Acute Lumbosacral Strain
This condition can result from injury to the low back, resulting in lower back pain or pain in the middle of the pelvis. This type of injury results from lifting excessive loads, lifting in a mechanically disadvantaged position or direct trauma to the lower back or falls in which the low back musculature is strained.
Signs and Symptoms. Unlike conditions such as spinal stenosis and herniated discs, which may come on gradually or spontaneously, people who suffer from this condition often experience low back pain immediately following an awkward movement, or strain type injury. The event that caused the acute lumbosacral strain causes immediate discomfort or pain. Often the discomfort is not overly severe and is appreciated mainly as a stiffness of the low back region due largely to muscle spasm. This is a mechanical back pain condition that does not typically involve neurologic components such as muscle weakness or numbness in the thighs or lower legs. In mild to moderate cases of this acute condition, the patient may be able to continue work and other responsibilities while recovering from the painful event that first caused this lower back pain condition.
If the trauma or the excessive load lifting is sufficient to cause severe acute lower back pain, continuation of normal everyday activities may be impossible in the short run, or activity may exacerbate the symptoms. In severe cases, the person suffering from the severe Acute Lumbosacral Strain may remain bedridden for some time, or may actually prefer lying down on the floor or other flat surface. The person may be incapacitated by the severity of the muscle spasms that result from the strained muscles causing this temporary acute pain. While the patient is in the grips of a severe case, any slight movement may spike his or her pain levels, and the gentlest movement of the stretcher used to transport him/her to the hospital may cause excruciating discomfort. This type of muscle strain injury is one of the most common reasons for emergency room admissions in the United States.
Though severe cases are not as common as the mild and moderate cases. The more common cases are manifested as low back discomfort. The pain in not usually spread throughout the back, but concentrated in one discrete area, related to the involved muscles that have become injured, strained, or overstretched. The pain is usually worse on one side of the back.
Diagnosis and Evaluation: Examination of the low back reveals unilateral or bilateral spasm of the lumbar paraspinal muscles. In humans the paraspinal muscles connect from the individual vertebral to facilitate some movement of the spine, and to prevent against excessive movements that would hurt the spine. Injury to the paraspinal muscles may result in increased pain levels when the individual attempts forward bending. Mobility of the spine and movement of the lower back may be significantly limited. If the paraspinal muscle spasm is unilateral, lateral movement towards the injured side may produce no discomfort (or even some relief), while lateral bending away from the injured side will usually increase discomfort/pain. The injury may be significant enough to produce some lateral lumbar scoliosis towards the side of the muscles in spasm.
Severe muscle spasms related to this condition may cause pain that radiated from the site of strain. The injury may be significant enough to spread throughout the lower and middle back, and to the lower extremities. This injury may be significant enough to cause difficulty with any back movement, and pain in the legs upon movement.
Reflex sensory examinations are normal. X-Rays will not present negative findings though lateral X-rays may reveal some straightening of the normal lumbar curvature. Lumbar scoliosis may be observed when the muscle spasm is unilateral.