Treatment of Lumbosacral Strain in Acute Phase & Recovery Phase: Prognosis, Recovery, Prevention

A lumbosacral strain is an associate degree injury to the muscles of the lower back. It’s typically caused by a forceful or fast twisting or bending movement. In this section of the article you will learn about the treatment for lumbosacral strain, lifestyle changes, recovery, prognosis and prevention of lumbosacral strain.

Here is the general initial process of treatment for lumbosacral strain:

• Avoiding such activities or movements that may worsen the lumbosacral strain.
• Adopt cold and ice therapy to get relief from inflammation and pain of lumbosacral strain.
• Use of anti-inflammatory medications may also be prescribed for treating lumbosacral strain.
• Sports massage can be used after an initial phase of 3 to 4 days. Sports massage to treat lumbosacral strain helps in ensuring proper flow of blood and relieving muscle spasms.
• Gentle stretching can be helpful in recovery of lumbosacral strain if you are comfortable.

1. Medications for Lumbosacral Strain

   Pharmacotherapy is commonly used for treating the case of lumbosacral strain. It helps in getting the situation in control and avoiding any complications. However the therapy should not be used for more than 6 weeks even in the case of serious lumbosacral strain.

   Muscle Relaxants for Treating Lumbosacral Strain

   In the early phase of treatment of lumbosacral strain, muscle relaxants via tablets or IM injections (intramuscular injection) are recommended for relieving muscle spasms. Muscle relaxants can also be used but it is not proven to show significant improvement. Methocarbamol (Robaxin) is commonly used as muscle relaxant for lumbosacral strain.

   Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) for Treating Lumbosacral Strain

   Doctors generally recommend NSAIDs for relieving muscle pain especially during the acute and maintenance phases of lumbosacral strain treatment. These drugs are known to have analgesic, antipyretic and anti-inflammatory effects. NSAIDs prevent synthesis of prostaglandin which helps in reducing inflammation. Some of the commonly used NSAIDs for lumbosacral strain are ibuprofen (Ibuprin, Advil, and Motrin) and Diclofenac (Voltaren).

2. Treatment for Lumbosacral Strain in Acute Phase

   Physical Therapy (PT) for Lumbosacral Strain

   Physical therapy can be used in the acute phase treatment of lumbosacral strain. Cold therapy can be used for a short duration to restrict the inflammation and edema to particular muscles where lumbosacral strain injury is caused. Electrical stimulation can also be used along with cold therapy to make it even more effective. It is necessary to follow the instructions related to body movements and daily routine to avoid any undue stress in the injured area.

   Medical Issues/Complications in Lumbosacral Strain

   The doctors recommend complete bed rest for a little duration of one to two days during acute phase of lumbosacral strain. However, modern theories suggest that some activity level can be more helpful in timely recovery as the body is more functional and active. Sports activities which involve extreme ROM (Range of Motion) of the spine, weight lifting etc… must be avoided.

   Other Treatments for Lumbosacral Strain

   Muscle relaxants or NSAIDs can be injected into the injured muscles causing the pain to get rid of muscle spasms in lumbosacral strain.

   • Try not to manipulate the injured area especially when the injury is in acute phase.
   • Minor lumbosacral corset is also proven to show relief from muscle spasms. However, the corset must not be used for long duration especially if the spasms have eased out.

3. Treatment for Lumbosacral Strain in Recovery Phase

   Physical therapy (PT) can aid in recovery phase of lumbosacral strain. Normally doctors recommend light muscle stretching physical therapy exercises during the recovery phase of lumbosacral strain to strengthen the paraspinal and abdominal and muscles. Along with the exercises, some other modalities like ultrasound, heat, ice and even soft tissue massage can be rewarding.

   Recreational therapy can also help in recovery phase of lumbosacral strain. Maintaining a proper upright posture during standing, sitting, moving or lifting things is helpful for the patients and athletes.

   Surgical Intervention for Lumbosacral Strain

   Generally surgical methods are not necessary for treating lumbosacral strain.

   If the regular treatment procedures involving conservative treatments are not helpful for lumbosacral strain and the patients is diagnosed with rheumatic issues during laboratory or radiographs tests, the patients must refer to rheumatologist. In certain situations like neurologic deficit surfaces it is necessary to refer a spine surgeon.

   Other Treatments (Injection, manipulation, etc…)

   Some other treatments like chiropractic manipulations and light muscle massage are also affective in getting relieve form muscle spasms and pain in lumbosacral strain. It also makes it easier for the patient to take exercise program more comfortably. However IM injections (intramuscular injection) may still be required.

4. Maintenance Phase of Lumbosacral Strain

   Maintenance phase is also crucial in the treatment process of lumbosacral strain. It is necessary to design a particular physical therapy program to suit the condition of the particular patient. The factors such as patients’ age, muscle pain etc… must be taken into consideration. The physical program must be gradually modified as the patient starts to gather flexibility and strength. Normally physical therapy is continued for 1 to 2 weeks but in some cases, it may be needed to continue for several months.

   The main thing is to establish a proper balance of strength and flexibility to ensure good recovery from lumbosacral strain. Once the injured muscles get stronger, the exercise program must be focused on rebuilding the proprioceptors. Overall, the exercises should be directed towards hip, paraspinal and abdominal muscles.

Following the some of the simple lifestyle changes suggested for lumbosacral strain:

• Exercising regularly is a good lifestyle change and is the key to stay fit and away from lumbosacral strain. Follow the instructions of your therapist to avoid recurrence of lumbosacral strain.
• It is better to avoid such games which can be tough for body like waterskiing, tennis etc… unless your body is fit. Pushing your body can cause further degradation.
• The individuals who are having back problems must stay away from the sports which require quick body movements. You may go for safer lifestyle options like walking and swimming.
• It is important to pay attention to your posture and keep it right and it is a good lifestyle change for lumbosacral strain.
• Maintain proper body weight with balanced diet and exercising is a great lifestyle change to prevent lumbosacral strain.
• It is best to keep moving unless there is a severe and extreme back injury. Complete bed rest should only be taken on the advice of your physician.
• Ice packs are very helpful in relieving pain fromlumbosacral strain, especially during acute conditions:
  • Fill a plastic bag with ice.
  • Take a towel and keep it over your skin under the ice pack.
  • Apply ice pack for 15-20 minutes and repeat it after every 2 hours or as per the situation.
  • Once you start to feel better and comfortable, switch to heat treatment which can be applied for about 30 minutes before activities.

The recovery period/healing time for lumbosacral strain varies from one individual to another, depending on the severity of the condition. Minor back strain or minor lumbosacral strain can be relieved in just about two or more days. However for serious lumbosacral strain injuries, it can take weeks. It is necessary to understand that everyone has a different capacity to recover. The symptoms of lumbosacral strain will start to vanish after just 3 days but it takes 1 to 6 weeks for complete elimination of symptoms.

Once the medication starts to work and your back pain is relieved, doctors recommend exercising gradually to get the muscles moving making them limber and stronger. It helps in the recovery and minimizes any chances of having lumbosacral strain again. It is better to avoid high impact sports and prefer low impact sports like walking, swimming etc…

Most important thing is to approach gradually towards your normal routine and physical activities. Give your body enough time to recover and heal. Avoid heavy movements until:

• You are fully comfortable in moving just as before the injury.
• You do not feel any pain or discomfort while jumping, walking, twisting or bending.

If you will try to push your body before it has healed completely, you can get into the risk of permanent injury accompanied by chronic back pain.

The prognosis/outlook for lumbosacral strain is excellent. Most of the case of lumbosacral strain (about 90 percent) can be completely treated with complete eradication of symptoms and problems in 6 weeks irrespective of the type of treatment used. However in the remaining cases of 10 percent where lumbosacral strain is not properly treated can take the form of chronic lumbosacral pain.

Prognosis of Lumbosacral Strain in Athletes: A patient must only return to playing after the complete recovery and when there is no pain or discomfort during playing. If the signs of pain are ignored, the situation of lumbosacral strain may get worse. Medications involving pain killers are not recommended as they can only suppress the pain but cannot heal the actual cause of lumbosacral strain. This is even more risky and can expose you to re injury making things worse.

Following are some of the preventive tips to avoid lumbosacral strain:

• Stop the activity just as you feel any signs of low back pain while lifting or doing any other physical activity.
• If going harder with your workout results into back pain, it is better to go slowly and approach gradually.
• Try proper stretching exercises before working out to prevent lumbosacral strain.
• It is important not to lie on your stomach while sleeping. Lie on your back while sleeping and place a pillow under legs if necessary.
• Bend down on your knees and not your waist while lifting heavy objects.
• Get your weight under control if overweight to prevent lumbosacral strain.
• Try to maintain good posture while sitting or walking. Always rest your back and keep straight while sitting in order to prevent lumbosacral strain.

As an athlete, you must be aware of the proper stretching exercises, proper warm up exercises and correct technique to lift heavy objects in order to avoid and prevent lumbosacral strain. Also if you maintain upright posture while sitting, lifting or even standing, your back stays safe and also the chances of any stress or injury are reduced.

Also Read:

• What is Lumbosacral Strain: Causes, Signs, Symptoms, Risk Factors, Diagnosis