Sprains and strains: Management
Managing muscular sprains and strains
Fortunately, sprains and strains typically respond well to treatment.
Most injuries of this type will feel better after 2 weeks, although severe injuries may take several months to return to normal.1
Here we review the different approaches that could help your patient get back to enjoying their life.
Guideline recommendations for treating sprains and strains
Sprains and strains can be managed simply in the first 72 hours following the injury
According to guidance from the National Institute for Health and Clinical Excellence (NICE), patients with sprains or strains should be advised to follow the PRICE and HARM protocols in the first few days after the injury.2
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PRICE protocol for sprains and strains
PRICE stands for:2
- Protection
- Rest
- Ice
- Compression
- Elevation
-
Protection
- Protect from further injury (e.g. by using joint supports)2
-
Rest
- For the first 48–72 hours after injury2
-
Ice
- Apply ice wrapped in a damp towel for 15–20 minutes every 2–3 hours during the day for the first 48–72 hours after injury2
-
Compression
- With a snug (not tight) elastic or tubular bandage, whilst the patient is awake2
-
Elevation
- Keep the injured area raised and supported on a pillow until swelling is controlled2
-
The PRICE protocol summarises how patients can take care of their sprain or strain in the first few days after the injury.
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HARM protocol for sprains and strains
HARM describes some key factors to avoid in the first 72 hours after injury:2
- Heat
- Alcohol
- Running
- Massage
-
Heat
- Avoid heat sources such as baths and heat packs2
-
Alcohol
- Avoid alcohol, which can increase bleeding and swelling and reduce healing2
-
Running
- Avoid running or other forms of exercise that can cause further damage2
-
Massage
- Avoid massage, which can increase bleeding and swelling2
-
The HARM protocol summarises what patients should avoid in the first 72 hours after injury if they have a sprain or strain.2
Analgesics can be used to relieve pain from sprains and strains
Paracetamol or topical medications such as non-steroidal anti-inflammatory drug (NSAID) gels can be used for sprains and strains.2–4
Codeine can be added on, if prescribed.2
Oral NSAIDs can be considered 48 hours after the injury, if needed.2,4
Utilising physical therapy to improve outcomes
Physiotherapeutic interventions can be beneficial for soft-tissue injuries
Treatment and rehabilitation plans must be individually tailored to maintain and improve range of motion, reduce pain and inflammation, and improve functional activities.
For example, massage therapy can reduce stiffness and muscle soreness – although this should not be used in the first few days after the injury.
Appropriate strengthening programmes using tailored exercises are often required in the longer term to maximise recovery, and training regimens may need to be adjusted.5
Using multimodal approaches to relieve pain from sprains and strains
A multimodal strategy is helpful
Pharmacological and physiotherapeutic interventions can be combined into a multimodal approach for managing sprains and strains. Guidelines recommend a range of intervention types.2
How can Dan and Nicholas be helped?
Dan
Dan, 42, has a young family and wants to make sure they are fit and active.
He is keen to use something targeted for his body pain which will also help with inflammation.
Dan gets pain in his calf from time to time when running which has stopped him from exercising in the past. He wants relief from his pain so he can continue to be active with his young family.
Voltarol Back & Muscle Pain Relief 1.16% Gel helps restore movement by relieving pain and reducing inflammation. Recommend Voltarol Back & Muscle Pain Relief 1.16% Gel to help Dan get back on with his life.
Nicholas
Nicholas has recently strained a muscle that he has injured several times before, and recovery is taking longer than it did in the past. As a result, he is unable to participate in his usual regular sports, which is making him glum and frustrated.
Nicholas needs a solution that offers effective pain relief and fast recovery.
Voltarol 140mg Medicated Plaster provides effective relief of muscle pain so Nicholas can get on with his life.
Understanding sprains and strains
Signs and symptoms
Explore an overview of how to recognise sprains and strains and know when to refer patients.
Overview of joint pain
Find out about joint pain and meet two patients with joint pain.
Learn more
Voltarol Back & Muscle Pain Relief 1.16% Gel Diclofenac Diethylammonium for strains and sprains
Relieves pain, reduces inflammation and speeds up the natural healing process.6–8
Voltarol 140mg Medicated Plaster Diclofenac Sodium for strains and sprains
Effective relief of muscle pain with a patch that targets pain and inflammation.8
