Low Back Pain Part 2: Muscular Injuries

Low Back Pain Part 2: Muscular Injuries

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(lively music) – One of the things that
cause muscular injuries of the low back include twisting or bending or violent maneuvers that would exert a force on the muscles. You can have a sudden contraction and you can injure either the
rotators of the lumbar spine, the oblique muscles. You can injure the forward
flexors of the lumbar spine, the abdominal muscles or
the hip flexor muscles. Or you can also injure
the lumbar extensors as well too, including
your gluteal muscles. Often this could be due
to the fact that the patient may be deconditioned or the muscles aren’t properly trained. Usually the symptoms of muscular injuries include localized low back pain. Usually we do not see a
large radiating component to the legs. We don’t usually see numbness or tingling or weakness but usually could be either a stiffness or aching pain. Sometimes, honestly, the
worst type of pain that we see coming in to our office is
due to just muscle spasm. It could be a very sharp
knife-like pain as well too. Usually we see that the
patient’s range of motion as far as bending forward
and bending backwards as if he’s limited by this. Usually the patient pretty much localize where the pain is. – For an evaluation regarding
muscle-related injury it’s very similar to any other evaluation. We’re doing a full functional evaluation. We’re evaluating her flexibility issues and we’re essentially
watching the patient move with their activities
to try and figure out what aggravates this area. Help patient in addition to evaluating the skin temperature and so
on and so forth and redness can also give an indication
that there might be underlying muscular injury. One of the most important
muscles that I found that can get injured
with low back problems is the iliopsoas which
runs from your lower back through your pelvis and
attaches to your inner thigh. This muscle is the main hip flexor. So when it is tight
and you have difficulty extending yourself back because of it then you put additional
pressure on your lower back. Vice versa, if you have
really tight hamstrings in the back part of your leg then bending forward
is limited by your hips and then you put additional
forces bending forward in your lower back. Now we’re gonna have
you rotate to the left and now add the hips in and rotate to the right and now add the hips in. Once again you can see where
you can rotate a lot more when you add the hips in. When we have limitations in
our legs and in our hips, you’re putting additional
motion in that lower back. Imaging regarding a muscle-related injury is more for to rule out that there’s anything else going on. – Usually I recommend ice
as the treatment modality for muscle strain and
sprain the first 48 hours. Beyond that if heat provides
more relief than ice certainly that could be used
to alleviate muscle spasm. Anti-inflammatories, non-steroidal
is what we usually use. We usually do not go to a
steroidal anti-inflammatory. Stretches and physical
therapy can help us both too. We also at Coordinated Health
have chiropractic care, however, usually I avoid it
in the first two to three days after a muscular sprain,
strain as you don’t want to exacerbate the symptoms
by any manipulation. – The idea is that our
bodies work in concert. Our legs work well with our back, work well with our arms
and so on and so forth and limitations in certain
areas can really affect the other areas. One of the most important
things for us early on on a diagnostic evaluation is to try and find out
where the limitations throughout the body that can
affect the muscular injuries or other injuries to the lower back and make sure that those
areas are addressed. When we talk about functioning, we talk about what do patients do? They bend over and they pick things up. Other limitations with being
able to do that in their hips and then that’s putting
additional stress on their back and has created the problem. These are the types of things
that we would want to work out not only diagnosing-wise in the exam but then also addressing those things in a physical therapy program. It’s really important for the patients to really understand what
causes these problems. So getting an education about
what their problem area is from their doctor, from
their physical therapist and then starting to
move will help expedite the recovery itself. In general, getting an exercise program that addresses these problem areas is gonna be the most important in doing the exercises
the right way and safe way and progressing these exercises
the right way and safely. – At home, patients with
lumbar strain or sprain type condition can perform a regular
daily stretching activity, stretch out their back extensors
and their abdominal muscles and their side rotators, their
gluteal muscles as well too. They can ice 15, 20 minutes, two, three times a day initially. They can also use over the
counter anti-inflammatories. (lively guitar music)

20 thoughts on “Low Back Pain Part 2: Muscular Injuries”

  1. Excuse doc but im a dark skinned African American. How would detect redness on my skin? Temperature I can understand, but redness I'm alittle stumped on that one.

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