Lumbar spine injuries

The spine is made up of a network of structures: the vertebrae, discs, ligaments, muscles and nerves. The lumbar spine withstands the greatest amount of strain during movement and because the intervertebral discs and ligaments are inherently weak, injury is always a possibility. A lumbar spine injury may take the form of a muscle strain, in which the muscles are stretched or torn; or a lumbar sprain may occur in which the ligaments are torn. A lumbar spine injury leads to low back pain and loss of function and is the cause of most hospital visits.

Low back pain that is accompanied by lower extremity weakness and/or loss of bladder or bowel control could be signs of a more serious injury, however any low back pain should be evaluated by your doctor. The most common symptoms of a lumbar sprain or strain are:

• Pain in the lower back and upper buttocks.
• Low back muscle spasm.
• Pain with activities and generally goes away with rest.

A sprain or strain of the lumbar spine results in inflammation of the soft tissue and this leads to pain and muscle spasm. Rest is important and helpful. Heat application tends to work better than ice, which seems to cause muscle spasm. Your doctor may prescribe anti-inflammatory medications.

Factors that contribute to lumbar spine injuries are:

• Sudden forceful movement.
• Lifting a heavy object improperly.
• Twisting the back in an unusual manner.
• A ruptured disc.

Other factors that contribute to lumbar spine injuries are:

• Lack of conditioning. This can cause the back to 'give out' during physical exercise or work activities.
• Obesity. Excess weight leads to poor posture which puts strain on the muscles, causing injury.
• Smoking.

The overall goals of physiotherapy would be to provide relief from the symptoms, normalise joint and soft tissue mobility and establish an effective exercise program for you. The physiotherapy evaluation looks at the progression of symptoms, mechanism of injury, posture and prior level of function. A physical examination will conducted to assess gait, active range of motion (AROM) of the spine and all extremities, strength, symmetry and tension signs. Treatment may involve pain management with ultrasound, manual therapy and positioning; stretching exercises to gain symmetry, posture correction, training in body mechanics, strengthening and conditioning to prepare the person to return to his normal daily activities.