Muscle Strains vs. Ligament Sprains: Identifying the Source of Back Pain

Putting a Spotlight on Spinal Pain

As any Pain Doctor will tell you, spinal pain in the lower back (lumbar region), is extremely common. Indeed, the most prevailing causes of lower back pain are lumbar muscle strains and sprains.

Did You Know?

“The thoracic spine can also be a site of spinal pain; but because it’s far more rigid, the thoracic spinal area is much less frequently injured than the lumbar & cervical spine” [1]

Being Mindful of the Source of Sprains & Strains

Pain Consultants are frequently educating their patients about the spine’s weight-bearing function and involvement in bending, twisting and moving; along with the fact that due to these constant motions, the lumbar spine is sensitive to strain.

“Lumbar muscle strain is caused when muscle fibres are abnormally stretched or torn. Lumbar sprain is caused when ligaments (the tough bands of tissue that hold bones together, are unusually stretched). Both of these can result from a sudden injury, or from gradual overuse” [1]. – And this is why it is essential to get an accurate diagnosis from a Pain Doctor

Of note: if the lower back (lumbar spine) is sprained or strained, the soft tissues become inflamed. This results in a debilitating scenario which generates pain and causes the muscle/s to spasm. Moreover, in some cases, the spinal pain can be rooted in more serious issues. Generally speaking, these incorporate spinal pain which radiates into the legs, the arms, or around the rib cage (from the back towards the front of the chest) [1].

Know Your Muscles!

Being aware of the three different types of muscles which work to support the spine, is very beneficial. – That way, you can explain things very easily to your Pain Doctor, while at the same time, know exactly what they are referring to!

The three types of muscles supporting the spine, comprise:

Extensors (back muscles and gluteal muscles)
Flexors (abdominal muscles and iliopsoas muscles)
Oblique or rotators (side muscles) [1]

What Are the Symptoms of Muscle Strains & Ligament Sprains?

“Non-surgical low back pain usually affects the central or para-spinal soft tissue without radiating into the arms, around the chest or down the legs. Conversely, pain radiating from the spine into the extremities or chest wall implies structural pinching of the nerves in the spine” [1]

Furthermore, other symptoms incorporate:
Stiffness in the lower back region which compromises one’s range of motion
Inability to maintain a normal optimum posture as a result of being in pain, or stiffness
Muscle spasms either while resting, or being active
Pain which is continual for a maximum of 10 days to a fortnight
Notable loss of motor function (for example: not being able to walk on the heels or toes) [1]

What Type of Diagnostic Testing Does a Pain Consultant Carry Out?

When you have an initial in-person or online consultation with a Pain Doctor, they will review your medical history, ask you pertinent questions; and then if required, arrange for an examination, and any necessary tests and scans.

Generally speaking, Pain Doctors only carry out diagnostic testing if the patient has been in pain for over a fortnight, and the situation has not improved as previously expected. In the same vein, if a patient’s pain is radiating into the extremities or around the chest (past the spinal epicentre of the focus of the pain), the Pain Consultant will take measures to to rule out any potential underlying causes (such as a compromised spinal disc) [1].


[1]. American Association of Neurological Surgeons (2020). “Spinal Pain.”