Back > Lower Back Strains and Sprains > Treatments

   Non-Surgical Treatment

Recovery at Home

Lower back strains and sprains can cause varying degrees of discomfort and hindered back movement. Many people can ease their pain with over-the-counter anti-inflammatory medication, like ibuprofen and aspirin. Household tasks, like lifting objects and opening and closing doors and windows, may be difficult after a back strain. Physicians generally recommend that you avoid physical activities until your back has healed. It can be helpful to arrange for someone to visit you after a back strain to help with any household chores. After 72 hours, you may be able to begin heat therapy, which brings blood to the muscles. However, heat therapy is usually not prescribed until about two weeks after the injury. Many types of heating pads are available and physicians generally teach you to use them at their discretion. Heat generally is applied twice a day for 20 to 30 minutes at a time.

Ointments and massage also may be used to soothe muscle pain. Your physician will decide if it is safe to begin this type of treatment. Certain patients may relieve some back pain with alternative therapies like acupuncture or herbal remedies, but should consult their physicians before trying any siuch types of treatments. Education is a big part of the treatment. Once pain decreases, you can generally begin controlled exercises that focus on strength and endurance. Treatments such as heat and electrical stimulation may also be used. Ninety percent of injuries resolve within two months. Though it has become common to visit chiropractors, it is prudent to see your physician first to make the diagnosis and determine if a chiropractor can safely help ease your lower back pain. Chiropractors manipulate your spine, which means they use their hands to administer quick forces to specific areas of your spine. Although research has supported the use of manipulation in certain conditions, physicians and chiropractors often disagree about its safety and the reasons why it helps ease back pain. Remember that some conditions can be worsened by spinal manipulation or need more aggressive treatment than chiropractors can offer. Therefore, it is essential to consult with your physician before visiting a chiropractor.

Rehabilitation

During physical rehabilitation for lower back strains and sprains, you will most likely need to do several exercises to stretch the back muscles and build their strength. This helps relieve stress to the lumbar vertebrae in your lower back and minimize the risk of straining your back in the future. When pain has been reduced, your physician will probably recommend that you begin rehab exercises. Your physician and physical therapist will decide on a custom rehab program that varies depending on your body type, level of involvement in activities, and severity of back strain. It may take up to ten weeks to return to activities if you have suffered a severe back strain. But mild strains often can be successfully rehabilitated in one or two weeks. The intensity and duration of stretching and strengthening exercises increases as your back heals. In general, rehabilitation of the back muscles can be broken into three parts:

   Stretching – physical therapists can teach you the most effective ways to stretch your back. Rehab includes side-to-side, forward, backward, twisting, upward, and downward stretches. After a lower back strain or sprain, you will likely have restricted motion. Over time, your ability to stretch farther in all directions will probably increase.

   Strengthening – once your lower back has achieved normal flexibility, you can usually begin strengthening exercises. Your physical therapist may recommend many different exercises to strengthen your back and abdominal muscles. Bending your back in different directions against resistance and performing partial sit-ups or "crunches" that do not bend the lower back are two of the most common examples of back and abdominal strengthening exercises.

   Return to activities – your physical therapist can make sure you have a full and pain-free range of motion before your rehab is finished. Progressive functional drills, which teach you proper technique for your favorite activities, are usually the final phase of rehab.

Rehabilitating a lower back strain or sprain can be difficult because so many daily activities, like lifting objects, can cause pain during the first few weeks. Try to be patient and follow your physical therapist's instructions.

Common causes of recurrent lower back strain include change in level of activity, overuse, inadequate conditioning, poor posture, and improper lifting. To prevent the recurrence of lower back strains, you should make the stretching and strengthening program you learned in rehab part of your regular exercise routine. A strong and flexible back may be more able to withstand any abnormal positions and strain that occur during sports and activities. Before activities, remember to warm up your back muscles by stretching in all directions. Tight back muscles may be more apt to pull or tear. You should also stretch your rear thigh muscles, called hamstrings, to relieve back stress. When stretching the back by bending forward, try to keep your weight centered over your feet, rather than out in front of you. When standing and sitting, physicians generally recommend that you keep your back in good posture. If you notice yourself slouching, roll your shoulders back so they are in line with your hips. Weight control is also important. One extra pound of body weight translates into three or four pounds of weight across your back. Lightening the load on your back helps take strain off the lumbar vertebrae and the lower back muscles. After you have suffered a lower back strain or sprain, you should take the following precautions to prevent recurrence:

   Be sure your shoes have cushioned soles. Avoid flat, unpadded boots and dress shoes if you are going to be walking a long distance or participating in physical activities.

   Take time to stand and stretch if you are sitting in one place for over an hour.

   Consider buying a chair or mattress specifically designed to provide lower back or lumbar support. The important thing is to have a well-functioning mattress set (box-spring foundation and mattress) that is not worn out and uneven. Find one that feels comfortable to you when you lie down on it for ten to 20 minutes in your regular sleeping position.

   Many orthopedic surgeons still recommend firm mattresses, but if you feel more pain after lying down on a firm mattress, then it may be too firm.

   Bend with your knees to pick things up off the ground to avoid straining your back. Try to lift heavy objects with your legs while keeping your back aligned in a straight posture.

Non-surgical treatment usually can heal lower back strains and sprains. Your doctor will likely suggest that you refrain from sports activities. For severe lower back strains that keep you from performing your regular activities, one to two days of bed rest usually is recommended. After two days, you should begin to move around again, but minimize activities that stress your lower back and cause pain. Studies have shown that more than two days of bed rest actually slows down your recovery. Initially, your doctor may recommend applying ice packs to your lower back for about 20 minutes every three or four hours. You will probably need to do this for two or three days or until the pain subsides, and you may need to continue to do it after exercise or activities for weeks or months until pain stops recurring. Braces are not used in the treatment of most back strains. If patients request them, they may be prescribed, but their benefit is questionable. The soft corsets that you see people wear provide no mechanical support to the spine. They function mainly as reminders to the person wearing them not to stress the lower back and to limit motion slightly. They also may provide support to the abdominal and lumber muscles. Over time the corset could theoretically contribute to muscle weakness and limited range of motion of the spine. You are typically prescribed pain medication as needed, depending on the severity of your back strain. Non-steroidal In rare circumstances, you may be given an injection of a local anesthetic for pain, or a corticosteroid to reduce inflammation. These injections cause a slight sting in your lower back that lasts about five seconds. For some people, lower back strains and sprains are chronic problems that come and go. Physical therapists can put you through "back school" – classes that educate patients on how to avoid back injuries and how to improve strength and endurance of the trunk muscles. The time it takes to heal lower back strains is highly variable:

   Mild strains typically heal in two to ten days.

   Moderate strains may need ten days to six weeks to heal.

   Severe strains can take between six and ten weeks to heal.

Your physician will probably prescribe a few regular check-up visits if you have a moderate or severe strain or sprain, but most of the treatment can be done at home.