The most common cause of low back pain is a muscle strain and/or ligament sprain. Other more serious causes would include:
A low back muscle strain occurs when the muscle fibers in the lower back (lumbar spine; see picture) are abnormally stretched or torn such as from a work injury or car accident.
A lumbar sprain occurs when the ligaments, the tough bands of tissue that hold bones together, are torn from their attachments.
Differentiating a strain from a sprain can be difficult, as both injuries will show similar symptoms. Many doctors refer to both injuries as a category called “musculo-ligamentous injuries” of the lumbar spine.
In general, it doesn’t matter what you call the problem because the treatment and prognosis for both back strains and sprains is usually the same.
Nearly everyone will experience low back pain at some point in their life–it is the second most common cause of missed days of work in the United States! (Only a common cold causes more missed work).
Almost all of these low back injuries are due to injuries of the muscle or ligament. If you don’t know the cause of your back pain, you should have it evaluated by a doctor. Some warning signs of a serious injury to the spine include:
- Loss of control of bladder or bowels
- Progressive lower extremity weakness
- Severe, Constant Pain
As said earlier, most back pain is caused by a muscle strain or ligament sprain. However, there are serious conditions that require more immediate treatment. If you are unsure of the cause of your symptoms, you should be evaluated by a chiropractor.
Why are sprains and strains of the low back so common?
The spine is supported by large muscles called the paraspinal muscles. These muscles both support the spinal column as well as the weight of the upper body. The five lumbar vertebrae are connected by tough ligaments that help to maintain the position of the spinal column.
These muscles, ligaments, and bones all work together to provide control and strength for nearly all activities. The lumbar spine and its muscles are needed for most all movements and activities. For this reason, the lumbar spine is prone to injury, and when an injury has been sustained, we are prevented from performing many activities.
What are the symptoms of a low back injury?
Most lumbar muscle strains and sprains cause symptoms isolated to the low back, usually they do not cause problems in the legs like some other spine conditions. The most common symptoms of a lumbar strain or sprain are:
- Pain around the low back and upper buttocks
- Low back muscle spasm
- Pain associated with activities, and generally relieved with rest
What causes these symptoms of low back pain and spasm?
When the lumbar spine is strained or sprained, inflammation of the soft-tissues results. This inflammation causes pain and can cause muscle spasm.
People are often surprised at how painful and debilitating a lumbar strain or sprain can be–these are not small injuries. They often force patients to remain in bed for a day or two, and can cause intermittent symptoms for weeks. That said, over 90% of patients are completely recovered from an episode of lumbar muscle strain or sprain within one month.
Why do some patients tend to have low back strains and sprains more often?
Good question! We do know some factors that tend to influence the development of this type of problem, but often these symptoms strike in unexpected situations. Most commonly, patients who develop a lumbar strain or sprain are doing an activity that places their back at risk. This may be a sudden forceful movement, lifting heavy object or twisting the back in an unusual manner. Knowing how to lift properly can help to prevent many back injuries.
Some well known factors that contribute to low back pain include:
- Poor conditioning
- Improper use/lifting technique
If you have persistent problems with your lumbar spine, consider these issues. If you smoke, are overweight, or do not perform regular back strengthening exercises, then you have steps that you can take to help control your symptoms.
Treatment of a lumbar muscle strain is important to understand. Once you know the cause of your symptoms, you can proceed with treatment. It is important that if you are not sure of the cause of low back pain, that you are evaluated by a chiropractic. There are low back conditions that require immediate treatment.
Step 1: Rest The first step in the treatment of a lumbar muscle strain is to rest the back. This will allow the inflammation to subside and control the symptoms of muscle spasm. Bed rest should begin soon after injury, but should not continue beyond about 48 hours. While it is important to rest the injured muscles, it is just as important to not allow the muscle to become weak and stiff. Once the acute inflammation has subsided, some simple stretches an exercises should begin.
Step 2: Chiropractic Care: Having your spine evaluated by a Doctor of Chiropractic is one of the best things you can do for yourself after suffering a lower back injury. Chiropractors are expertly trained at dealing with changes incurred to your spine and there are many potential solutions to your problem(s).
One of them may be that you are in need of spinal adjustments. The goal of the chiropractic spinal adjustment is to correct the spinal changes that occurred as a result of your injury and that are detected during the examination. To do that, the doctor applies pressure to the bone and “unlocks” it from its improper position. The bone will then be free to align itself correctly. Relief is often felt immediately, but in severe cases it can take several treatments. This is because the muscles connected to misaligned vertebrae get used to their new/injured positions and have a tendency to pull the bone back out of place. After several adjustments the spine begins to “hold” their normal position better and the bone settles into its proper alignment.
Step 3: Exercises: Proper conditioning is important to both avoid this type of problem and recover from this injury. By stretching and strengthening the back muscles, you will help control the inflammation and better condition the lumbar back muscles. The exercises should not be painful. Without some simple exercises, the low back muscles can become “deconditioned,” or weak. When the low back muscles are deconditioned it is very difficult to fully recover from low back injuries. Your chiropractor should be able to recommend the proper types of exercises to you.
Step 4: Further Evaluation If your symptoms continue to persist despite treatment, it may be necessary to further evaluate your spine by having an MRI, CT, and/or Bone Scan performed. Laboratory work may also be needed to make an accurate diagnosis.
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