What is Low Back Sprain

A sprain is a stretch or tear in the bands of tissue that hold bones and joints together (ligaments). Sprains of the lower back (lumbar spine) are a common cause of low back pain. A sprain occurs when ligaments are overextended or stretched beyond their limits. The ligaments can become inflamed, resulting in pain and sudden muscle tightening (spasms). A sprain can be caused by an injury (trauma), or it can develop gradually due to overuse.

There are three types of sprains:

• Grade 1 is a mild sprain involving an overstretched ligament or a very slight tear of the ligament.
• Grade 2 is a moderate sprain involving a partial tear of the ligament.
• Grade 3 is a severe sprain involving a complete tear of the ligament.

What are the causes?

This condition may be caused by:

• Trauma, such as a fall or a hit to the body.
• Twisting or overstretching the back. This may result from doing activities that require a lot of energy, such as lifting heavy objects.

What increases the risk?

The following factors may increase your risk of getting this condition:

• Playing contact sports.
• Participating in sports or activities that put excessive stress on the back and require a lot of bending and twisting, including:
  • Lifting weights or heavy objects.
  • Gymnastics.
  • Soccer.
  • Figure skating.
  • Snowboarding.
• Being overweight or obese.
• Having poor strength and flexibility.

What are the signs or symptoms?

Symptoms of this condition may include:

• Sharp or dull pain in the lower back that does not go away. Pain may extend to the buttocks.
• Stiffness.
• Limited range of motion.
• Inability to stand up straight due to stiffness or pain.
• Muscle spasms.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• A physical exam.
  • Your health care provider may push on certain areas of your back to determine the source of your pain.
  • You may be asked to bend forward, backward, and side to side to assess the severity of your pain and your range of motion.
• Imaging tests, such as:
  • X-rays.
  • MRI.

How is this treated?

Treatment for this condition may include:

• Applying heat and cold to the affected area.
• Medicines to help relieve pain and to relax your muscles (muscle relaxants).
• NSAIDs to help reduce swelling and discomfort.
• Physical therapy.

When your symptoms improve, it is important to gradually return to your normal routine as soon as possible to reduce pain, avoid stiffness, and avoid loss of muscle strength. Generally, symptoms should improve within 6 weeks of treatment. However, recovery time varies.

Follow these instructions at home:

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area during the first 24 hours after your injury.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• If directed, apply heat to the affected area as often as told by your health care provider. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
  • Place a towel between your skin and the heat source.
  • Leave the heat on for 20–30 minutes.
  • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.

Activity

• Rest and return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid activities that take a lot of effort (are strenuous) for as long as told by your health care provider.
• Do exercises as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you have questions or concerns about safety while taking pain medicine, talk with your health care provider.
• Do not drive or operate heavy machinery until you know how your pain medicine affects you.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Warm up and stretch before being active.
• Cool down and stretch after being active.
• Give your body time to rest between periods of activity.
• Avoid:
  • Being physically inactive for long periods at a time.
  • Exercising or playing sports when you are tired or in pain.
• Use correct form when playing sports and lifting heavy objects.
• Use good posture when sitting and standing.
• Maintain a healthy weight.
• Sleep on a mattress with medium firmness to support your back.
• Make sure to use equipment that fits you, including shoes that fit well.
• Be safe and responsible while being active to avoid falls.
• Do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking or water aerobics. Try a form of exercise that takes stress off your back, such as swimming or stationary cycling.
• Maintain physical fitness, including:
  • Strength. In particular, develop and maintain strong abdominal muscles.
  • Flexibility.
  • Cardiovascular fitness.
  • Endurance.

Contact a health care provider if:

• Your back pain does not improve after 6 weeks of treatment.
• Your symptoms get worse.

Get help right away if:

• Your back pain is severe.
• You are unable to stand or walk.
• You develop pain in your legs.
• You develop weakness in your buttocks or legs.
• You have difficulty controlling when you urinate or when you have a bowel movement.