Sprains and strains: Signs and symptoms

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Recognizing sprains and strains

Since sprains and strains can be managed relatively simply, it helps to know how to identify this common type of soft tissue injury.1,2

Signs and symptoms icon

Signs and symptoms

Both sprains and strains can cause pain, inflammation, and swelling.

  • Symptoms of a sprain occur around the affected joint and can include bruising, loss of function, and mechanical instability if severe3
  • Symptoms of a strain affect the injured muscle and can include spasm, weakness, and cramping3
  • Symptom severity depends on both the severity of the injury and the time since the injury took place — it can take up to 24 hours for bruising and swelling to appear3
  • Questions to ask your patient

    Here are some questions you could consider asking your patient to help assess their pain:4

    1. “Are you feeling any soreness now?”
    2. “Do you hurt anywhere?”
    3. “Are you having any discomfort?”
    4. “Have you taken any medications for pain?”
    5. “Have you had any soreness that kept you up at night?”
    6. “Have you had trouble with any of your usual day-to-day activities?”
    7. “How intense is your pain?”
  • When to refer your patient for further care

    The NICE guidelines on sprains and strains recommends that patients should be immediately referred to an emergency department if any of the following is suspected:3

    • Fracture
    • Dislocation
    • Damage to nerves or circulation
    • Tendon rupture
    • Wound penetrating the joint
    • Known bleeding disorder
    • Signs of septic arthritis (e.g., fever, joint swollen and warm to touch) or hemarthrosis (joint is very painful and swollen immediately after injury)
    • A large intramuscular hematoma
    • A complete tear, or a tear of more than half of the muscle belly

    NICE = National Institute for Health and Care Excellence.

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