Sprains and Strains

When to Seek Medical Care

Sometimes you need to see a doctor for help in diagnosis and treatment. For strains or sprains, the pain can increase in the first 1-2 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 may 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.

Exams and Tests

When visiting the doctor, expect many questions about the accident. The mechanism of injury can give clues as to what stresses were put on the body part and what injuries likely happened. The doctor will perform a thorough physical examination of the injured area. The physician will want to examine the joint above and the joint below an injury to make sure no hidden injuries are missed.

The doctor may need to take x-rays or perform other tests. X-rays only show bones and not the soft tissues, such as the muscles, tendons, and ligaments. The physician determines when it is appropriate to order x-rays and when certain injuries, especially of knees, ankles, and the low back, are very unlikely to warrant x-rays to rule out any broken bones. The physician should discuss the reasons for or against taking x-rays.

Sprains and Strains Treatment 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, Nuprin) might be better because these medications relieve both pain and inflammation. Remember to follow the guidelines on the bottle for appropriate amounts of medicine, especially for children and teens.