A lower back sprain (or lumbar sprain) is an injury caused by an overstretched or torn ligament in your lower back area. Ligaments are fibrous pieces of tissue that connect two or more bones in your back or joint. The lower back area is commonly defined as the area below your rib cage.
Lower back sprains produce pain and swelling in the lower back area. In severe cases, you may also experience bruising or contusions in the area and some redness.
The good news is that they are usually simple to treat. In general, mild or moderate sprains respond to as little as a few weeks of reduced physical activity (in addition to a few other measures) and do not require surgery.
To reduce the risk of another sprain in the future, doctors may suggest a program of physical therapy. The goal of this program will be to keep your lower back ligaments stretched and strong enough to withstand the demands that you make of them as part of your daily routine.
Types Of Lower Back Sprain
As with other types of soft tissue injury, doctors classify lower back sprains into three types depending on the degree of severity of the injury:
Mild or type I sprains, in which the lower back ligaments are slightly overstretched and do not suffer any tearing (other than micro tearing);
Moderate or type II sprains, in which one of more ligaments are partially but not completely torn;
Severe or type III sprains, in which one or more of the lower back ligaments are completely severed. A lower back sprain of this severity may require surgical correction.
Causes Of Lower Back Sprains
A back sprain can be either the result of a single instance of overstressing the back ligaments (through improper lifting, for example). Alternatively, it can be the cumulative long term impact of overuse of back muscles and ligaments by repetitive movements.
Typical causes of a lower back sprain include the following:
Poor posture, in which you hunch your shoulders forward while standing or sitting and do not keep them straight and held back. The result can be an excessive proportion of your upper body weight being borne by your lower back. Over time, this can result in overuse of your lower back ligaments and a sprain;
Incorrect lifting technique, in which you lift heavy loads with your back (i.e. by bending your back) instead of with your legs. Please see the diagram to the right for an illustration of this. This can happen either as a result of a single incorrect lift or progressively over time;
Playing sports in which you frequently receive blows to the body, or experience falls that may twist your back. Examples are contact sports like football or rugby;
There are other sports in which the back is frequently subjected to high forces as a result of an action you frequently undertake. Over time, these high forces can exert stresses on your back that can cause a sprain due to overuse. Examples of this are fast bowlers in cricket or pitchers in baseball. Golf strokes can sometimes subject your back to high forces that can have this type of result.Weightlifting can also subject your back to high forces.
In addition to the above specific instances, there are a number of factors that can increase your risk of experiencing a lower back sprain:
Being overweight, as this places an excessive load on your lower back structures. This is particularly the case if it is combined with poor posture, as mentioned above;
If your back or abdominal muscles are tight or underdeveloped, you are at a higher risk of developing lower back problems like sprains or strains.
What Are The Symptoms Of A Lower Back Sprain?
If you have this type of injury, you may experience some or all of the following:
Pain & swelling in the lower back. The pain may become worse if you run, bend or twist, or sometimes if you just stand up;
Contusions or bruising in the lower back;
Your lower back may feel “tender to the touch”;
You may experience a “snapping” or “popping” sensation at the time the injury occurs.
If you have any of these symptoms, you should make an appointment with your doctor for diagnostic testing and medical advice.
As mentioned at the start, most lower back sprains respond to conservative home based treatment. As a result, if your doctor diagnoses a sprain of this sort, he or she will likely suggest the following:
A period of reduced activity, with a complete cessation of activities that may stress your back (e.g. heavy lifting or sports);
Applying ice or a cold compress to your lower back for 20 minutes at a time. Do this at intervals of 2-3 hours for a few days or until the swelling has receded;
You can then commence treatment using a heating pad (such as the Theratherm) to increase blood flow through the lower back. As with the ice treatment, do this for periods of approximately 20 minutes and at intervals of 2-3 hours for a few days;
If your pain is severe, your doctor may also suggest an over the counter pain medication like Tylenol;
Non Steroidal Anti Inflammatory Drugs (NSAIDs) such as Advil may be prescribed if your lumbar sprain is causing inflammation in your lower back;
Once your pain has started to go away, you may be referred to a physical therapist. This healthcare professional can diagnose a program of back stretching and strengthening exercises that will reduce your risk of reinjury as you return to normal activity.
Although your doctor will suggest reducing your level of physical activity, he or she will likely advise against complete bed rest. This can cause atrophy (weakening) of your lower back soft tissues and increase the risk of another sprain or strain in the future.
In addition to the above, doctors may suggest wearing a lower back brace for additional lumbar support. This will be helpful in reducing the risk of reinjury if your sprain was caused by heavy lifting. Despite this, you should ensure that you correct your lifting technique as advised above.
If your lower back sprain was related to poor posture, you can try wearing an upper back brace. This will help to remind you to maintain good posture while standing or sitting and reduce stress on your lower back.
If you are overweight, a weight management program (diet and/or exercise) will also reduce the pressure on your lower back.