Overview Back strain is a fairly broad category called “soft
tissue injury,” which covers muscles, tendons and ligaments.
About 80% of back and neck pain is muscle-related.
The stomach muscles, or abdominals, enable the back to
bend forward. They also assist in lifting. The abdominals work with
the buttock muscles to support the spine. The oblique muscles go around
the side of the body to provide additional support to the spine.
Another type of strain relates to spinal ligaments that
run in front and in back of the vertebral bodies. Tendons, which also
connect muscles in the spine, can develop inflammation, or tendonitis.
Some people believe that part of what makes the back
muscles more prone to strain is that they are shorter than other big
muscles in the body. The muscles in our thighs that enable us to walk,
run and jump are longer and less prone to strain. It’s very unusual
to strain a thigh muscle.
[top]
Causes Muscles in the back can strain or spasm and form
a hard lump, like a charley horse in the leg. Back muscle spasms can
be caused by injury and pain, whether the source is muscle strain,
or a disc problem. A spasm, defined as an involuntary convulsive contraction
of muscle fibers, can be excruciating. The muscle spasm can be steady
or come in waves of contractions. Your muscle is sending you a signal
that it has been pushed beyond its ability.
[top]
Symptoms A symptom of muscle strain may be an excruciating
spasm in the back that is very painful.
[top]
Diagnosis Outlined below are some of the diagnostic tools
that your physician may use to gain insight into your condition and
determine the best treatment plan for your condition.
Medical history: Conducting a detailed medical history
helps the doctor better understand the possible causes of your back
and neck pain which can help outline the most appropriate treatment.
Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.
X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are
of limited value, however, since they do not show muscles and ligaments.
MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside
of your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very
safe and usually pain-free.
CT scan/myelogram: A CT scan is similar to an MRI
in that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A
local anesthetic is injected into the low back to numb the area.
A lumbar puncture (spinal tap) is then performed. A dye is injected
into the spinal canal to reveal where problems lie.
Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup.
These tests, called electromyography (EMG) or somato sensory evoked
potentials (SSEP), assist your doctor in understanding how your nerves
or spinal cord are affected by your condition.
Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton.
Bone scans are also used for finding lesions for biopsy or excision.
Discography is used to determine the internal structure
of a disc. It is performed by using a local anesthetic and injecting
a dye into the disc under X-ray guidance. An X-ray and CT scan are
performed to view the disc composition to determine if its structure
is normal or abnormal. In addition to the disc appearance, your doctor
will note any pain associated with this injection. The benefit of
a discogram is that it enables the physician to confirm the disc
level that is causing your pain. This ensures that surgery will be
more successful and reduces the risk of operating on the wrong disc.
Injections: Pain-relieving injections can relieve
back pain and give the physician important information about your
problem, as well as provide a bridge therapy.
Treatment Surgery is never appropriate for muscle strain. As
with any muscle injury, it’s natural for an
individual to stop moving the injured area and wait for it to heal.
Ironically, this is counter-productive. Restricting movement causes
the muscle to weaken , become less flexible, and receive less circulation.
In fact, gentle stretching and exercise is the best way to resolve
the injury by getting it moving and increasing circulation.
Recommendations:
Rest.
Apply ice for five minutes at a time for the first
48 hours, then switch to heat.
Take anti-inflammatories, preferably ibuprofen like
Advil or Nuprin as directed on the bottle. Acetominophen (Tylenol)
may be taken for pain, if you are allergic to ibuprofen.
Try our home remedy exercises. But remember, no exercise
should be painful. Stop if they cause an increase in pain or symptoms.
An appointment with a nonsurgical spine specialist
is most appropriate for muscle-related back pain.
Call us immediately if you experience any emergency,
red-flag symptoms
FAQ What’s the difference between a sprain
and a strain? While someone may argue that the two words are different,
that a sprain is a more serious injury than a strain, in reality, sprain
and strain have evolved to mean essentially the same things to doctors
and lawyers. Both words relate to an overworked muscle, ligament or
tendon that is overstretched.
Some may argue that strain relates to stretching or tearing
of muscles or tendons, while sprain relates to tearing of ligaments
or tissues in a joint area. For example, if bones in a joint are forced
beyond a comfortable range of motion, the joint may be sprained.
Another word that you may hear is “muscle spasm,” where
a muscle locks up in an excruciating, hard lump.
What’s the difference between a simple
strain or a more serious herniated disc? Most people erroneously think that the more excruciating
the pain, the more likely that you herniated a disc. That is not the
case at all. In some cases a back spasm can knock you down to your
knees. A person can have excruciating pain, but if it is mostly in
the low back, it’s probably not a herniated disc. Typically,
a herniated disc in your back will radiate pain down into your leg,
or pain will radiate down your arm if you have a blown disc in your
neck.
[top]
