Anatomy & Background
A complicated system of ligaments and muscles serves to control movement, maintain posture, and support the lower back and pelvis. The muscular system of the lower back is complex, and includes the deep erector spinae or paraspinal muscle groups that run parallel to the spine. There are also larger and more superficial muscles that help to move and protect the lower back.
The lower back and abdominal muscles work together with the ligaments to provide movement, stability, and postural support to the lower back and abdominal area.
The larger superficial muscles help move and stabilize the lower back. The deeper spinal muscles can be multisegmental, connecting and attaching to more than one vertebra or muscles that support, stabilize and move one segment in relation to another.
When lumbar or spinal motion is pushed to the extreme, such as in a car accident, these ligaments and muscles can be damaged. Muscle damage strain or muscle spasm can produce pain, soreness, loss of motion, and if severe enough joint instability.
Irritation or injury of the structures of the spine may produce spasm and pain of the muscles of the back and buttock areas. One muscle that is often involved in back problems is the piriformis. It is located in the buttock area and may become painful, sore and go into spasms with nerve, disc, and low back or sacroiliac joint irritation. Unfortunately, the sciatic nerve passes beneath the piriformis and can be compressed when the piriformis is irritated. This can cause symptoms that radiate into the legs.
Injury to the lumbar spine can cause weakness, spasm, or tightness of the muscles of the lower back and can result in pain, decreased ability to maintain good posture, limitation in movement and instability of the back.
Cause of injury
Lumbar sprains and strains are a common injury, most often caused by excessive weight bearing or lifting, and trauma like a motor vehicle accident or a fall. Sharp increases in physical activity or added stress on the ligaments in the back are also a common cause of lumbar sprains.
Symptoms
- Back pain or tenderness
- Swelling or bruising in the lower back
- Pain when moving or using the back in daily activities
- A “popping” or “tearing” feeling in the lower back
- Warmth or redness of the skin over the injured area
- Decreased ability to move, including performing bending and lifting motions.
Treating the injury
If you suspect you have a lumbar strain or muscle spasms, the initial treatment should consist of avoiding the positions and activities that produce any pain. A course of conservative treatment is usually recommended that includes rest and immobilization, ice, physical therapy and non-steroidal medications to reduce inflammation. If symptoms persist, treatment by your doctor may be necessary.
Mild Cases
In mild cases many patients found that rest, ice and medication was enough to reduce the pain. Physical therapy is recommended to develop a series of postural, stretching and strengthening exercises to prevent re-occurrence of the injury. Return to the activity that caused the injury should be gradual to prevent a return of symptoms.
Moderate to Severe Cases
If the problem persists, consult with your health care provider next. Your physician should perform a thorough evaluation to determine the possible cause of your symptoms, the structures involved, the severity of the condition, and the best course of treatment.
Medicine Intervenes
Procedures that your physician may recommend and perform in addition to physical therapy may include:
- REST and ICE
- Bracing the affected area
- Pain medication to reduce the discomfort and allow the patient to perform the recommended exercises
- The use of NSAIDS (Non Steroidal Anti-Inflammatory Drugs)
- Steroidal medication or injections to reduce inflammation
- Trigger Point Injections
- Plasma Rich Platelet Therapy
- Prolotherapy
