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Sprains and strains: Symptoms, diagnosis and treatment

Sprains and strains are common and sometimes painful injuries to muscles and ligaments, whether from playing sport or an accident or fall around the home.

Sprains are stretches, twists or tears to a ligament connecting bones together. Sprains may affect knees, ankles, wrists and thumbs.

Strains are stretches or tears to muscle fibres. Strains include hamstring strains in the legs and lumbar strains in the back.

In most cases, sprains and strains can be treated at home with PRICE therapy – protection, rest, ice, compression and elevation. Painkillers may also help with discomfort.

In some more severe cases, medical attention may be needed. A doctor will take a detailed medical history and do a physical examination of the affected area. Hospital X-rays can help rule out a bone fracture. In some cases an MRI (magnetic resonance imaging) scan is advised to check for ruptured tissues.

What are the symptoms of sprains and strains?

Sprains affect your ligaments, the fibrous bands of tissue that support joints. Strains affect your muscles or tendons, the fibrous tissue that connects muscles to bones. Both usually occur after a fall or sudden movement that violently pulls or twists a part of your body. Chronic overuse of muscles or joints can also cause strains and sprains.

Symptoms of a sprain:

  • Pain in the affected joint
  • Rapid swelling of a joint, often accompanied by bruising
  • Stiffness and difficulty moving a joint
  • Increase in skin temperature near the swelling and redness of the skin

Symptoms of a strain:

  • Sharp pain at the site of an injury
  • Pain followed by stiffness and tenderness, and in some cases, swelling and bruising
  • Inability to fully bear weight on your knee or ankle
  • Limited range of motion of the shoulder, elbow or wrist

Seek medical advice if:

  • The pain, swelling, or stiffness does not improve in two to three days.
  • You feel a popping sensation when you move a sprained joint; this may indicate a serious injury that requires immediate medical treatment.
  • You can't move or bear weight on an injured joint, you may have a broken bone.
  • The bones in an injured joint don't seem to be aligned properly, the ligaments that hold the joint together may be badly torn, requiring surgical repair.
  • An injured muscle doesn't move at all, the muscle may be torn completely through and require immediate medical attention.
  • You have repeated sprains or strains, indicating a chronic weakness that should be checked by a doctor.
  • You have difficulty moving or walking after straining any back muscle.
  • You have a fever, and the injured area is red and hot; you may have an infection.

What are the treatments for sprains and strains?

Treatment of both sprains and strains focuses on control of the initial pain and swelling with PRICE therapy and painkillers, followed by adequate rest to allow healing.

Elastic bandages may then be used to support or immobilise the injured area while it heals. A sprained ankle or knee often calls for crutches to keep weight off the joint for a day or two while it heals. In some cases, bracing or casting is needed. To speed healing, doctors may also recommend treatment from a physiotherapist after the initial swelling is controlled. Occasionally, surgery may be needed to repair a torn ligament.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on November 30, 2015

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