In life, there will always be such and such small accidents, playing ball, bending down to move things, even after a hard sneeze... A sharp pain struck from the waist, and the whole person could not move for an instant.
Every time you hurt your waist, you have to nurse for a while. You may be extremely depressed: Why does a small action "flash"?
"Flashing waist", medically known as "acute waist sprain", generally occurs in improper posture when moving things, excessive force during exercise, and external force collisions [1].
Where did that good waist flash? Generally 3 places are the most common:
1. Injured soft tissue
Acute injuries to soft tissues such as lumbar muscles, fascia, and ligaments are common, and low back pain, lumbar stiffness, and low back muscle spasms are common.
(Source: spine-health)
2. Injury or misalignment of the small joints (articular interlocking)
It is mainly the relaxation of the joint capsule that causes instability in the lumbar joints, and occasionally there will be cases of misalignment and jamming of the joints.
These patients may have several typical presentations: low back pain, low back weakness, fear of weight bearing and positional changes, the need for external support when sitting and standing, and some patients may have severe lower extremity radiating pain due to nerve root entrapment in the foramen area [2].
3. Lumbar disc injury
The structure of the intervertebral disc is similar to the "pie", the outer "crust" is called the fibrous ring, the inner "filling" is called the nucleus pulposus, and the external force injury may cause acute injury to the intervertebral disc fiber ring with degenerative changes, which will trigger a local inflammatory response, resulting in more serious lumbar pain.
Some patients have lacerations of the fibrous ring, and the nucleus pulposus comes out of the fibrous ring tear, which often produces severe lower limb radiation pain and numbness, and even lower limb weakness and abnormal defecation function, and such patients often need to be treated surgically [2].
Projects with a high probability of acute waist sprain have a common action called a standing action, such as a basketball jump shot, a volleyball frontal flexion buckle, and so on.
When standing up, the erector spine muscles are strongly contracted, but the abdominal muscles cannot be properly relaxed and elongated or the standing action is over, and the instantaneous contraction cannot be contracted in time, which may lead to the contraction of the psoas muscle exceeding its own ability to withstand and produce waist structural damage.
In addition, the following situations are also prone to waist sprains:
In ball sports, in order to maintain the balance of the body when competing for the ball, the waist and abdomen muscles contract rapidly and violently, and the contraction force exceeds the load;
Skiing and other movements in which the trunk is in a forward-leaning state for a long time, and the psoas muscles are tense for a long time;
Movements such as weight-bearing squats require the waist muscles to repeat mechanical movements.
1. Pain
Low back pain is a herniated symptom of acute lumbar sprain [2], and patients with disc injury may have radiating pain in the lower extremities, which often appears and persists immediately after the injury, and cough, loud talking, and abdominal force will exacerbate the symptoms, while lying flat will relieve it [4].
2. Forced asana
Most people may present with flexion to the affected side and limited lumbar movement.
3. Paraspinal tenderness
There is significant paravertebral tenderness in the injured area and is exacerbated by increased pressure in the abdomen.
4. Spasm of the lower back muscles
The damaged muscles cause reflex spasms due to pain and other factors, and can be clearly corded with the touch of the hand.
Before exercising, do a good job of fully warming up so that the muscles and ligaments are fully moved and stretched;
Arrange fitness programs reasonably, and pay attention to fitness time not too long;
To strengthen the core muscles of the waist, two exercise methods are recommended here [5]:
Hip bridge training
Plate support
Warm reminder: Some waist rotation movements and "Xiaoyanfei" movements are not suitable for some patients with lumbar disc herniation, and should be consulted before proceeding.
After a lumbar sprain, the correct way to relieve pain is these 5 ways:
1. Bed rest
The bed should be of moderate hardness, or a hardboard bed with a 1 to 2 cm thick cotton pad, free position, painless or light pain.
Acute psoas muscle and fascia sprain, bed rest after 1 to 2 days, can try to get up and move, acute lumbar joint sprain and fibrous ring tear should adhere to bed rest for 3 to 4 weeks.
2. Apply cold compresses after sprains
To constrict local blood vessels and prevent the exudation of tissue edema from worsening, the time is controlled at about 15 minutes, and it is repeated every 2 to 3 hours.
3. Apply hot compresses after 48 hours of sprains
To relieve muscle spasms, warm compresses are applied for 10 to 15 minutes every two hours to increase local blood flow.
4. NSAIDs (non-steroidal) anti-inflammatory analgesics
Optional oral or topical anti-inflammatory analgesics, such as ibuprofen, buttaline, etc.
5. Waist brakes
Patients with severe low back pain can wear waist brakes (using waist circumference with support bars) as appropriate, and the wearing time is not recommended for more than 4 weeks, otherwise it is easy to cause atrophy of the lower back muscles [6].
note:
· In the acute phase (within 48 hours of the sprain), massage and orthopedic treatment should not be avoided, otherwise the injury will be aggravated;
· Patients with radiating pain in the lower extremities should have a complete MRI examination of the lumbar spine to check for nerve root compression;
· Patients diagnosed with joint intersection or lumbar disc nucleus prolapse need to go to the spinal surgery clinic or emergency department as soon as possible, and use surgical treatment as appropriate to relieve nerve root compression.
Review expert: Ren Dongfeng
Deputy Chief Physician of the Department of Orthopedics, Fourth Medical Center of PLA General Hospital
bibliography
[1] Adult Acute and Subacute Low Back Pain[J]. Institute for clinical Systems Improvement.2018 Mar-6th Edition.
Chen Zhongqiang,Liu Zhongjun,Dang Gengcheng. Spine Surgery[M].9th Edition. Beijing People's Medical Publishing House, 2017: 731-735
[3] NIH website: https://www.niams.nih.gov/health-topics/sprains-and-strains#tab-prevention.
He Kejun,Li Chaohong. Causes and prevention methods of acute lumbar sprain in sports[J]. Journal of Neck and Back Pain,2005,26(3):216-218.
[5] Chinese expert consensus on the diagnosis and treatment of acute and chronic nonspecific low back pain[J].Chinese Journal of Spine and Spinal Cord, 2016, 26(12):1134-1138
[6] Zhou Mouwang, Yue Shouwei, He Chengqi, etc." Rehabilitation treatment of lumbar disc herniation", Chinese expert consensus. Chinese Journal of Rehabilitation Medicine.2017.32(02):129-135
Editors: Ye Zhengxing, Wang Yan, Zhang Liang
Typesetting: Han Ningning | Proofreader: Wu Yihe
Operations: Li Yongmin | Coordinator: Wu Wei