Lumbar sprain from AZ: How to manage the crisis?

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 Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine 

You made a wrong move, and you think you have suffered a lumbar sprain (also called lumbago or kidney circumference)? Worse still, you may have no idea why you locked your back when you woke up!

What should be done ? Should we put hot or cold after a lumbar sprain? Will the doctor put me on sick leave if I go to see him? What is the treatement ? Are there exercises that could help me (Hint: YES! And I offer 3 at the end of the article)?

In short, you are looking for quick and effective solutions to reduce your pain and heal your lumbar sprain as quickly as possible. Let's get started without further delay!

Lumbar sprain, back strain, lumbago…what exactly is it?

Lumbar sprain, lumbago, kidney tower, acute low back pain… all these qualifiers are used to designate the same thing. In general, a sprain refers to an overstretching of a ligament. On the other hand, the terms "kidney circumference" and "lumbar sprain" are more general, and include all musculoskeletal structures (ligaments, muscles, tendons, etc.) of the lumbar region.

It can be a ligament micro-tear, joint irritation or even overstretching of a back muscle. Either way, an inflammatory process ensues. And that hurts! Fortunately, it is not an attack of the kidney as such (this would be much more serious!). We use this expression because the pain is located in the lower back (near the kidneys, but much more on the surface!).

Symptoms associated with lumbar sprain

The symptoms associated with the sprain are pain (often severe) in the lower back area. This pain can even radiate to the middle of the back, to the sides, and even possibly to the buttocks. If the pain radiates further down the leg, it may be another condition such as herniated disc, sciatica or cruralgia.

The pains are most often increased during trunk movements (especially sudden movements), and when trying to sneeze or cough. In more severe cases, the discomfort may be present at rest, and significantly limit daily activities. Even taking deep breaths can be uncomfortable!

L'elumbar torso is often associated with stiffness in the lower back, which can lead to an inability to move the spine in full amplitudes (hence the famous expression “My back is blocked!”). There may also be muscle spasms and altered posture due to pain.

Duration and prognosis: How long does a lumbar sprain last?

When you suffer from a lumbar sprain, the pain is so intense that it can sometimes seriously worry us. And even more if it's the first time!

By writing “back blocked” on Google, you may have come across a back pain forum. It talks about emergency surgery, infiltration, incapacitating chronic pain, prolonged absence from work, cancer… In short, everyone seems to be suffering martyrdom and major depression!

Rest assured !!! 

In general, the evolution is favorable following a lumbar sprain, and the vast majority of patients heal within 6 weeks. That's a fact. Moreover, even if you have very bad back pain initially, do not think that the high intensity of the pain is synonymous with a more severe attack.

Admittedly, those who have a lumbar sprain are unfortunately at risk of recurrence in 75%, and 5% of people are at risk of developing chronic pain (the testimonials you read in forums often come from this particular population!).

But in general, the statistics are encouraging, and the majority of episodes of acute low back pain eventually resolve. Phew!

How can I be sure that nothing is serious?

We concluded that people who suffer from a sprained lower back usually get better eventually. On the other hand, it is essential to discuss the cases where low back pain requires urgent care. Not to worry you (again, less than 5% of cases where back pain is the cause of a serious impairment)… but rather so that you and I can have peace of mind!

In summary, if you ever experience any of these symptoms, you should consult as soon as possible:

    • Pain following severe trauma
    • Constant, progressive, non-mechanical pain (not influenced by movement)
    • Chest pain or severe abdominal
    • Constant night pain
    • Unexplained weight loss
    • Saddle anesthesia (around the genital area)
    • New-onset urinary or fecal incontinence

 

 

Who can I consult?

 

If you suffer from a lumbar sprain, you may consider consulting a health professional. It's an excellent decision! First of all, the doctor is often the gateway allowing you to take charge of your condition.

As for the various therapists, they are also equipped to help you identify the source of your problem, clarify the diagnosis and offer solutions adapted to your situation.

Now, who is the best therapist to see based on your symptoms? Between the physiotherapist, osteopath, chiropractor, or massage therapist, it can be difficult to choose.

Know that there is not really a good answer, and that it is especially necessary to choose a therapist in whom one has confidence, and who is comfortable with the treatment of acute low back pain. As this is a very frequent condition, the vast majority of therapists will be able to help you recover, and/or refer you to the appropriate resources if necessary (specialist, medical imaging, Etc.).

I just hope you don't come across a bad therapist which will waste your time and money!

Treatment: What can be done to relieve the symptoms?

Back pain after an episode of lumbar sprain can be debilitating, and greatly affect our daily activities (not to mention our mood!).

Here are 6 possible solutions to consider to avoid aggravating your symptoms, and guide you on the road to recovery. If you ever have to consult a professional, he will of course be able to advise you in a more exhaustive and appropriate manner.

1. Stay active 

 If you favor complete bed rest after your lumbar sprain, I'm sorry to tell you that you are wrong. You MUST move after a turn of the kidney, as long as it's done progressive and safe way.

Exercise bike, walking, swimming, there is not really an activity that has been shown to be superior. For this reason, it is essential to go with an activity that gives you pleasure!

2. Apply ice and/or heat

Let's take a close look at the mechanisms by which cold or heat act to reduce certain types of pain (such as pain from a lumbar sprain):

Effects of cold

The fact of relieve pain using cold has a name, we call it the "cryotherapy" (cold therapy).

You should know that pain secondary to body aches, sprains, tears or other traumas are mainly the result of inflammatory phenomena, including the formation of a edema which compresses the surrounding nerve endings, transmitting a message of pain to the brain.

It is precisely to fight against these inflammatory phenomena and this painful edema that doctors generally prescribe nonsteroidal anti-inflammatory drugs, or even corticosteroid injections (Corticosteroids are powerful anti-inflammatories).

Le cold can also fight local inflammation by training a vasoconstriction, that is, a reduction in the diameter of the blood vessels. This physiological phenomenon will allow limit the formation of edema (accumulation of water at the interstitial level, i.e. outside the vessels) and bruises (accumulation of blood in the tissues) source of pain.

It is important to clarify that inflammation is not necessarily a bad thing! In fact, it is a physiological phenomenon (normal) very important which allows, among other things, the repair of tissue damage.

There is therefore no question of outright eliminating any local inflammation in the event of trauma. Certainly, this could drastically reduce the pain, but this would prevent healing of the lesion (risk of becoming chronic).

The different methods used (NSAIDs, cryotherapy, corticosteroid infiltrations, etc.) only allow limit the intensity of inflammation, and therefore pain, pending healing of tissue damage.

In addition to reducing inflammation, cryotherapy (cold therapy) is able to relieve pain thanks to:

  • Slowing down cellular metabolism: the cold slows down the metabolic activity of cells, which leads to a decrease in the production of metabolic waste responsible (in part) for pain, such as lactic acid.
  • Has an anesthetic effect: cold is a natural anaesthetic! It is able to numb the pain quickly and provides immediate relief.

Effects of heat

Heat is also recommended to relieve certain types of pain (including that of thelumbar sprain). Here are some of its effects:

  • Acceleration of cellular metabolism: the increase in the metabolic activity of the cells located in the affected region makes it possible to accelerate the repair of tissue damage.
  • Increased blood circulation: the heat causes local vasodilation (increase in the diameter of the blood vessels), which also speeds up healing by providing the various elements necessary for tissue repair (oxygen, nutrients, growth factors, etc.).
  • Muscle relaxation: heat reduces painful muscle tension.
  • Blocking of nociceptors: the application of heat reduces local pain by slightly blocking the sensory receptors responsible for transmitting pain signals to the brain.

What to choose ?

Now that you know the effects of hot and cold, you will surely better understand why it is generally recommended, after a lumbar sprain, to apply cold during the acute phase et heat from a distance of the latter.

In fact, the application of cold (ice wrapped in a towel or other cloth) on the painful area helps to reduce the intensity of the local inflammatory reaction (without eliminating it!) during the acute phase and benefit from a anesthetic effect immediate.

Once the acute phase has passed (after the first 48 to 72 hours), the inflammation is usually reduced. It is then recommended to apply rather heat (via a hot water bottle or by taking a hot bath) to reduce muscle spasms and tension sources of pain.

Applying heat away from the acute phase will also allow you to heal faster, as it promotes the repair of tissue damage.

Furthermore, it is important for you to know thatthere is no consensuss vis-à-vis the use of thermotherapy (the use of hot or cold to treat) in the management of pain. Two people with the same pathology can react differently : one relieved by the cold, the other by the heat…

It is therefore up to you to find the method that will work best for you, but always following the instructions: cold in the acute phase, hot at a distance from the acute phase.

Warning, the use of cold and heat is not without danger. You must comply with a number of precautions to avoid burns, redness and other negative effects extreme temperatures.

To learn more, visit this article which discusses the difference between heat and ice in detail.

3. Promote a comfortable sleeping position

Good sleep hygiene will allow you to sleep better, which will inevitably promote optimal healing of your back problem. In several cases, a memory foam orthopedic pillow or a comfortable mattress can help relieve symptoms.

For advice on good sleeping postures to adopt in the presence of back pain, see the following article.

4. Breathe

Yes yes, breathing has a role to play in back pain, and a optimal breathing will allow you to heal even faster.

5. Meditate

Don't worry, no one is asking you to become Master Yoda. On the other hand, it has been shown that the mindfulness (Mindfulness in English) can be beneficial in case of low back pain.

6. Try natural remedies

Although they are not necessarily supported by a large number of scientific researches, we often observe a relief of symptoms with certain essential oils, grandmother's recipes or other products derived from homeopathy. From natural products the most frequently used are:

Use of essential oils

To relieve the pain of a lumbar sprain, it is possible to use certain essential oils to the virtues anti-inflammatory et analgesics as :

  • wintergreen essential oil;
  • Peppermint essential oil;
  • Rosemary essential oil;
  • Ylang-ylang essential oil;
  • Lemon eucalyptus essential oil;
  • True lavender essential oil;
  • Basil essential oil;
  • Marjoram essential oil.

To take advantage of the anti-inflammatory, analgesic and soothing properties of these essential oils, simply dilute one or two drops in vegetable oil (olive or sweet almond oil for example), then use the mixture to perform gentle, circular massages in the lumbar region once or twice a day or occasionally.

Taking herbal pain relievers

Many plants have and calm skin et natural painkillers which can be effective in relieving the pain of a lumbar sprain. Here are a few :

  • Ginger ;
  • Turmeric;
  • White willow bark;
  • blackcurrant;
  • Scots pine;
  • chamomile;
  • Peppermint.

In addition to the remedies mentioned above, other products can be tried to relieve the symptoms of lumbar sprain:

  • Glucosamine and chondroitin
  • Vitamin D
  • Turmeric
  • Tiger Balm and other capsaicin products
  • bryonia alba
  • Arnica
  • Clay poultice
  • white willow bark

Note: To know everything about natural products (use, risks, indications, etc.),see the following article.

You have been warned! : It is recommended to inform their doctor in case of use of medicinal plants (compliance with contraindications and dosages, avoid drug interactions, etc.).

What exercises can I do while waiting?

As mentioned previously, it is essential to integrate an active approach to optimally treat your back circumference. This is where therapeutic exercise comes in.

Obviously, a healthcare professional will be able to adjust and adapt an exercise program so that it is beneficial for your back. the physiotherapist (physiotherapist) is the therapist of choice when we want to be active and suffer from back pain.

Here are 3 exercises that I regularly prescribe to my patients suffering from lumbar sprain (kidney circumference) in the office. Obviously, they will be integrated within a global care, and adapted according to the patient: 3 exercises to do after a lumbar sprain (in video) 

In addition to therapeutic exercises, it is important to keep active as much as possible. This is all the more true if you do repeated back exercises. A healthcare professional may discuss with you some preferred activities or sports on a daily basis, as well as prescribing an adapted program aimed at acting in prevention.

How to sleep with a lumbar sprain?

After an episode of kidney strain, it is not uncommon for sleep to be affected. This is often due to an awkward position which increases stress on the vertebrae lower back, and causes limiting pain. Moreover, the static posture induced by sleep often causes morning stiffness.

To manage symptoms, it is not uncommon for patients to take painkillers, anti-inflammatories, or muscle relaxants before bedtime. It is also recommended to try heat or ice just before sleep to relieve symptoms. If you benefit from exercises and stretches from a physical therapist, they would also be done before sleep to relieve symptoms.

In terms of sleeping posture, the recommended positions are those in the supine position (lying on your back with a pillow under your knees) or in lateral decubitus (lying on your side with a pillow between your legs). It should be noted that the quality of the mattress can influence pain, as can the pillow in some cases.

To benefit from advice aimed at relieving back pain at night, see the following article. 

Conclusion

So! If you've got your lower back stuck, hopefully you're better equipped to take charge of your condition. Be sure to apply the 5 tips mentioned in the article above, as they are an excellent starting point.

A lumbar sprain, if treated well, can heal quite quickly and allow a return to daily activities. On the other hand, it can also evolve into something more difficult to treat, with compensatory schemes and cognitive distortions.

It is for this reason that we must keep our spirits up, be proactive, and seek the help of a health professional in case of doubt.

Good recovery!

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