Back Injuries: Spine Sprains, Strains and Fractures

Your back is made up of bones (vertebrae), muscles and other tissues extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, or a sudden jolt, such as a car accident. The lower back is the most common site of back injuries and back pain. Common injuries include:

These back injuries can cause pain and limit your movement. Treatments vary but might include medicines, icing down the affected area, rest, physical therapy or surgery (in the case of a severely herniated disc).

You might be able to prevent some back injuries by maintaining a healthy weight, lifting objects with your legs (making sure to bend your knees) and using lower-back support when you sit.

What are back sprains and strains?

Back sprains are similar to strains, but technically a different injury. However, the symptoms and treatments for each are nearly identical. The strength of our backs are muscles around the spine and the tough ligaments that hold together your vertebrae bones. A sprain is a stretching or tearing of those ligaments, while a back strain is an injury to the muscles.

Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains from playing sports. Symptoms include pain, muscle spasms, swelling and trouble moving the muscle.

Back fractures

Compression fracture

Osteoporosis, a condition in which bones thin and weaken, can cause compression fractures in your spine. The primary symptom is pain at the site of the break. Most of these fractures due to weakened bones occur at or near the waistline.

Fractured vertebrae

Sometimes an impact that fractures or dislocates vertebrae can also injure your spinal cord. However, most injuries don't cut through your spinal cord. Instead, they cause damage when pieces of vertebrae tear into cord tissue or press down on the nerves that carry signals for movement. There are two types of injuries, depending on the severity and risk of paralysis:

• Complete spinal cord injury – The spinal cord can’t send any signals below the level of the injury. As a result, you’re paralyzed below the injury.
• Incomplete spinal cord injury – You have some movement and sensation below the injury.

A spinal cord injury is a medical emergency. Immediate treatment can reduce long-term effects.

Treatments may include medicines, braces or traction to stabilize the spine, and sometimes surgery. Later, treatment usually includes medicines and physical rehabilitation therapy. Mobility aids and assistive devices may help you to get around and do some daily tasks.

How to protect yourself from back injuries

While it’s not possible to prevent all back injuries or guard against any genetic risk factor, here are some lifestyle changes you can make to lower your risk of back sprain or strain:

• Maintaining a healthy weight can reduce pressure on your back and spine
• Practice proper lifting techniques and lift objects with your legs rather than bending over
• Build strength with exercises that increase core stability 
• Practice better posture while sitting or standing
• Utilize different sleeping positions 
• Wear low-heeled shoes
• Quit smoking

Additionally, avoid the following exercises that may increase the likelihood of lower back pain:

• Straight-leg sit-ups
• Bent-leg sit-ups during acute back pain
• Leg lifts
• Lifting heavy weights above the waist (military press or biceps curls while standing)
• Stretching done while sitting with legs in a “V” position
• Standing toe-touches

Diagnosing back injuries

Our spine specialists work closely with emergency department staff, who are often the first to evaluate people following an accident with an injury to the spine. If you are referred to Ohio State Spine Care, a physician will perform a thorough history as well as physical and neurological exams to check for neurological and muscular problems around the spine.

If you have a more severe back sprain or strain, an X-ray, an MRI or other imaging services may be used to rule out a broken back or herniated disc as the cause of your back pain.

Our team of neurologists, orthopedic doctors, physical medicine and rehabilitation specialists, and neurosurgeons will consult with one another to accurately diagnose you.

Treatment for back sprains and strains

The treatment, especially at the onset of the pain, will likely be the same whether you have torn a ligament (back sprain) or a muscle (back strain). In most cases, a back strain or sprain will be corrected without a need for surgery.

Nonsurgical treatment for back sprains and strains may include:

• Resting
• Using ice packs for the first 24 to 48 hours after the injury
• Wearing a brace for support
• Exercising to strengthen muscles and increase stability
• Physical therapy – We have specialists in rehabilitation of spine injuries and conditions
• Anti-inflammatory medication
• Spinal injections for pain relief
• Using spine orthobiologics, which use the body’s own cells to repair the injured area
• Acupuncture

Treatment for back fractures – compressed or fractured vertebrae

Treatment usually includes rest, pain relief medication and sometimes a brace or surgery to stabilize your spine. You can take bone-strengthening medication to prevent additional fractures.

Nonsurgical treatment

• Medication – Bone-strengthening medication helps prevent new fractures of the back.
• Wearing a brace (if the fracture is stable and unlikely to worsen).
• If you have a fracture of a facet joint that joins two vertebrae — often from sports activities — rest is the first line of treatment. If pain persists, we can utilize radiofrequency ablation (also called radiofrequency neurotomy), a procedure using intense heat produced by radio waves to disable nerves that are causing pain.

Surgical treatment options

• Compression fractures causing severe pain can be treated with minimally invasive procedures called vertebroplasty and kyphoplasty, where medical cement is placed within the bone to stabilize it and help with pain.
• Some more complex back fractures may require more extensive surgery to stabilize your back vertebrae.
• If you have a back fracture related to cancer, our spine specialists work closely with our oncology teams at The James Cancer Hospital and Solove Research Institute to coordinate your care and treatment.

Research

Ohio State Spine Care conducts innovative research and participates in clinical trials.

An area of focus includes:

Lumbar burst fractures [Radiographic and Clinical Outcomes Following Non-operative versus Operative Treatment of AO Type A3 Fractures: A Prospective, Randomized Clinical Trial with an Observational Component]: We are conducting a comparative study of surgery versus bracing for fractures that occur with sudden compression in the lower back (lumbar spine) to test which approach produces optimal results.

Enroll in a clinical trial