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Emergency Department Discharge Instructions

Back sprain or strain



Emergency Care Discharge Instructions

Instruction summary

A pulled muscle in the back can be extremely painful. The good news is that most cases resolve within two weeks.

To manage the pain, start by taking anti-inflammatory medications like Ibuprofen (which is the same thing as Motrin or Advil) or Naproxen (same thing as Aleve). These drugs reduce the inflammation around the torn muscle. If you have been prescribed a strong medication like Tylenol #3 or Percocet, only use it if your pain is not controlled by anti-inflammatory medications. Always wait an hour after one pill before deciding whether you need another, and take the medications as directed. If you are taking one of the strong medications, do not drive or operate heavy machinery, as these medications can make you sleepy. For this reason, they may be more helpful at night, if you can’t sleep because of the pain. These strong medications usually also cause constipation, so take an over-the-counter medicine for constipation, such as Metamucil or Docusate, at the same time as taking these medications.

Remember to try simple measures like applying an ice pack to the painful area. Place the icepack (wrapped in a thin towel) on the area for ≈10 minutes, and then allow the skin to return to normal temperature before putting the ice on it again. The cold helps to takes away the swelling in the area. Heat can be used later on, after the swelling is gone, to help with stiffness.

Complete bedrest is no longer recommended. However, do take it easy for a few days, and avoid all heavy lifting (which includes lifting children). Don’t sit for prolonged periods, because this actually increases the strain on your back. When you are lying in bed, a firm mattress is best. See if putting pillows underneath your knees helps.

Follow-up with your family doctor if the pain hasn’t resolved after two weeks.

Reasons to return to the ER
  1. Difficulties with urination (no urine for >6 hours despite attempts to pee)
  2. Incontinence of stool (pooping without meaning to)
  3. Weakness in both of your legs
  4. Numbness in the top part of your inner thigh on both sides
  5. Fever (≥38.0 °C or 100.4 °F)