Why we have Back Sprains / Strains
Most people sprain/strain ligaments and muscles of the back. The back is a very complex structure. The main purpose is to support your frame, allowing safe movement, while protecting the important vital organs in your abdominal area. The spine is also the conduit for the nerve signals going from your brain to the legs and organs. The back must be strong, for protection, while also flexible to allow movement. To achieve those purposes, the back is a complex organization of bones, ligaments, muscles and nerves. Each element has very specific functions, and proper function demands precise coordination. Because of so many moving parts, it is actually amazing that we do not have more back pain.
The muscles of the back are multiple and paired, right and left. The muscles must also be balanced to allow the back to remain erect and coordinated. As we twist from side to side, one set of muscles must contract, and shorten (concentric), while a corresponding set of muscles on the other side of the motion must elongate, in a controlled manner (eccentric). Considering, that there are multiple planes of motion (so called six degrees of motion), the complexity of the coordination of these muscles become more apparent. All muscles fatigue with excessive use. With the fatigue, these muscles can get overstretched, leading to the back muscle Strain.
The structure that becomes like a rope, extending off muscles are called tendons. The tendon is the extension of the muscle that attaches to the bones. In the back, there are multiple small muscles with multiple tendons that insert onto the spine bones (spinous processes). These tendons can also become frayed or weakened during overuse, or overstretch. This stretching of a tendon is also considered a back strain.
In addition to the muscles and tendons, there are ligaments, which are rope like structures that connect a bone to the bone. In the back, there are multiple paired ligaments that connect boney parts to one another. Over time, these ligaments can wear or stretch, causing the so call back sprain.
As you can imagine, all these paired muscles, tendons, and ligaments can be a source of pain. With all the necessary pairing, and coordination of all these structures, an overstretch incident can be the source of pain. With so many components involved, it would be very difficult to definitely identify which specific muscle, tendon, or ligament is the cause of the pain. In addition, as these are soft tissues, X-rays would not be able to identify the cause. Even with MRI’s, unless there is a significant tear of any of these components, the study will not likely pin point the soft tissue pain generator.
So, when you have back pain, it is likely secondary to a sprain/strain of one of these muscles, tendons or ligaments. While your physician will also ask questions to make sure it is not something more serious, the vast majority of back pains are from these sprains and strains. Also remember, that as we all age, these components do wear away. It is a part of life. Luckily, most episodes of back sprains /strains do heal with minimal or no pain.
- Ren CZ, Fang XL, Du XZ. [Fifty-six cases of acute lumbar sprain treated by buccal acupuncture combined with exercise therapy]. Zhongguo Zhen Jiu. 2014 Mar;34(3):245-6. PubMed PMID: 24843964
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What is a back sprain or strain? It means the muscles, ligaments or tendons of your back have been stretched to the point of injury. Normally, any muscle, ligament or tendon has a normal range of stretch, but with either over stretching or rapid stretching, they can get stressed beyond their normal. To give an example, if you stretch a rubber band it will return back to its shape after the force has been removed. If you stretch a rubber band beyond its tolerance, it can deform, and it will not return back to its original shape. The components of the rubber band has become weakened, and it will not return to its normal. For muscles, ligaments, and tendons, there can also be a stretch that is beyond its normal tolerance resulting in injury and weakness. In your back, there are literally hundreds of muscles, ligaments, and tendons. The muscles are oriented in multiple layers, and connect different areas of the spine. Just so we can be specific in our words, muscles are the soft belly that can contract or lengthen, Tendons are the ropey ends of the muscles that can attach to the bones, and ligaments are the ropes that connect one bone to another. From the animation you can see that the muscles run from the base of the skull to the tailbone. Closer look at the muscle layers also identify many smaller muscles and tendons that join individual vertebrae. Additional views of the spine show many ligaments joining bones to one another. Each of these muscles, ligaments, and tendons can be over stretched, and cause pain. Fortunately, the body has the ability to repair the damage caused by the over stretch. Most of the time these sprains and strains resolve with time. If you do have back sprain or strain, standard advice would be to take anti-inflammatory agents, provide ice to decrease swelling to the areas, and gently stretch to prevent prolonged stiffness. In my practice, I often refer patients to my exercise app. I hope this explanation of the back sprain and strain was useful to you. Thank you for watching. If you'd like more information about similar topics, please subscribe to our newsletter or to our YouTube channel. Thank you.
Last modified: January 9, 2020