for a day or two and then heat is often helpful. Ice reduces initial swelling and pain, while heat facilitates muscle rest, blood flow, and healing. Nonprescription medications including anti-inflammatories like ibuprofen and aspirin as well as analgesics like acetaminophen are helpful. Rest should be limited to no more than two days. Over 90% of these will resolve readily in less than a month. Chiropractic therapy, massage, and physical therapy may all help improve function and diminish pain.
Full medical evaluation may be necessary if the pain continues longer than several weeks, or there are more serious problems like:
- actual leg weakness,
- loss of control of the bowels or bladder,
Rarely will an injury to the spine, discs or nerves be present. Even in cases of more severe back injuries, most of these also heal with conservative care. Only in cases of neurologic compromise causing leg weakness or loss of control of the bowel or bladder would surgery be a definite consideration.
Low back pain is usually due to a muscle strain. Learning proper body mechanics and maintaining good core strength helps prevent injury. Almost everyone strains his or her back at some point. Conservative care and time will heal almost everyone.
Thomas Cohn, MD
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