What is a Thoracic or Lumbar Sprain/Strain?
A thoracic or lumbar sprain or strain involves an injury to the soft tissues of the back. Sprains involve injury to ligaments or discs and strains refer to muscle and tendon injuries. The thoracic region is located in the upper portion of the back and the lumbar region is in the area of the lower back.
What causes a Thoracic or Lumbar Sprain/Strain?
Most thoracic or lumbar sprains and strains are caused by heavy lifting, twisting motions, involvement in sports, poor posture or body mechanics, motor vehicle accidents, and falls. Sprains result from overstretched ligaments in the back and strains are caused by overuse of a muscle or overstretching the muscles of the back. Strains can also be the result of excessive activity levels or inadequate warm-up prior to engaging in an activity.
What are the symptoms of a Thoracic or Lumbar Sprain/Strain?
Symptoms of a thoracic or lumbar sprain or strain are dependent on how severe the injury. Most injuries are graded on a scale from first degree to third degree. First-degree sprains are mild and cause little to no pain or other symptoms. Second-degree sprains can cause pain, muscle spasm and some joint instability. Third degree sprains usually result in a completely torn ligament accompanied by severe pain and joint instability. Muscle strains are graded in a similar fashion, with first-degree strains causing little pain or other symptoms and second-degree strains causing some noticeable loss of strength as well as pain. Third-degree strains involve complete tears of the muscles and tendons and a complete loss of muscle function. In addition to pain, instability and weakness, there may also be tenderness and swelling.
How is a Thoracic or Lumbar Sprain/Strain diagnosed?
Dr. Yakov Simkhayev will take a complete medical history and perform a physical exam. Questions will be asked related to when the symptoms began, what activities caused the symptoms, what worsens or relieves symptoms, and the relative severity of symptoms. Pressure will be placed on the areas of suspected injury to identify swelling, tenderness and pain. Patients may be asked to perform certain movements to determine range of motion limitations and to identify what increase or decreases pain. X-rays or magnetic resonance imaging (MRI) may be recommended to rule out other causes of pain, such as fractures, or to determine if there is any damage to spinal discs. Other diagnostic tests, such as electromyography (EMG) or nerve conduction studies are only warranted if treatment does not alleviate symptoms.
When should I seek care for a Thoracic or Lumbar Sprain/Strain?
If you experience pain in your back that does not go away after a short period of rest, ice application and anti-inflammatory medication, it is best to see a medical professional. If you experience sudden or severe pain, loss of mobility, complete muscle weakness, or if you have sustained an injury where a fracture or other serious injury may have occurred, you should seek immediate medical attention.
What will the treatment for a Thoracic or Lumbar Sprain/Strain consist of?
Treatment for thoracic or lumbar sprains and strains involves limiting activity that causes pain (heavy lifting, twisting, bending, etc.), applying ice for the first 48 hours and then heat thereafter, and taking nonsteroidal anti-inflammatory medications (NSAIDs). An initial course of rest may be recommended but inactivity should not be prolonged. Physical therapy is often recommended if initial treatment does not provide relief and may include any combination of targeted exercises, temporary immobilization, electrical stimulation, moist heat therapy and trigger point injections. Exercises to strengthen the back and ergonomic training can help prevent re-injury. Surgery is only indicated in rare circumstances when a complete tear of the ligaments or muscles occur.
Which muscle groups/joints are commonly affected by a Thoracic or Lumbar Sprain/Strain?
Thoracic sprains and strains affect the upper portion of the back and lumbar sprains and strains affect the lower portion of the back.
What type of results should I expect from the treatment of a Thoracic or Lumbar Sprain/Strain?
Most patients with mild and moderate thoracic or lumbar sprains and strains will make a full recovery and will be symptom free in a matter of days, weeks or possibly months. If activity levels are resumed too quickly, however, re-injury may occur. More severe injuries may result in recurring or chronic pain.