So picking up where we left off from our previous article on this topic. By the way, if you haven’t read our last article now would be the time to do so as it covers the basic concepts of the lower back and why it is susceptible to injury. Anyway, as we were saying, injuries of the lower back are in fact a very serious matter, as the lower back plays such a vital role in our daily mobility as human beings. Lower back injuries may present acutely due to a sudden harmful force or significant trauma.
Or it can be a chronic issue that builds up overtime and progressively gets worse. This is usually due to postural issues or imbalances in your biomechanics. Lower back injuries can also show up as common injuries such as sprains or strains of the connective tissues or it can present as something far less common such as ankylosing spondylitis. Now, if you are like most of the general population that went: “Sondy-what?!” after reading that last sentence, then you have come to the right place.
As we will be covering injury types, definitions, signs and symptoms as well as how to go about a diagnosis and acute treatment options.
Common Lower Back Injuries
These are known as “bread and butter” cases in the medical world, not that they're any less significant but because they are so commonly seen that it feels like we encounter these injuries almost everyday. These types of injuries can be both acute and chronic with differing levels of intensity or severity of pain and discomfort.
These common injuries include the following:
Sprains and Strains
These injuries are colloquially defined as “pulling” a muscle, tendon or ligament in the back. This is usually as a result of poor biomechanics when doing a lifting, pulling or twist movement that predominantly involves your lower back. Other causes of sprains and strains within the lower back musculature can be poor posture resulting in detrimental loading patterns and compensations. And finally excessive sudden forces exerted externally on the lower back that exceed the internal stability and strength of the lumbar region. The connective tissue structure gets compromised resulting in the fibers being overstretched. This results in damage to the integrity of the connective tissue fibres.
Just for clarification, sprains occur between connective tissue structures that connect bone to bone like a tendon for example. On the other hand strains occur in structures that predominantly connect bone to muscle tissue this mostly occurs in muscle fibers and the occasionally ligament. Regardless, both can occur at varying ranges of severity and require different levels of intervention.
The most commonly accepted and used classification of strains and sprains is the traditional grading system. In this system sprains and strains are graded on a scale of 1 to 3, where a grade one sprain or strain is regarded as the least problematic usually characterized by some damage to the overall structure of the tissue. Contrastingly, a grade 3 sprain or strain is characterized as the complete rupture of the connective tissue fibers. While a second degree or grade 2 sprain or strain falls somewhere in between these two classifications and it usually ranges between being moderately severe tear within the fibers to a borderline rupture of the fibers.
The extent of the injury and the ultimate classification will determine the exact protocol needed for treatment and rehabilitation. But more on this a bit later in the series.
Signs and Symptoms of Strains and Sprains
The most common symptom you usually expect to see with this type of lower back injury is a popping sensation experienced at the moment of injury. This is characterized as the moment the connective tissue was pulled