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Lumbo-dorsal back sprain

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GENERAL INFORMATION

DESCRIPTION

A lumbo-dorsal back sprain is a violent overstretching of one or more ligaments in the lumbo-dorsal vertebrae of the spine. This is the most stable section of the vertebral column. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. Appropriate health care includes: doctor’s diagnosis; application of tape, cast (rare), or elastic bandage; self-care during rehabilitation; physical therapy (moderate or severe sprain); hospitalization (rare) for traction; surgery (severe sprain).

SIGNS & SYMPTOMS

  • Severe pain at the time of injury.
  • Popping or feeling of tearing in the child’s back.
  • Tenderness at the injury site.
  • Swelling in the child’s back.
  • Bruising that appears soon after the child has been injured.

CAUSES

Stress on a ligament that temporarily forces the lumbo-dorsal vertebrae out of their normal location. A sprain of the lumbo-dorsal vertebrae will frequently occur when your child performs a stressful act while off-balance, or during repeated stressful activity involving muscles in the lumbo-dorsal area.

RISK FACTORS

Contact sports involving throwing and lifting; gymnastics or diving; previous spine injury; obesity; poor muscle conditioning.

PREVENTING COMPLICATIONS OR RECURRENCE

Your child should build strength with an appropriate conditioning program. The child should warm up before sports and should tape vulnerable joints before practice or competition to prevent reinjury.

BASIC INFORMATION

MEDICAL TESTS

Your own observation of symptoms; medical history and physical exam by a doctor; X-rays of the spine to rule out fractures.

POSSIBLE COMPLICATIONS

Prolonged healing time if the child’s usual activities are resumed too soon; proneness to repeated back injury; inflammation at the ligament attachment to bone (periostitis); prolonged disability (sometimes); unstable or arthritic spine following repeated injury.

PROBABLE OUTCOME

If this is a first-time injury, proper care and sufficient healing time before your child resumes activity should prevent permanent disability. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are: mild sprains–2 to 6 weeks; moderate sprains–6 to 8 weeks; severe sprains — 8 to 10 weeks.

TREATMENT

HOME CARE

If your doctor does not apply a cast, tape, or elastic bandage:

  • Continue using an ice pack on the child 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured area. Use for 20 minutes at a time.
  • Wrap the injured area from the top of the hip to the lower rib cage with an elasticized bandage between ice treatments.
  • Massage gently and often to provide comfort and decrease swelling.
  • Ask your doctor about the advisability of the child using a special corset.

MEDICATION

  • For minor discomfort, use aspirin, acetaminophen, or ibuprofen.
  • Your doctor may prescribe stronger pain relievers; injection of a long-acting local anesthetic to reduce pain; injection of a corticosteroid, such as triamcinolone, to reduce inflammation.

ACTIVITY

Your child can resume normal activities gradually after clearance from your doctor.

DIET & FLUIDS

Increase the child’s fiber and fluid intake to prevent constipation that may result from decreased activity.

OK TO GO TO SCHOOL?

Yes, when condition and sense of well-being will allow.

CALL YOUR DOCTOR IF

  • Your child has symptoms of a moderate or severe lumbo-dorsal back sprain, or a mild sprain persists longer than 2 weeks.
  • Pain, swelling, or bruising worsen despite treatment.
  • Pain develops in the child’s leg.
  • Any of the following occur after surgery: increased pain, swelling, redness, drainage, or bleeding in the surgical area; signs of infection (headache, muscle aches, dizziness, or a general ill feeling with fever).
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

From the Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. © 1989 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange

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