If you have hurt your lower back, could it be a lumbar sprain?

If you suddenly experience back pain after lifting a heavy object or twisting your body, it is commonly expressed as 'I sprained my back.' In such cases, one may first consider lumbar sprain with tension or damage to the surrounding muscles and ligaments.

However, not all sudden lower back pain is due to sprains. If numbness or weakness in the leg occurs together, if pain develops after a severe trauma, or if osteoporosis is present, fractures or nerve problems must be ruled out first.

The lumbar spine refers to the lower back area. Sprain refers to a condition in which ligaments and soft tissues around a joint are damaged due to sudden force.

In actual clinical practice, it may be difficult to accurately distinguish between cases where only ligaments are injured and cases where muscles or tendons are tense. Therefore, it is more important to review the following content together than just looking at a single disease name.

• In which movement did the pain begin?
• In which direction does moving your back cause pain?
• Is the pain limited to the lower back?
• Is there accompanying leg pain or numbness?
• Whether it improves or worsens over time

• Sudden pain in the center of the lower back or on one side
• Difficulty bending forward or straightening the back
• Stabbing pain when sitting down and standing up
• Pain that worsens when turning over in bed or twisting the body
• A sensation that the muscles around the lower back are tightly tense.
• A posture that appears tilted to one side due to pain
• Severe stiffness when starting to move

In lumbar sprain, pain often remains mainly around the lower back. If pain extends down to the calf or foot, or if leg strength and sensation have changed, the lumbar nerves must also be examined.

lifting heavy objects

Pain may begin when you suddenly exert force while bending forward at the waist, or when lifting an object and twisting your body simultaneously.

during exercise or changing direction

Pain may occur after performing activities that involve rapid rotation of the torso, such as golf, tennis, or soccer, or after engaging in exercises you are not accustomed to.

When you slip or lose balance suddenly

Even if you do not fall, the process of quickly correcting your body posture can cause tension in the lower back muscles and ligaments.

When suddenly increasing activity after a long period of rest

Suddenly engaging in activities that are more than usual, such as moving house, hiking, household chores, or exercise, can place a greater burden on the lower back.

Many common lumbar sprains can be assessed for initial condition and treatment direction through history taking and physical examination.

The occasion when the pain began

We check whether pain occurs in certain postures or movements, and whether there has been any trauma from falling or impact.

Lumbar movement

We examine which direction causes severe pain when bending, straightening, and rotating the lower back.

Movement of the pelvis and hip joint

We check the range of motion of the pelvis and hip joint that move together with the lower back, as well as the tension in the surrounding muscles.

Nerve function of the leg

If there is leg pain or numbness, we check muscle strength, sensation, reflexes, and gait.

Daily movements

We check which functions are limited when standing up from a chair, walking, putting on shoes, turning over in bed, and lifting objects.

Based on the examination results, we determine whether it is close to a general sprain or if imaging studies or evaluation by another medical institution are needed first.

If you have the following symptoms, you should first undergo an appropriate examination rather than receiving Chuna manual therapy or performing self-stretching.

• Pain caused by a severe fall or traffic accident
• Sudden pain in a person with osteoporosis
• If leg strength suddenly drops or gradually weakens
• If your leg drags or walking becomes unstable
• Changes in bowel and bladder control
• Reduced sensation in the perineum
• high fever or chills
• If you have a history of cancer or infection and develop new pain

Especially if the lower back is very painful or difficult to move when pressed directly after trauma, you must check for a fracture.

If the lower back pain is caused by a minor movement and there are no warning signs, imaging studies are not always necessary.

Through history taking and physical examination, we can first assess the extent of trauma, range of motion, and nerve function. However, if there is a risk of severe trauma or fracture, progressive muscle weakness, or suspicion of infection or other conditions, consideration may be given to X-ray, CT, or MRI.

Initial activity regulation

You can temporarily reduce lifting heavy objects that significantly worsen pain and repetitive bending. If there are no special warning signs, it is better to walk within your limits for short periods and change positions frequently rather than lying down for a long time.

Chuna manual therapy

After confirming restricted movement around the lower back and pelvis, muscle tension, and joint function, we can perform the procedure using techniques and intensity appropriate to the patient's condition.

During periods of severe acute pain, you can approach recovery of movement gently within a range that does not induce pain rather than with strong stimulation.

After treatment, check the following again.

• Range of motion for bending and straightening the waist
• Sitting to standing
• Walking and turning over in bed
• Location and intensity of pain
• Changes in leg symptoms

Acupuncture treatment and pharmacopuncture treatment

We can select [it] based on the patient's condition by examining excessive tension and pain symptoms in the muscles around the lower back.

Exercise and Recovery

Once the pain subsides, gradually restore movement of the lumbar spine and hip joint, as well as function of the trunk and gluteal muscles. It is important to start within the range of what is currently possible rather than beginning with intense strength training from the very beginning.

Pain relievers and injection therapy

Most cases of lumbar sprain can be treated at a Korean medicine clinic with the Chuna manual therapy, acupuncture, pharmacopuncture, and activity regulation described above. Only when pain is so severe immediately after injury that sleep is difficult or movement is challenging, using analgesics or NSAIDs briefly alongside them is often sufficient.

Overexerting yourself while pain is masked by medication makes it easy to resprain the back, and the more medications are taken or injections are received repeatedly, the more risks follow, such as gastrointestinal and kidney burden or tissue weakening. It is rare for repeated injections to be needed in a simple sprain, and if so, it must be re-checked whether other underlying causes are present.

It is advisable to avoid having someone press forcefully on a severely painful lower back or repeatedly twist it to make a sound.

Chuna manual therapy is not a treatment that must always be performed forcefully. First, confirm the trauma and neurological status, then select the appropriate direction and intensity for the patient.