Sprain & Strains

Introduction

Sometimes you need to see a doctor for help in diagnosis and treatment. For strains or sprains, the pain can increase in the first one to two days, as the spasm surrounding the injury sets in. If after trying RICE (see Self-Care at Home) and over-the-counter medications the pain is not controlled or if the injury is thought to be more severe than initially believed, then a visit to a doctor is wise. A doctor's visit also is important if swelling gradually develops over a large joint, such as a hip, knee, elbow, or wrist.

Sometimes you need the help of hospital equipment and specialists. Seek care immediately in any of the following cases:

• If you are concerned that a bone is broken or a joint is dislocated
• If you have numbness or tingling associated with the injury (This may signify damage to a nerve.)
• If the injured part of the body is cold and discolored (This may be associated with damaged blood vessels and loss of circulation.)

Children present a special situation. Due to growing bones, muscles, and tendons, these structures can react differently to stress. Parents can be rightly concerned about possible broken bones. Remember, even if you can walk on an injured limb or move it, you may still have a broken bone. It just means that the muscles and tendons are working across the joint.

Self-Care at Home

Initial treatment for sprains and strains should occur as soon as possible. Remember RICE!

• Rest the injured part. Pain is the body's signal to not move an injury.
• Ice the injury. This will limit the swelling and help with the spasm.
• Compress the injured area. This again, limits the swelling. Be careful not to apply a wrap so tightly that it might act as a tourniquet and cut off the blood supply.
• Elevate the injured part. This lets gravity help reduce the swelling by allowing fluid and blood to drain downhill to the heart.

Over-the-counter pain medication is an option. Acetaminophen   (Tylenol) is helpful for pain, but ibuprofen (Motrin, Advil) or naproxen (Aleve) might be better because these medications relieve both pain and inflammation. Remember to follow the guidelines on the bottle for appropriate dose of the medicine, especially for children and teens. Underlying medical conditions or use of other prescription medicines may limit the use of over the counter pain medications.

Prevention

Sprains and strains are caused by accidents. People don't plan on becoming injured, but there are some practices that may help prevent injuries. Muscles need to be warmed up before exercise and work. A stretching program is helpful in minimizing the risk of injury. Even simple tasks at work can cause painful strains if the body is not ready to do the work.

Outlook

The goal of treatment for sprains and strains is the return to the level of function that the person had before the injury. This means that the expectation is for the injury to completely heal. The time frame for recovery depends on the severity of the injury. It may take just a few days for a slight sprain of an ankle to heal, or it may take months for a knee to heal that has to be surgically reconstructed.

Perhaps the most important therapy for all injuries is rehabilitation. This may be a home exercise program that your doctor outlines, or it may be a formal physical therapy program. You should have an understanding before leaving the office or hospital of what work is expected to rehabilitate the injury. Ask the following questions:

• What limitations are there for activity and work?
• What is the time frame for recovery?
• When is it safe to return to full activity?
• When should a reevaluation be scheduled?