Neck and Low Back Strains and Sprain
A sprain is a ligament injury caused by overstretching the ligament beyond its optimal capacity. It may even result in a ligament tear.
A strain refers to damage to the muscle or its tendon when it is stretched beyond its capacity. In severe cases, it may even result in a tendon or muscle tear.
Causes of Neck and Low Back Strains and Sprains
The neck is the most flexible part of the spine and supports the weight of the head. The unique anatomical structure of the cervical vertebrae allows free movement of the head. The neck is also composed of muscles and ligaments. Any excessive stress on the ligaments and muscles may injure or damage them.
Some of the most common activities and movements that may cause stress on the soft tissues of the neck include lack of adequate warm-up exercises prior to sports, a fall, awkward position of the neck during sleeping, poor posture, and spearing in football. Motor vehicle accidents usually result in severe sprains and strains called whiplash injuries due to sudden unexpected movement of the neck.
Low back or lumbar strains and sprains occur when the muscles, tendons or ligaments in the lower back get stretched or torn. It may be caused by lifting heavy objects, sitting or standing for a longer time, a direct blow over the area, or sports such as basketball, baseball, or golf that involve sudden twisting of the lower back. The risk of sprains and strains to the neck and lower back increases with increased low back curvature, weak abdominal muscles, and a forwardly tilted pelvis.
Symptoms of Neck and Low Back Strains and Sprains
A sprain or strain results in neck or low back pain, which may develop immediately after the injury or may present after a few hours or even days after the injury. The pain is usually intense and pounding in nature with a sudden onset. Neck pain may also radiate to the shoulder, upper back, or arms while low back pain may radiate to the hips, buttocks or down the legs. Pain may also be associated with muscle spasms. The affected region may be tender to the touch with localized swelling and stiffness. Even slight movement can sometimes aggravate the pain. Whiplash injuries are a more severe type of neck injury. They usually result in headaches, dizziness, jaw pain, and a ringing sensation in the ears. In rare cases, injuries causing sprains and strains may also result in loss of bowel or bladder function which is a medical emergency.
Diagnosis of Neck and Low Back Strains and Sprains
An accurate diagnosis is crucial for effective treatment of this condition. To arrive at an accurate diagnosis the doctor will inquire about your symptoms, time of their appearance, and a history of any treatments employed previously. A medical history, a physical and neurological examination are also essential for diagnosis.
Neurological examination is conducted to identify any signs of neurological injury and involves the evaluation of reflexes and muscle weakness. To confirm the diagnosis and to rule out other causes with similar symptoms an X-ray or a CT scan may also be performed. Sometimes, electromyography may also be ordered if an underlying muscle abnormality is suspected.
Treatment of Neck and Low Back Strains and Sprains
Although the pain is excruciating, in a majority of cases non-operative therapies are sufficient. Some of the non-operative therapies include rest, activity modification, medications such as muscle relaxant, and intermittent application of ice pack followed by moist heat application. A neck collar or back brace may also be recommended for a few weeks to support the neck or lower back as well as to prevent any movement in order to potentiate healing. Non-steroidal anti-inflammatory drugs or NSAID’s and muscle relaxants may also be prescribed to reduce the pain and swelling. Physical therapy, chiropractic, or acupuncture may also be effective in some cases. Interventional options include trigger point injections done in the office and/or with x ray guidance
