Like millions of people who suffer from lower back strain, you, too, may have experienced this condition, at least once in your life. Usually, this occurs after you lift, twist or fall, and the result often resolves in a few days. When the pain lingers, however, or intensifies for more than a week, physical therapy is advised. In these situations the body has lost its ability to repair the injury. Most people don’t recognize that the position of the back when the strain occurs is crucial to understanding how to resolve the problem.
Let’s look at two main conditions.
Flexion injury. This type of injury occurs when a person is hurt while bent forward, which is the most common kind of strain. Since the hip flexors (muscles that run across the front part of the leg where it meets your body) are usually tight from extensive sitting, it is easy for them to go into spasm and lock the lumbar spine (lower back) in a flexed position. People with this strain usually feel pain when going from a sitting to standing position, and find that straightening their back is most difficult. They are most comfortable lying on their sides or backs with their knees bent up.
This is most easily treated by releasing trigger points in the muscles in the front of the body. The spine and pelvis usually require some structural adjustment to realign areas that were locked. A program of stretching will keep the muscles more balanced and reduce the chance of future injury.
Extension strain. Although extension strains are less common, they are equally as debilitating. Here, the back is in an arched backward position—as when lifting something overhead onto a shelf with both hands. In sports this injury occurs when a player lands on his or her back while arched over another player.
In this type of injury, sitting up perfectly straight is the most comfortable position. Bending the back (and sometimes the neck) causes a lot of pain and pulling in the lower back. Activities such as putting on shoes and socks can be very challenging. Sleeping is most comfortable on the stomach. Doing a sit-up is usually out of the question, since the spine is locked straight. Usually, someone with this type of back strain will feel very stiff and uncomfortable getting out of bed in the morning.
In more complicated or chronic conditions, a person can experience both types of strains at the same time. This can happen when trying to prevent a fall, or from a whiplash injury. In all cases, the pain is localized in the lower back and may, in some instances, radiate down the back of either leg.
If pain from a back injury increases over a period of two weeks, call your doctor. A short series of physical therapy treatments utilizing manual therapy and exercises often takes care of the problem.