HEALTH ALPHABETS
Help for sprains
UMA KRISHNASWAMY
REUTERS
A SPRAIN is a common injury caused by an overstretching or tearing of ligaments near a joint. Since ligaments are an integral part of joint stability and function, strains can jeopardise joint function. Sprains can affect any joint: ankle, wrist and are usually secondary to injuries sustained in daily life or during sports. Once a sprain is sustained, the individual becomes prone to re-injury.
Sprains manifest as: pain in and around a joint, swelling, difficulty in moving the joint and bruising. The severity determines the above manifestations. In a minor sprain, where the ligaments are merely overstretched, there may be local pain and minor swelling, but no difficulty in moving the joint. In a severe sprain, where the ligaments are torn, there may be unbearable pain, inability to move the joint or even the affected limb, with a large swelling and bruising.
Sprains are generally easy to diagnose but, in severe instances, a doctor may suggest an x-ray to rule out underlying bone injury. In the majority of instances, sprains can be managed by self-care and medical attention is required only in severe instances.
The following self-help measures are very useful: Rest, Ice, Compression and Elevation (known by the acronym RICE). Resting the joint consists of avoiding movement and weight bearing for the initial 24-48 hours. A common mistake is to rest the joint for either too long or too short a period.
An ice pack is applied to the injured area for 15-20 minutes at a stretch every hour for the first few days. This helps reduce bleeding, swelling and bruising and, hence, brings much comfort. Again, this is often forgotten. It is important to remember that ice packs must not be continued beyond the first few days as they may not help.
Compression to the area is the other adjunct. For example, a wrist or ankle may be strapped conveniently with an elasticated bandage. It is important to apply the compression uniformly and without causing undue pressure. Individuals with diabetes, vascular or neurological diseases should seek medical help regarding compression bandaging.
Elevating the injured area is another useful measure to bring down swelling. For example, a sprained ankle joint may be placed on one or two pillows at night. In addition, most individuals require simple painkillers to keep comfortable. If over-the-counter painkillers do not help, approach a doctor early. Similarly, if the symptoms do not reduce after two or three days or if the pain and swelling intensify, seek medical advice early.
Once there is a reduction in the symptoms, which usually occurs after two or three days, remove compression bandaging and begin gentle exercises. This is to put the joint through its range of movements and stretching the muscles involved. At this point, ice packs are replaced with application of warmth and gentle massage of the injured area. The intensity of exercise is gradually increased and by sustained exercising, re-injury can be prevented or reduced.
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