Lumbar Sprain Flashcards
What is a lumbar strain/sprain?
Injury to the paraspinal musculature
Most frequent cause of lost work time and disability in adults
What is low back pain considered?
Symptom not a diagnosis
What is important to consider in a lumbar strain/sprain?
Acute vs chronic
90 days is magic number
What causes a lumbar strain/sprain?
Lifting
Trauma
What are contributing factors to lumbar strain/sprain?
Poor fitness Poor body mechanics Job dissatisfaction Smoking Psychosocial issues
What are the s/s of lumbar strain/sprain?
LBP
Radicular pain to buttocks/posterior thigh
Difficulty ambulating
Difficulty sleeping/finding comfortable position
What must a provider ask about in a potential lumbar strain/sprain?
BOWEL OR BLADDER FUNCTION
SADDLE ANESTHESIA
WEAKNESS IN THE LOWER EXTREMITIES
**Ask about abdominal pain
What is included in physical exam oflumbar strain/sprain?
Low back or SI joint tenderness - Bony vs muscular Decreased ROM Motor and sensory exam (radiculopathy) - L4-S1
What imaging
+/- plain films
- Always after trauma or with atypical symptoms
MRI is not indicated in acute lumbar sprain
What is included in DDX of lumbar strain/sprain?
Ankylosing spondylitis Drug-seeking behavior Extraspinal causes Vertebral body fracture Herniated disc Infection Multiple myeloma
What is the treatment of lumbar strain/sprain?
Conservative
- Start with pain control and advance to return to activity
- Be careful with prescribing narcotics &/or muscle relaxers
- Get these patients back to work
What can a lumbar strain/sprain lead to?
Chronic low back pain
