The spine is made up of a network of structures: the vertebrae, discs, ligaments, muscles and nerves. The lumbar spine (lower back) withstands the greatest amount of strain during movement and because the ligaments of the lumbar spine are inherently weak, injury is always a possibility. A lumbar spine injury often takes the form of a muscle strain, in which the muscles are overstretched or torn; or a lumbar sprain may occur in which the ligaments are torn. These types of lumbar spine injury usually lead to low back pain which if severe enough can be quite debilitating until treatment is sought.
Low back pain that is accompanied by lower extremity weakness, numbness, altered sensation or loss of bladder or bowel control could be signs of a more serious injury, however any low back pain should be evaluated by your health professional.
The most common symptoms of a lumbar sprain or strain are:
- Pain in the lower back and upper buttocks
- Low back muscle spasm
- Pain with activities and generally goes away with rest
A sprain or strain of the lumbar spine results in inflammation of the soft tissue and this leads to pain and muscle spasm. Rest is important and helpful. Heat and ice are both effective at reducing muscle spasm and pain. Your doctor may prescribe anti-inflammatory medications as well.
Factors that contribute to lumbar spine injuries are:
- Sudden forceful movement
- Lifting a heavy object improperly
- Twisting the back in an unusual manner
- A ruptured disc
- Sleeping on an unsupported mattress
Other factors that contribute to lumbar spine injuries are:
- Lack of conditioning, meaning the lumbar stabilising core abdominal muscles are weak. This can cause the back to 'give out' during physical exercise or work activities.
- Obesity. Excess weight leads to poor posture, which puts strain on the muscles and joints of the lumbar spine and may cause injury.
- Repetitive or sustained postures can give rise to overuse of the muscles and ligaments of the lumbar spine, causing injury.
The overall goals of physiotherapy are to provide relief from the symptoms, normalise joint and soft tissue mobility and establish an effective exercise programme for you. The physiotherapy evaluation looks at the progression of symptoms, mechanism of injury, posture and prior level of function. A physical examination will be conducted to assess gait, posture, active range of motion (AROM) of the spine, strength, symmetry and tension signs.
Treatment may involve pain management with soft tissue massage, acupuncture, trigger point therapy, passive joint mobilisation, heat, ultrasound and passive stretching exercises. If necessary we will give you a postural correction exercise programme, as well as specific core strengthening exercises to improve body mechanics, strengthening and conditioning to prepare you to return to normal daily activities and prevent re-injury.
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