Lumbar sprain

Synonyms for lumbar sprain

• Lumbago
• Back pain

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What is a lumbar sprain?

A lumbar sprain is an injury to the joints of the vertebrae in the back. Generally, there is stretching of one or more ligaments of the vertebrae in the back.

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What are the symptoms of a lumbar sprain?

The main symptoms are:

• Pain and stiffness in the lower back after a sudden movement, a fall, or an accident
• Back muscle spasms
• Back movements trigger the pain

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In general, there can be two «types of lumbar sprain»:

• Lumbar sprain with symptoms in lumbar flexion (rounded back)
• Lumbar sprain with symptoms in lumbar extension (hollow back)

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Here are the positions or movements that increase pain depending on the type of lumbar sprain:

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For lumbar sprain with symptoms in lumbar flexion (rounded back), the pain is generally increased by:

• Sitting for long periods
• Driving for a long time
• Bending over
• Putting on socks, pants, underwear, shoes
• Sneezing and coughing

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For lumbar sprain with symptoms in extension (hollow back), the pain is generally increased by:

• Walking for a long time (worse if walking slowly, better if walking faster)
• Standing for a long time (grocery shopping, cooking, waiting in line, or watching a show while standing still)
• Lying on your stomach or on your back with your legs extended
• Reaching up to put objects on a high shelf

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«It is possible to have both types of lumbar sprain at the same time and therefore have symptoms that are in both categories. However, one category is often worse.»

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What are the serious symptoms of a lumbar sprain?

The presence of certain signs and symptoms should prompt you to seek prompt medical attention at the emergency room or from a doctor. 

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These include:

• Severe weakness or paralysis of one or both legs
• Significant or even complete loss of sensation in one or both legs
• Recent loss of balance when walking
• Significant and new incoordination
• New difficulties with bladder or bowel control
• Loss of sensation in the genital area or when wiping after a bowel movement

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Serious symptoms are only present in less than 1% of lower back pain cases. Most of the time, although the pain can be very unpleasant, the condition improves.

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What are the causes of a lumbar sprain?

Generally, a lumbar sprain is caused by a specific event such as:

• A sudden awkward movement of the back
• A car accident
• A fall
• An effort that is greater than usual (for example, straining to lift a load)

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It is very common for a lumbar sprain to occur while performing a trivial action, often the day after a significant effort. For example, one day you move all day and lift heavy loads without any problem. The next day, you bend over to pick up a pencil and your back 'locks up' as you straighten up.

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The fatigue accumulated from moving can temporarily make you less robust and resilient in your daily movements for a few days, especially if you are not used to this type of effort.

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How is a lumbar sprain diagnosed?

The diagnosis is made based on the history of symptoms and the clinical examination.
It is important to know that medical imaging (X-ray, MRI, etc.) is not relevant in 99% of cases.

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When should you consult a physiotherapist for a lumbar sprain?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What physiotherapy treatments are available for a lumbar sprain?

As with all traumatic injuries, we must allow the body to perform its natural healing process.

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« Inflammation is a normal and necessary process for proper healing. There is therefore no miracle way to speed up healing. »

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However, it is very important to make sure to eliminate any factors that could slow down healing.

Here are some examples of things that could slow down healing:

• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints, muscles, and nerves
• Worries or fears related to the injury or pain

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« For this reason, your physiotherapist can help you optimize the healing of the injury. They will be able to guide you in the best possible direction to ensure that the injury heals effectively. »

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Think of healing from a traumatic injury like taking care of a plant. Pulling on the plant won't make it grow faster. However, you can make sure it gets enough water, sunlight, and fertilizer. We want to put the plant in a good environment to heal. It's the same for a traumatic injury.

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Your physiotherapist will perform an assessment to determine your limitations and the severity of your sprain by evaluating the following elements:

• The mobility of your spine
• The gliding of your nerves
• Your postural habits
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Will mobilize the joints in your back and your nerves to reduce pain and improve movement.
• Provide you with specific exercises to do at home to address the cause of the problem
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your postural habits and movements

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What can you do at home for a lumbar sprain?

Temporarily stop doing the movements that cause too much pain, and then gradually start doing them again. Do not remain completely still for long periods, as you will POTENTIALLY be stiffer and experience more pain afterward.

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Here are some tips that may help depending on the type of lumbar sprain:

For a lumbar sprain with symptoms in lumbar flexion (rounded back):

• Limit the time spent sitting (get up every 20 minutes to walk a little).
• When you are sitting, straighten your lower back a little by sticking your buttocks out. Place a rolled-up towel in your lower back to remind you to sit up straighter.
• Go for frequent walks for a duration that is comfortable. Running might even be good for you (it depends on the person).
• In the car, sit well back in the seat and tilt the backrest slightly backward. Move the seat slightly closer to the steering wheel.
• Stick your buttocks out slightly to lean forward.
• When the pain is present, spend a few minutes on your stomach or on your back with your legs extended. This should relieve you.

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For a lumbar sprain with symptoms in lumbar extension (arched back):

• Limit the time spent standing (sit down every 20 minutes while the pain decreases)
• If you are standing still, place one foot in front of the other and make small weight transfers forward and backward.
• When cooking, place one foot inside the cabinet in front of you.
• When the pain is present, spend a few minutes lying on your side with a pillow between your knees. This should relieve you.

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If you don't see any improvement after 10 days, you should consult a physiotherapist.

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Did you know?

• 90% of lower back pain episodes heal in 6 to 12 weeks
• 50% of lower back pain episodes heal in 1-2 weeks

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To learn more...

You can listen to the podcast "Parle-moi de santé" produced by one of our physiotherapists, Alexis Gougeon. Episode #7 discusses the topic of lower back pain.

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Episode #7 lower back pain

Find the episode on YouTube :

Click below to listen to episodes on podcast platforms:

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Sources

• Alexander CE, Varacallo M. Lumbosacral Radiculopathy. InStatPearls [Internet] 2019 Mar 23. StatPearls Publishing

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