A sprain is an injury to a ligament at a joint. When a joint is moved beyond its normal range of motion it stresses and stretches the inelastic fibers of the ligament and can cause tearing. Because the primar y function of ligaments is to provide passive stabilization to the area, loss of stability can range from mild to severe with a ligament sprain. Symptoms of a back sprain can include:

Back pain with movement or at rest Feelings of weakness in the back Stiffness in the spine and nearby muscles Pain with coughing or sneezing Spinal instability which could impact spinal nerves or the spinal cord and cause changes in bowel or bladder function, sensation changes below the level of the injury and weakness. Any of these signs would constitute an emergency and a trip to the emergency room for prompt assessment is needed

The spine has many important ligaments that help absorb shock, hold bones in their proper places and restrict excessive motion. For example, the ligaments of the spine help protect the bones and spinal cord from excessive flexion (forward bending) and extension (backwards bending). In the upper, middle and lower back there are several important ligaments:

• Anterior longitudinal ligament: runs the entire length of the spine on the front side of the vertebral bodies and intervertebral discs
• Posterior longitudinal ligament: runs the entire length of the spine on the posterior side of the vertebral bodies and intervertebral discs
• Supraspinous ligament: connects one spinous process (bony prominence at the back of the vertebral bodies that can be felt and sometimes seen when looking at the back) to the next spinous process
• Ligamentum Flavum: the strongest ligament of the bunch, it runs the length of the spine in front of the lamina (bony structures that surround the spinal cord) to protect the spinal cord and nerves.
• Interspinous Ligaments: run longitudinally between the spinous processes and connect to the ligamentum flavum

We can categorize a sprain based on its severity:

Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.

Grade II (moderate): partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.

Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair.

If you decide to work with a physical therapist to help correct your back sprain issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your back sprain PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY FOR A SPRAINED BACK

If a ligament sprain in the back is severe and causing instability around the spinal nerves and spinal cord, your orthopedic surgeon or neurosurgeon might recommend surgical intervention to stabilize the spine or bracing to minimize motion of the spine while it is healing. If this is necessary, your timeline for beginning physical therapy might change. For mild to moderate sprains, working with a physical therapist right away can help reduce symptoms and facilitate early healing.

In the first week or so after a back sprain, your physical therapist will guide you on how to protect the recently-injured and newly-healing ligament. You want to minimize any movement that causes pain or places any stretch or strain across the injured site. This often requires some modifications to your daily activities.

Aside from protecting the area of injury, in this very early phase, your physical therapy treatment will focus on reducing inflammation and pain and maintaining strength in unaffected areas near the site of injury. To achieve these goals your physical therapy treatment may consist of the application of ice or light soft tissue work to mobilize any edema. Modalities such as electrical stimulation or ultrasound may be applied to increase circulation, decrease inflammation and control pain.

As the healing tissues become stronger, inflammation subsides and pain is reduced, it is time to move on to the next phase of rehab which consists of light muscle activation and endurance work, graded active range of motion and very light stretching. Finally, in the later stages of healing your physical therapy treatment will focus on exercises and activities that prepare the injured ligament to withstand the stress and strain of everyday life and the sports and recreational activities we love to do. Each of these interventions will be individualized to your specific needs.

CALL TO SCHEDULE AN EVALUATION FOR YOUR SPRAINED BACK

While no one wants to deal with a sprained back, having the right care team to help you recover can make all the difference. The team of physical therapists at Evolve is here and ready to get you on the road to recovery. Call to schedule your initial evaluation today.