Soft tissue injuries are very common and are seen frequently throughout our practice. Obtaining a good history is essential in determining whether or not the symptoms are stemming from a muscular strain. Some individuals present with specific injuries while others do not. Common injury mechanisms include whiplash secondary to motor vehicle accidents, improper form while weightlifting, lifting heavy objects, sleeping incorrectly, etc.
There are a variety of methods used to treat muscular strains. Ice is used to minimize swelling and heat is often used to increase blood flow/assist with the natural healing process. Oftentimes, we educate patients to use whichever makes them feel better; alternating heat and ice is sometimes very effective as well. Anti-inflammatories (NSAIDS) such as Ibuprofen or Aleve are very helpful in reducing local inflammation and relieving pain. NSAIDS work by blocking prostaglandins, which are substances that enhance pain during inflammation and sensitize your nerve endings. Some patients find Acetaminophen (Tylenol) to be equally effective; alternating between NSAIDS and Tylenol is also another option. Medications such as muscle relaxers can be used to control spasms as well. Lidocaine patches and other topical pain relievers such as Bengay, BioFreeze, and Icy Hot can also help to manage symptoms.
When patients are unable to manage their symptoms with at home remedies, they typically present to our orthopedic practice. One medication that is useful in treating acute injuries is a medrol dosepak (also known as methylprednisolone). This is a steroid taper that is used to decrease inflammation and help to improve the patient’s current symptoms; it is also used to ensure that their symptoms are manageable so that they can effectively participate in physical therapy.
For cervical and lumbar muscular strains, myofascial treatments in physical therapy are particularly helpful. These treatments include but are not limited to heat, ice, massage, foam rolling, electrical stimulation, ultrasound-guided therapies, cupping, kinesiotaping and dry needling. Dry needling is a technique used to treat a range of musculoskeletal issues. It helps by reducing local tension in the tissue, reducing inflammation, and improving blood flow to the area. This in turn aids in restoring range of motion, correcting movement impairments, reducing muscle spasm and pain, and promoting proper function. For the low back, core strengthening exercises are very useful. Yoga and Pilates, in particular, are great for core stabilization and strengthening. Spine surgery does not treat muscular strains. Overall, there are many non-operative treatment modalities when it comes to muscular strains in the neck and low back.