THElumbar sprain is a condition that is frequently encountered in athletes and the active population. Clinically, it usually manifests as recent and sudden onset low back pain to which may be added stiffness, tensions and spasms in the muscles of the lumbar region. Un careful clinical examination is necessary in order to look for a possible associated nerve damage (herniated disc, sciatic neuralgia, etc.).
Treatment ofbenign lumbar sprain is mainly based on the fight against pain and muscle contractures, psychological care and rehabilitation. As for thesevere lumbar sprain (complete rupture of rare occurrence), its treatment is essentially surgical.
Your doctor has diagnosed you with lumbar sprain and you forgot to ask him how long will it take to heal? If so, or if you are just curious, you will find the answer to your question in this article!
What is a lumbar sprain?
Our spine is composed of 33 vertebrae stacked on top of each other and separated by intervertebral discs.
To ensure the stability of the spine, numerous ligaments connect these vertebrae, notably the longitudinal ligaments anterior and posterior, intertransverse ligaments, interspinous ligament and yellow ligament.
There are also ligaments that connect between the last two lumbar vertebrae (L4 and L6) and the bones of the pelvis, the iliolumbar ligaments (the most frequently affected by lumbar sprains).
At a Wrong move, one of these ligaments stretches excessively (elongation) or breaks partially or completely. This is called a sprain.
A lumbar sprain so is a overstretching, a partial or total rupture of a ligament located in the lower back. It can also involve other soft tissues such as the muscles or tendons.
Lumbar sprain is mainly manifested by pain lumbar sudden onset (on the occasion of a false gesture) which worsen during movements of the spine and which are most often accompanied by stiffness, tensions or muscle spasms painful.
For more details on thelumbar sprain, its symptoms, causes and management, see the following article.
Lumbar sprain: what are the factors that influence its healing?
Before moving on to the different factors that influence the healing of a lumbar sprain, it is important to understand what is happening at the level of the pathological region (ligament injury).
What are the healing stages of a lumbar sprain?
You should know that a ligament injury, such as that observed during a lumbar sprain, heals spontaneously by following the following three steps:
- Inflammatory phase:
It sets in from the first minutes of the lumbar trauma and lasts some days. This phase is characterized by micro-bleeds due to the rupture of a few blood capillaries at the level of the lesion site, a vasodilatation (increase in the caliber of healthy blood vessels) and a supply of many inflammatory cells and molecules (macrophages, cytokines, chemokines, etc.). An edema (swelling) then forms and sometimes very intense pain appears.
Note : the inflammatory phase does not only concern the first injury, it comes back every time the ligament gets injured again (relapse or “re-injury” of the same lesion). This is why one should not consider oneself "cured" on the pretext of a disappearance of pain.
It's also important to remember that inflammation isn't always a bad thing. In effect, the inflammatory reaction is a physiological phenomenon, perfectly normal, which is used to repair tissue damage and to fight against various infections.
Inflammation becomes problematic when it is too intense or that she persists too long. It is therefore necessary to use various methods to reduce it or limit its intensity such as taking nonsteroidal anti-inflammatory drugs (NSAIDs), applying ice, local corticosteroid injections (infiltration)…
- Repair phase:
During this phase, fibrous cells (fibroblasts) are attracted to the lesion site and stimulated to produce collagen fibers in large quantities to repair the injured ligament.
At the end of this phase, which generally lasts between 4 and 21 days, there will be enough collagen to repair the ligament damage. However, the ligament is still fragile and can be damaged again if it is stressed.
- Remodeling phase
During this phase, which can last 21 days to a year, the ligament is progressively remodeled with a reorientation of collagen fibers in the direction of the mechanical stresses exerted on it.
Thus, the ligament becomes more and more resistant and gradually regains normal functioning.
What factors influence healing?
Here are some of the factors that influence the duration of a lumbar sprain:
- The severity of the lesion: simple ligament overstretching (elongation or strain) heals very quickly (generally in less than 6 weeks), while a partial or total rupture requires more serious treatment (surgery) and therefore takes much longer to heal.
- The affected ligament: some ligaments take longer to heal than others (depending on their volume, the degree of their stress, their elasticity, etc.).
- Physical activity : it is important to maintain gentle physical activity to avoid weakening of the back muscles, of course by favoring movements which do not arouse pain and which do not risk aggravating the ligament injury (recommended treatment by a physiotherapist ).
- General physical condition: young, healthy subjects generally recover faster from a lumbar sprain.
- Response to drug treatment: some people respond better to painkillers, anti-inflammatories, or muscle relaxants than others.
- Psychosocial factors: the pain of a lumbar sprain, as in many pathologies, is accentuated by stress, anxiety, emotions and other psychosocial factors. For faster healing, it is important to take this psychological component into account, in particular by implementing a certain number of anti-stress methods (psychotherapy, meditation, sophrology, etc.).
Note : it is important to remember that the intensity of the pain does not always reflect the severity of the ligament damage from a lumbar sprain.
Conclusion: How long for a lumbar sprain to heal?
In general, there are 3 main varieties of lumbar sprains according to their duration:
- Acute lumbar sprain: it lasts from a few days to 4 weeks.
- Subacute lumbar sprain: it lasts from 4 to 12 weeks.
- Chronic lumbar sprain: it lasts more than 12 weeks.
In the vast majority of cases, the symptoms of a benign lumbar sprain disappear in less than 6 weeks.
Warning, we are talking here about symptoms only. Indeed, complete healing (restoration of the integrity of the ligament) can take several months or even years.
Resources
https://www.lombafit.com/lumbago-a-z/
https://www.lombafit.com/entorse-lombaire/
https://www.lombafit.com/douleur-dos-glace-ou-chaleur/
References
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[7] S. Liang, G. Zhang, J. Li, L. Zhong, and C. Zhang, “Wrist ankle acupuncture in the treatment of acute lumbar sprain: A protocol for systematic review and meta-analysis”, Medicine, flight. 99, no 49, 2020.
[8] "Lumbar Sprain: Causes, Symptoms and Treatment of Lumbar Sprain", Dr. Michael Desbiens, Chiropractor, June 30, 2016. https://chiroste-foy.com/entorse-lombaire-tour-de-rein/ (accessed October 22, 2022).
My name is Katia, I am specialized web editor in writing medical articles. Being passionate about medicine and writing, I set myself the goal of making medical information accessible to as many people as possible, through the popularization of even more complex scientific concepts.
My name is Katia, I'm 27 years old and I'm a web writer specializing in writing medical articles. Being passionate about medicine and writing, I have set myself the goal of making medical information accessible to as many people as possible, thanks to the popularization of even more complex scientific notions.