Back strain is a fairly broad category called “soft tissue
injury,” which covers muscles, tendons and ligaments. About 80%
of back and neck pain is muscle-related.
The stomach muscles, or abdominals, enable the back to
bend forward. They also assist in lifting. The abdominals work with the
buttock muscles to support the spine. The oblique muscles go around the
side of the body to provide additional support to the spine.
Another type of strain relates to spinal ligaments that
run in front and in back of the vertebral bodies. Tendons, which also
connect muscles in the spine, can develop inflammation, or tendonitis.
Some people believe that part of what makes the back muscles
more prone to strain is that they are shorter than other big muscles
in the body. The muscles in our thighs that enable us to walk, run and
jump are longer and less prone to strain. It’s very unusual to
strain a thigh muscle.
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Causes
Muscles in the back can strain or spasm and form a hard lump, like a
charley horse in the leg. Back muscle spasms can be caused by injury
and pain, whether the source is muscle strain, or a disc problem. A
spasm, defined as an involuntary convulsive contraction of muscle fibers,
can be excruciating. The muscle spasm can be steady or come in waves
of contractions. Your muscle is sending you a signal that it has been
pushed beyond its ability.
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Symptoms
A symptom of muscle strain may be an excruciating spasm in the back that
is very painful.
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Diagnosis
Outlined below are some of the diagnostic tools that your physician may
use to gain insight into your condition and determine the best treatment
plan for your condition.
Medical history: Conducting a detailed medical history
helps the doctor better understand the possible causes of your back
and neck pain which can help outline the most appropriate treatment.
Physical exam: During the physical exam, your physician
will try to pinpoint the source of pain. Simple tests for flexibility
and muscle strength may also be conducted.
X-rays are usually the first step in diagnostic testing
methods. X-rays show bones and the space between bones. They are of
limited value, however, since they do not show muscles and ligaments.
MRI (magnetic resonance imaging) uses a magnetic field
and radio waves to generate highly detailed pictures of the inside
of your body. Since X-rays only show bones, MRIs are needed to visualize
soft tissues like discs in the spine. This type of imaging is very
safe and usually pain-free.
CT scan/myelogram: A CT scan is similar to an MRI in
that it provides diagnostic information about the internal structures
of the spine. A myelogram is used to diagnose a bulging disc, tumor,
or changes in the bones surrounding the spinal cord or nerves. A local
anesthetic is injected into the low back to numb the area. A lumbar
puncture (spinal tap) is then performed. A dye is injected into the
spinal canal to reveal where problems lie.
Electrodiagnostics: Electrical testing of the nerves
and spinal cord may be performed as part of a diagnostic workup. These
tests, called electromyography (EMG) or somato sensory evoked potentials
(SSEP), assist your doctor in understanding how your nerves or spinal
cord are affected by your condition.
Bone scan: Bone imaging is used to detect infection,
malignancy, fractures and arthritis in any part of the skeleton. Bone
scans are also used for finding lesions for biopsy or excision.
Discography is used to determine the internal structure
of a disc. It is performed by using a local anesthetic and injecting
a dye into the disc under X-ray guidance. An X-ray and CT scan are
performed to view the disc composition to determine if its structure
is normal or abnormal. In addition to the disc appearance, your doctor
will note any pain associated with this injection. The benefit of a
discogram is that it enables the physician to confirm the disc level
that is causing your pain. This ensures that surgery will be more successful
and reduces the risk of operating on the wrong disc.
Injections: Pain-relieving injections can relieve back
pain and give the physician important information about your problem,
as well as provide a bridge therapy.
As with any muscle injury, it’s natural for an individual
to stop moving the injured area and wait for it to heal. Ironically,
this is counter-productive. Restricting movement causes the muscle to
weaken , become less flexible, and receive less circulation. In fact,
gentle stretching and exercise is the best way to resolve the injury
by getting it moving and increasing circulation.
Recommendations:
Rest.
Apply ice for five minutes at a time for the first 48
hours, then switch to heat.
Take anti-inflammatories, preferably ibuprofen like
Advil or Nuprin as directed on the bottle. Acetominophen (Tylenol)
may be taken for pain, if you are allergic to ibuprofen.
Try our home remedy exercises. But remember, no exercise
should be painful. Stop if they cause an increase in pain or symptoms.
An appointment with a nonsurgical spine specialist is
most appropriate for muscle-related back pain.
Call us immediately if you experience any emergency,
red-flag symptoms.
What's the difference between a sprain and
a strain?
While someone may argue that the two words are different, that a sprain
is a more serious injury than a strain, in reality, sprain and strain
have evolved to mean essentially the same things to doctors and lawyers.
Both words relate to an overworked muscle, ligament or tendon that is
overstretched.
Some may argue that strain relates to stretching or tearing
of muscles or tendons, while sprain relates to tearing of ligaments or
tissues in a joint area. For example, if bones in a joint are forced
beyond a comfortable range of motion, the joint may be sprained.
Another word that you may hear is “muscle spasm,” where
a muscle locks up in an excruciating, hard lump.
What’s the difference between
a simple strain or a more serious herniated disc?
Most people erroneously think that the more excruciating the pain, the
more likely that you herniated a disc. That is not the case at all. In
some cases a back spasm can knock you down to your knees. A person can
have excruciating pain, but if it is mostly in the low back, it’s
probably not a herniated disc. Typically, a herniated disc in your back
will radiate pain down into your leg, or pain will radiate down your
arm if you have a blown disc in your neck.
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Click here for narrated videos of spine surgeries, procedures and what causes various symptoms. Click here to see medical illustrations that help you understand back and neck problems. Click here to see an exercise library that has special stretches that can relieve pain symptoms.
John J. Regan, MD is the author of the First Chapter of Minimally Invasive Spine Surgery: Clinical Examples of Anatomy, Indications, and Surgical Techniques.
Our spine Internet site acts as on-line spine encyclopedia. In addition, as a free community service, Spine Group Beverly Hills mails out Home Remedy Books on a limited basis to residents in Southern California. Click here to learn more.
We understand that traveling with a back problem can be difficult and unsettling. That’s why we enable you to set up a telephone consultation with Spine Group Beverly HIlls in advance, to determine if a trip would be worthwhile. Because this involves significant time for our practice to receive your information and diagnostics, and for Dr. Regan to review your case in advance of your call, there is a fee for this consultation. Click here to learn more.
The vast majority of back problems improve on their own or with nonsurgical treatment. There are a few warning signs, however, that may indicate serious spinal problems. If you experience any of these symptoms, seek medical attention immediately. Click here to learn more.
Want to tackle back or neck pain? Dr. Regan has developed an educational journal to help patients get Back to Life. Click here to download our latest Back to Life Journal.
Welcome to Spine Group Beverly Hills Watch the video above to hear a message from Dr.
John Regan about finding freedom from back pain.
Recognize emergency symptoms
for back and neck pain Do you have weakness or numbness in a hand or foot?
Are you unable to raise your toe as you walk?
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If you answered yes to any of these questions, click here.
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