Anatomy & Background
Lumbar Muscles and Ligaments
A complicated system of ligaments and muscles serves to control movement, maintain posture, and support the lower back and pelvis. Ligaments are fibrous bands of soft tissue that attach a bone to another bone. The ligamentous system of the spine protects the intervertebral discs from injury, and prevents excessive movement of the spine
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. In addition, there are 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 and help move and stabilize the lower back. The deeper spinal muscles can be multi-segmental, 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 or whiplash injury, these ligaments and muscles can be damaged. Ligament damage sprain and muscle damage strain 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 area. 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 spasm with nerve, disc, and lower 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 causing weakness or tightness of the muscles or laxity of the ligaments of the low back can result in pain, decreased ability to maintain good posture, limitation in movement and instability of the back.
Causes of Lumbar Sprains
Lumbar sprains and strains are a common injury, most often caused by excess weight bearing or lifting, trauma, motor vehicle accidents 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.
- 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.
In mild cases patients found that rest, ice and medication may be 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 activity should be gradual to prevent a return of symptoms.
Moderate to Severe Cases
If the problem persists, consult with your health care provider. 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.
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