How Do I Treat a Lumbar Sprain?

Acute lumbar sprain is an acute laceration caused by sudden excessive pulling of soft tissues such as lumbar muscles, fascia, and ligaments due to external forces. It often occurs when lifting heavy objects and contracting lumbar muscles. Acute lumbar sprain can tear tissue such as attachment points of lumbosacral muscles, periosteum, fascia and ligaments.

Basic Information

English name

acute lumbar muscles prain

Visiting department

Orthopedics, general surgery

Common locations

Muscles, fascia, ligaments, etc.

Common causes

Soft tissues such as lumbar muscles, fascia, ligaments are overstretched

Common symptoms

Back pain, restricted mobility, tenderness at the injury site

Causes of Acute Lumbar Sprain

There are two main causes of soft tissue damage to the waist:

Sprained waist

Mostly caused by walking slipping, jumping, twisting the body and running, most of them are caused by muscles and ligaments being restrained, so the injuries are minor.

2. Lumbar contusion and laceration

It is a relatively serious injury, such as excessive force or improper posture and improper cooperation during high climbing, lifting, and carrying heavy objects, causing damage and tearing of the muscle fascia, ligaments, intervertebral facets and joint capsules .

Clinical manifestations of acute lumbar sprain

The patient developed low back pain immediately after the injury, with persistent severe pain. The next day could be caused by local bleeding, swelling, and lower back pain. Some patients only slightly twisted the waist. There was no obvious pain at the time, but after the rest, they felt back pain. . Waist movement is limited, can not be straight, difficulty in prone, supine, twisting, coughing, sneezing, urinating can make the pain worse. When standing, often support your waist and support your chair with both hands when sitting to reduce pain. Pain occurs immediately on one or both sides of a sprained lumbar muscle; sometimes pain can occur half a day or overnight after the injury, lumbar movement is blocked, pain is slightly milder at rest, and more painful when moving or coughing. Local muscle tension, tenderness and traction pain were obvious during the examination, but there was no congestion.

Acute lumbar sprain

The auxiliary examination method of this disease is mainly X-ray examination.

Minor injury

X-ray plain film showed no abnormal performance.

2. Serious injuries

X-ray showed that there were no abnormal findings of ligament damage in general, or the physiological protrusion of the waist disappeared. The fractures of the superior spine and interspinous ligament showed that the distance between spinous processes increased or merged with spinous processes, and the articular process fractured.

Diagnosis of acute lumbar sprain

Patients had a history of lifting heavy objects, and some patients complained of hearing crisp sounds. The severely injured person had severe pain and could not move immediately; the milder person could still work, but the pain worsened after the break or the next day, and he could not even get up. During examination, the patient's waist was stiff, the lumbar lordosis disappeared, and scoliosis and spatula of the sacroiliac muscles may be present. Obvious tenderness points can be found at the injury site.

Differential diagnosis of acute lumbar sprain

Lumbar sprain

The lumbar muscles are the most powerful in each segment of the spine, and their main role is to maintain the body's posture. In the sitting or standing position, the muscles of the lower back are constantly contracted to resist gravity acting on the head, spine, ribs, and pelvis. It not only controls the downward gravity transmitted by the body during forward flexion, but also restores the upright posture. In addition to the lateral muscle groups, the sacroiliac muscles are the most susceptible to damage. The most common site is the patella attachment point, followed by the aponeurosis near the spinous process or the transverse process, and the tear in the middle of the abdomen is less common.

2. Spinal ligament injury

The supraspinous ligament is a cord-like fibrous tissue attached to the spinous processes of each vertebra. The surface is connected to the skin, and it plays the role of maintaining the trunk upright and limiting excessive forward flexion of the spine. The superior spinal ligament of the lumbar region is strong, but it is often absent or weak at the waist 5 to 1, and the range of motion of the waist is large, so it is easy to cause damage.

3. Interspinous ligament injury

The interspinous ligament is located between two adjacent spinous processes, deep in the superior spinal ligament. Its ventral side is connected to the yellow ligament, and the dorsal side is fused with the spinal muscle fascia and superior spinal ligament, forming a powerful spine movement. constraint. The flexion and extension of the waist makes the spinous processes separate and squeeze, and the fibers of the interspinous ligament rub against each other, which can cause degeneration over time. Based on this, plus trauma factors, the interspinous ligament can break or relax.

4. Lumbar facet joint disorders

Each lumbar spine has three joints, two posterior synovial joints and one anterior disc joint. The articular surfaces of the upper and lower articular processes of adjacent vertebrae coincide, forming an articular process joint, which is surrounded by a thin and strong joint capsule, which can engage in flexion, extension, and rotation, and plays a role in stabilizing the spine and preventing vertebral body sliding. When the waist is suddenly excessively forward flexed and rotated to one side, the joint space of the joint process can be enlarged, the synovium enters the joint space, and the synovium is embedded when the waist is straight, causing acute low back pain.

5. Injury of the lumbosacral joint

The weight of the upper body of the human body is supported on the lower body by the intervertebral disc and facet joints between the lumbosacral region. The lumbosacral region is the most heavily loaded part of the spine. When the spine flexes, stretches and rotates, it acts on the articular process joints, and the joints are connected by joint capsules and ligaments to allow certain movements, but are stretched, lacerated and subluxed during overextension. Causes lumbosacral joint injury. In addition, abnormal structures of the lumbosacral region, such as recessive spina bifida and lumbar spine, are also causative factors.

Complications of Acute Lumbar Sprain

In this disease, the supra-spinous ligament, interspinous ligament, and iliac-lumbar ligament are common. In severe cases, the ligament can be torn or the spinous process can be stripped. Some patients may have a synovial incarceration of the posterior joint of the lumbar spine, which is mainly manifested by unbearable severe pain in the lumbar region immediately after the injury, and all the lumbar muscles are in tension and rigidity. The disease generally does not cause nerve damage. Recessive spina bifida may occur in some particularly severe patients.

Acute Lumbar Sprain Treatment

The acute phase should rest in bed. Those with obvious tenderness points can use 1% procaine (or add 1 ml of hydrocortisone acetate) to close the pain points, supplemented by physical therapy. Can also be topically applied to activate blood, loose silt, analgesic plaster. After the symptoms are alleviated, gradually begin to exercise the back muscles.

Prevention of Acute Lumbar Sprain

The main points to prevent the occurrence of acute lumbar sprain are as follows:

1. Employees should be educated, strictly abide by operating procedures, familiar with production technology, prevent brutality, eliminate and reduce the incidence of work-related injuries.

2. Improve working conditions as much as possible and replace heavy physical labor with mechanical operations. Attention should be concentrated during work, especially when carrying heavy loads collectively under the unified command, working together and keeping pace.

3. Master the correct working posture. For example, when carrying and lifting heavy objects, try to keep your chest and waist straight, hips and knees flexed. You should stand up with your lower limbs firmly, take a step after standing firmly, and carry and lift heavy objects. Take a half-squat position so that the object is as close to the body as possible.

4. Strengthen labor protection. When doing heavy physical work such as carrying, lifting, moving, lifting, etc., a waist belt should be used to help stabilize the lumbar spine, increase abdominal pressure, and enhance muscle work efficiency. If you work in a cold and humid environment, you should take a hot bath to get rid of cold and humidity and eliminate fatigue. Try to avoid bending over for too long.