Lower Back Strain/Sprain: What’s the Difference?

Anatomy of the “back”

In order to understand a lower back strain/sprain, a small anatomy lesson must be done. The back is a complex structure of bones and muscles, supported by cartilage, tendons and ligaments. “Back” is a common term which can include portions of the neck, thoracic spine and lumber spine. The back—especially the lumbar, or lower portion of the back—bears much of the body’s weight during walking, running, lifting and other activities.

Defining a strain vs. sprain

A strain is a general term for an injury that affects a muscle or tendon. Then, the location of the injury or which muscle or tendon is affected is then specified. For example, a lower back strain means muscles or tendon that are attached to lower back have been injured and may involve tears in the tissue. Alternatively, a hamstring strain means that specific muscle has been injured.

Unlike a strain, a sprain means an injured or torn ligament. Ligaments are non-stretchy bands of tissue which attach bone to bone. Primarily, their job is to prevent excessive motion or hypermobility at a joint, and give extra stability to our joints.

How does a lower back strain/sprain happen?

• Quick or unusual movement: Quickly moving or twisting the back puts extra force through the muscle, especially if there are heavy weights involved
• Improper lifting/bending: Repetitively overstressing the back muscles can lead to injury E.g. weightlifting with bad form in the gym. Consequently, a chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.
• Trauma: Unfortunately, a fall on the back or a forceful blow to the it can move the joints more than their normal range, generating shear forces that strain/sprain the tissues of the lower back. Accordingly, this kind of trauma usually affects more then one muscle or tendon.
• Poor posture: Repetitive and excessive time spent in improper postures or underlying conditions like scoliosis (excessive curvature in the spine) can put extra stress on muscles and ligaments and make them more prone to injuries. Thus, poor sitting and postural habits can makes the muscles weaker.
• Obesity: Excessive body weight adds extra load and therefore, stress, on the back. This may make it more sensitive to injuries.

What does a lower back strain/sprain look like?

• Pain in the back
• Swelling, warmness and/or redness around the painful area
• Reduced range of motion
• Certain activities are painful like getting up in the morning, putting socks on, etc.
• Muscle spasms or cramps
• Prolonged sitting, standing or walking increases pain
• Sometimes, radiating pain down into the hips or glutes

How is it diagnosed?

Mild strain/ sprain can be diagnosed from:

• Subjective history like how the injury occurred, signs and symptoms reported
• Physical examination by health care provider like a physiotherapist or physician
• X-ray to rule out fractures
• Ultrasound
• MRI

How is it treated?

Manual therapy is one of the treatment techniques used by physiotherapists for a lower back strain/sprain

The following management will help you to recover from back injuries.

1) Icing: Firstly, immediately after the injury within 48-72 hours, icing helps to  reduce pain and swelling

2) Medication: Medication prescribed by the family doctor can help
manage pain and inflammation

3) Reduce painful movement: Additionally, limiting or modify aggravating movements which cause back pain for some time. This is necessary to give the muscle or ligament time to heal

4) Modalities: Electrotherapies like IFC and ultrasound will help reduce pain and inflammation

5) Soft-tissue work: Gentle massage or soft-tissue work will help muscles stiffness and pain

6) Brace: Sometimes, using a back belt/brace temporarily will reduce excessive movement occurring at the back to minimize pain. However, it is important not to become reliant on the brace as long term use can result in weakening of the core muscles

7) Strengthening exercises: Once pain has been reduced, back and core muscle strengthening exercises will help return you to your previous function and in the prevention of future injuries.

8) Stretching exercises: Stretching of tight muscles will help reduce stiffness and gaining your mobility back again

9) Postural Correction: Similarly, postural exercises will teach the most efficient postures to induce the least strain and stress on muscles. As a result, this should minimize the risk of reinjury

10) Proper technique and ergonomics: Finally, learning proper techniques for lifting, bending, carrying or how to properly set up your work desk are very important to reducing stress on your body

Infographic demonstrating a proper lifting position for the back

Need help?

If you have experienced a back strain/sprain or recent back issue, look no further than PhysioNow. We have many expert Registered Physiotherapists in 9 locations across the GTA from Burlington to Etobicoke. We would be more than happy to assist you with any questions or to get you started on an individualized treatment program. Book with PhysioNow today for your first assessment and treatment.