Your “lumbar spine”, or low back, is made up of five bones stacked on top of each other with a shock-absorbing disc between each level. Your low back relies on muscles and ligaments for support. “Sprains” and “strains” are the result of these tissues being stretched too hard or too far, much like a rope that frays when it is stretched beyond its normal capacity. The term “sprain” means that the tough, durable ligaments that hold your bones together have been damaged, while “strain” means that your muscles or tendons that move your trunk have been partially torn.
Most people experience low back pain at some point in their lifetime, and 70% of those patients can attribute their symptoms to sprain/strain injuries. Lumbar sprains and strains may result from sudden or forceful movements like a fall, twist, lift, push, pull, direct blow, or quickly straightening up from a seated, crouched, or bent position. Most commonly, sprains and strains are not the result of any single event, but rather from repeated overloading. The spine can generally manage small isolated stressors quite well, but repetitive challenges lead to injury in much the same way that constantly bending a piece of copper wire will cause it to break. Examples of these stressors include: bad postures, sedentary lifestyles, poor fitting workstations, repetitive movements, improper lifting, or being overweight.
Symptoms from a sprain/strain may begin abruptly but more commonly develop gradually. Symptoms may range from dull discomfort to surprisingly debilitating pain that becomes sharper when you move. Rest may relieve your symptoms but often leads to stiffness. The pain is generally centered in your lower back but can spread towards your hips or thighs. Be sure to tell your doctor if your pain extends beyond your knee, or if you have weakness in your lower extremities or a fever.
Sprain/strain injuries cause your normal healthy elastic tissue to be replaced with less elastic “scar tissue.” This process can lead to ongoing pain and even arthritis. Patients who elect to forego treatment and “just deal with it” develop chronic low back pain more than 60% of the time. Seeking early and appropriate treatment like the type provided in our office is critical.
Depending on the severity of your injury, you may need to limit your activity for a while, especially bending, twisting, and lifting, or movements that cause pain. Bed rest is not in your best interest. You should remain active and return to normal activities as your symptoms allow. The short-term use of a lumbar support belt may be helpful. Sitting makes your back temporarily more vulnerable to sprains and strains from sudden or unexpected movements. Be sure to take “micro breaks” from workstations for 10 seconds every 20 minutes. Following acute injuries, you can apply ice for 15-20 minutes each hour. Heat may be helpful after several days or for more chronic origins of pain. Ask your doctor for specific ice/heat recommendations. Some patients report partial relief from sports creams.
Our spine is made up of twenty-four individual vertebra stacked on top of each other. To allow for flexibility and movement, there is a cushion, or “disc” in between each pair of vertebra. As we age, these discs can wear, becoming progressively thinner over time. This leads to a cycle of arthritic changes, including bone spurs and narrowing of the opening where our nerves exit the spine. Sometimes your nerves can become “pinched” in these narrowed openings. This results in pain, numbness or tingling into your arm along the path of the irritated nerve.
This problem is common, affecting half of the population by age 40 and up to 85% percent of the population by age 60, with men affected slightly more often than women. Symptoms of this type of arthritis include pain or numbness in your neck, arm or shoulder area. Neck stiffness, limited range of motion and headaches are common. Some patients report temporary relief when placing their affected hand on top of their head.
You should avoid prolonged reading or sustained positions where your head is rotated, laterally flexed or looking up. Avoid any position that causes an increase in radiating pain. Avoid high impact activities, like running, when they cause any increase in pain. Low impact activities like walking, water aerobics and yoga may be helpful.