Spinal Sprains & Strains
The vertebral column, also known as the spinal column or simply spine, is a column of 26 bones in an adult body (24 vertebrae interspaced with cartilage in addition to the sacrum and coccyx). In adolescents, the column consists of 33 bones as the sacrum's five bones and the coccyx's four do not fuse together until after adolescence. The spine is further divided into regions: cervical (the neck), thoracic (upper back), lumbar (lower back), sacral, and coccygeal. In between the vertebrae are thin regions of cartilage known as intervertebral discs, which are made of a fibrous outer shell (annulus fibrosus) and a pulpy center (nucleus pulposus).
The lumbar spine, commonly referred to as the lower back, is the part of the spine that curves inwards towards the stomach. The lumbar spine connects with the thoracic spine at the top and extends down to the sacral spine, and is built for flexibility and power, enabling the body to lift, bend, and twist. The spinal cord stops at the point where the thoracic spine meets the lumbar spine and continues to branch out to form the cauda equina, which is a network of nerves that extend to the lower extremities of the body. Since the spinal cord does not run through the lumbar spine, it is very rare that an injury to the lower back would result in paralysis or damage to the spinal cord.
The lumbar spine also bears much of the body’s weight during walking, running, lifting, and other activities; therefore it’s vulnerable to injuries such as sprains and strains. A sprain is the stretching or tearing of ligaments that hold the bones in the back together and prevent excessive motion. A strain, on the other hand, is an injury to a tendon or muscle that helps support the spine.
Common symptoms of a back sprain or strain are:
- Pain that worsen with activity or movement
- Cramping or spasms of the muscles in the back
- Limited or restricted range of motion or function of the back
Spinal sprains and strains are typically diagnosed based on medical history and physical examination. After discussing the individual's symptoms, the physician will examine the back by applying pressure on different areas to look for location of pain. The physician may also order an x-ray to rule out fractures or other causes of pain.
Immediate treatment of spinal sprains and strains is typically as follows:
- Relative Rest - Walking may be painful, so it’s best to avoid putting pressure on the back and limiting activity during the healing process. Time is the best treatment as the body takes time to heal injured tissue.
- Ice - Ice should be applied for the first 48 to 72 hours or until the swelling subsides for 10 to 20 minutes no more than once per hour. Use of a barrier, such as a towel, is strongly advised to protect the skin. Heat should be avoided while inflammation is developing; once the swelling goes down, heat can help soothe the pain.
Once the swelling and spasm subside, returning to normal activity as tolerated is advised as prolonged immobility or rest can cause symptoms to persist and recovery to be delayed.
Most people who experience spinal sprains and strains recover within a couple of weeks with the proper treatment. If symptoms persist beyond a few weeks, additional treatment might be required and will be determined on a case-by-case basis. Prevention of these injuries focuses on maintaining a healthy weight, exercising regularly, and using good body mechanics when doing activities.
CALL 911 IMMEDIATELY IF YOU ARE HAVING A MEDICAL EMERGENCY!
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