A few medications and procedures to treat strains and sprains

If you are one of the thousands of Canadians who sprain an ankle every day, or an overzealous team player with a muscle strain, knowing what to do can make all the difference. Here are some options:

• For moderate pain from a strain or sprain, try acetaminophen, which is relatively gentle on the stomach. Because acetaminophen won't do anything for inflammation, however, it’s not a good choice if you have swelling. For swelling (as well as pain) try a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or aspirin. Keep in mind that these over-the-counter (OTC) drugs don't promote healing and shouldn't be taken long term without checking with your doctor.
• Sometimes OTC medications aren't enough. For a debilitating back strain, for example, ask your doctor about a strong prescription pain medication, such as hydrocodone or the COX-2 inhibitor rofecoxib. Adding a prescription muscle relaxant, such as cyclobenzaprine, can sometimes ease your discomfort by stopping any spasms. A topical NSAID solution, diclofenac, is also available. Most prescription painkillers and muscle relaxants should be used for only a few weeks at most.
• If your injury is severe, your doctor may give you a corticosteroid injection in the injured joint or the surrounding tissue to reduce pain and inflammation. Today such injections aren't widely used for mild strains and sprains because they can delay healing and might tempt you to use the injured joint before it’s fully healed, making the situation worse.

• If you have a severe strain or sprain, your family doctor or an orthopedist might treat it as if it were a fracture, applying a plastic, plaster or fibreglass cast for several weeks. Surgery is rarely needed for most strains and sprains, but occasionally a ruptured ligament or a severe fracture (often mistaken for a sprain) does require an operation to repair it.
• Whatever the extent of your injury, most doctors recommend a regimen of rehabilitative therapy once the initial pain and swel­ling subside. This will strengthen muscles and tendons and prevent future injuries (the biggest risk for another ankle sprain is having had one already). While you can do exercises on your own, you may prefer to work with a physical therapist, who can offer a range of rehabilitative techniques, including heat, electrical stimulation, ultrasound and massage.

Some doctors specializing in soft tissue injuries are now experimenting with prolotherapy, also known as non-surgical ligament reconstruction.

• A solution, often containing a form of sugar, is injected into the area where an injured ligament or tendon attaches to the bone. This causes a localized inflammation, which in turn stimulates the flow of tissue-repairing blood and nutrients to the injury site.
• Although responses to prolotherapy vary widely, many people see results in four to six treatments.

Straining a muscle or spraining your wrist or ankle has a big impact on your daily lifestyle. To get better as fast as possible, follow these tips. Always consult a doctor to make sure your ailment is handled in a safe way.