Diagnosing Sprains and Strains

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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When should you see a doctor for a sprain or strain?

Sometimes you need to see a doctor for help in diagnosis and treatment. For strains or sprains, the pain can increase in the first one to two days, as the spasm surrounding the injury sets in. If after trying RICE (an acronym for "rest, ice, compression, and elevation" of the injured limb) and over-the-counter medications the pain is not controlled or if the injury is thought to 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.

What tests do physicians use to diagnose a sprain or strain?

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. Injuries of knees, ankles, and the low back, are often unlikely to warrant X-rays to rule out any broken bones. The physician should discuss the reasons for or against taking X-rays.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

Young, Craig C. "Ankle Sprain." Medscape.com. Dec. 16, 2014. <http://emedicine.medscape.com/article/1907229-overview>.


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Reviewed on 3/7/2017

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