Back strain and sprain: The Daily PANCE Blueprint

Home Back strain and sprain: The Daily PANCE Blueprint

Back strain and sprain: The Daily PANCE Blueprint

A 38-year-old male presents to the clinic complaining of low back pain that occurred suddenly while lifting heavy boxes yesterday. The back pain is in the lumbar area. He denies any numbness, tingling, or weakness. His physical exam is unremarkable except there is tenderness of the paraspinal muscle. Which of the following is the best management option?

A. Referral to an orthopedic surgeon
B. NSAIDs and activity as tolerated
C. Back brace and opioids
D. Avoid heavy lifting only
E. Bed rest and muscle relaxants

Answer and topic summary

The answer is B. NSAIDs and activity as tolerated

Acute low back pain is one of the most common reasons patients see a healthcare provider and it is often (definitely not always) caused by lumbar strains/sprains. Most patients do recover quickly from strained back muscles. However, red flags for acute back pain should be looked out for, such as fevers / systemic deficits, pulse deficits, neurological symptoms, bladder/bowel dysfunction, progressive/worsening, a recent history of back surgery, etc. Management of a back muscle strain includes NSAIDs and muscle relaxants and continuing activities as tolerated.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Spinal Disorders (PEARLS) ⇒ Back strain and sprain

Also covered as part of the Emergency Medicine EOR topic list

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