Muscle Injuries that are involved with Lower Back Pain
By Sherwin Nicholson | SN Health Resources
The muscles of the lower back can undergo different forms of injury
Two common injuries are:
Strains and Contusions
Strains occur when a muscle is pulled or extended beyond its tensile limits. This happens by overstretching the muscle. Muscles are also strained by forcing them to contract or remain contracted beyond it limits until failure.
As the muscle can no longer hold it resistance, soft tissue damage occurs. Here the muscle fibers begin to tear. The severity of the injury is related to the amount of excessive force placed beyond its ability to withstand the force sustained.
Examples of such strains can range from the following.
- Overexertion during exercise requiring very heavy lifting
- Pulling a muscle as a result of holding a heavy object for long periods of time
- Bending or twisting in an awkward angle
- Slipping or falling causing a weaker muscle to overextended
Contusions occur when direct force is applied to the tissue and not from the muscle. These are compressive or crushing forces. This is also a soft-tissue injury. Contusions occur at or near the point of contact.
At the area of impact, there is local damage in which tissue is destroyed and local bleeding occurs. Contusions are visible by the appearance of a bruise at or near the site of contact.
Examples of contusions are from:
- Direct blows from sports or other physical activity
- Slips or falls where the body lands on the muscle
- Intense pressure on the muscle from over manipulation or palpations
Muscle Strains are Graded
To facilitate proper diagnosis and treatment, health care practitioners use a system which classifies muscle injury into 3 degrees or grades.
Grade 1 (Least Severe)
Grade 1 is the mildest form of muscle strain. Muscles fibers might or might not show signs of tearing when overstretched. There is usually a full recovery within a few days to a few weeks.
Some bruising may or may not be visible along with swelling. This grade is accompanied with some amount of pain.
Grade 2 (Moderately Severe)
Here, the overstretched muscle has signs of tearing with symptoms of both bruising and swelling. The intensity of pain is much higher. There is usually some amount of rupturing of the small blood vessels causing visible bruises.
Most people with this type of strain will find it difficult to move the joint associated with the strain. This grade usually requires 4-6 weeks for adequate recovery.
Grade 3 (Most Severe)
Grade 3 is the most intense and painful of the muscle strains. Here, the muscle is overstretched to the point of serious and harmful tearing. Tears can range from a partial to complete tear and separation of the muscle.
Patients can recount the moment of feeling and hear a distinct and sudden popping sound at the time of injury followed by intense pain and loss of movement.
The amount of damage is significant requiring 6-12 for partial tears. Surgery is usually recommended for full separations.
Muscles strains can trigger spasms as one set of muscles try to restrict the movement of the body to protect the injured muscle. This type of protection is known as muscle guarding. For example, a muscle strain can readily occur during simple movements.
A typical example, such as leaning sideways to reach something in the back of your car.
A mild to moderate muscle strain can occur during this movement. Small micro-tearing may occur causing pain and injury.
Other muscles immediately tense up to restrict movement, effectively ‘locking’ you up.
Symptoms of pain experienced are from three different areas: the effect of muscle guarding, the initially overstrained and torn muscles, and possible lumbar disc and nerve injury. This injury may require at least a few days to weeks to fully heal.
Although the tear will repair over time, others muscles which are guarding will cause pain. Any possible lumbar disc or vertebrae injury may still be present. It is important to find help for these issues as only treating the initial muscle strain is insufficient for relieving lower back pain.
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