Treatment and Management for Acute Lumbosacral Strain

Treatments for a patient's lumbosacral strain may depend on the general health of the patient, the cause of the injury, and the severity of its symptoms.

Treatment and management for acute lumbosacral strain often includes a combination of bed rest, the prescription of muscle relaxants and narcotic pain medications, or injection of a local anesthetic into the paraspinal muscles that are causing the lower back pain.

In cases where the severity of the injury involves severe lower back pain and the inability to move, the patient is brought back to their home and should be placed on bed rest. Typically, patients with this condition should sleep on a bed with a bed board or a firm mattress. Though doctors are hesitant to prescribe muscle relaxants or narcotic pain medications for most back conditions, the severity of symptoms of this condition may require one of these two types of medications. Because of the fact that these types of injuries heal within days or weeks, prescribing narcotics to treat the back spasms associated with acute lumbosacral strain will be considered relatively safe. Because the strain is not a chronic condition that will results in several weeks or months of medication treatment, the possibility of dependence or addiction is will be relatively low. Also, the pain levels of this condition is often so incapacitating that even heavy breathing or the slightest movement may be sufficient to cause pain levels to spike. Clearly, this is a condition that involves severe back pain, and one in which the suffering patients deserve aggressive pharmacological treatments.



Muscle relaxants are occasionally helpful in reducing the muscle spasm, and the use of them and narcotics together may amplify the therapeutic effects. Muscle relaxants that are used to treat Acute Lumbosacral Strain and other lower back pain conditions include methocarbamol, metaxalone, cyclobenzaprine, and carisoprodol. Doctors who are concerned with issues such as dependence associated with narcotics may prescribe one of these muscle relaxants only originally, and may add narcotic pain medications if the original prescription does not produce significant pain relief.

Physiotherapy in the forms of heat and gentle massage may speed the rate of recovery of the muscles and provide some pain relief.

If the muscle spasms and associated pain persists at high levels despite bed rest and one or more of the treatments mentioned above, anesthetic injection may provide immediate pain relief in cases that indicate the precise cause of the injury and the muscles involved. In such cases, a local anesthetic is injected directly into the paraspinal muscles that are in spasm. In many cases, the injection of the local anesthetic brings immediate pain relief and provides a long enough duration of relief that it continues until the injury has healed on its own.

Unless there is an underlying condition that has caused the paraspinal muscles to go into spasm, and not a more common sprain and strain type injury, the injury will usually heal on its own, regardless of the chosen treatment for acute lumbosacral pain. The muscle spasm will usually heal on its own, though bed rest, medication and physiotherapy may help to speed the healing process or make the patient more comfortable as they heal. While bed rest for most back conditions is contraindicated (not recommended), for this condition normal activity may be impossible for the patient or may prolong the healing process.

To facilitate the healing process, patients may perform a combination of these three low back exercises, either in their bed, or on a flat surface in their home: Pelvic Tilt, Iliopsoas muscle stretching in the supine position, and Iliopsoas muscle stretching in crouching position. Click here to learn more about these lower back pain stretched and exercises.