Sprains and strains - Treatment 

Treating sprains and strains 

Most sprains and strains can be managed at home, using over-the-counter painkillers to ease pain.

If the injury is only minor, you can look after yourself by 'avoiding HARM' and using 'PRICE therapy'. These acronyms are described below.

PRICE therapy

PRICE stands for protection, rest, ice, compression and elevation.

  • Protection  protect the injured area from further injury by using a support or (in the case of an ankle injury) wearing shoes that enclose and support your feet, such as lace-ups.
  • Rest  stop the activity that caused the injury and rest the injured joint or muscle. Avoid activity for the first 48 to 72 hours after injuring yourself. Your GP may recommend you use crutches.
  • Ice  for the first 48 to 72 hours after the injury, apply ice wrapped in a damp towel to the injured area for 15-20 minutes every 2-3 hours during the day. Do not leave the ice on while you are asleep, and do not allow the ice to touch your skin directly because it could cause a cold burn.
  • Compression  compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a crepe bandage or a simple elastic bandage available from a pharmacy. It should be wrapped snugly around the affected area but not so tightly that it restricts blood flow. Remove the bandage before you go to sleep.
  • Elevation  keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid having long periods of time where your leg is not raised.

Avoiding HARM

For the first 72 hours after a sprain or muscle strain you should avoid HARM. This means that you should avoid:

  • Heat  such as hot baths, saunas or heat packs (applying a controlled amount of heat to affected joints)
  • Alcohol  drinking alcohol will increase bleeding and swelling and decrease healing
  • Running  or any other form of exercise that could cause more damage
  • Massage  which may increase bleeding and swelling

Moving sprained joints

Most healthcare professionals recommend you should not stop using a sprained joint because the injury will heal quicker if you begin to move the joint as soon as you are able to.

Your GP will be able to teach you a range of exercises that will help you to improve the function of the joint.

An exception may be made in cases of severe ankle sprains. Studies have found people whose ankle joint was immobilised for 10 days with a short cast recovered normal ankle function quicker than those who were treated using exercise soon after the injury occurred.

Immobilising strained muscles

The advice for muscle strains can be different. Depending on your injury, you may be advised to keep your injured muscle still for the first few days. Your doctor may arrange for a brace, cast or splint to help keep it as still as possible.

The aim of immobilising the muscle is to allow it to start healing so you can move it without tearing or pulling it again in the same place. After a few days you will probably be advised to start using the muscle again.

Treating pain

Paracetamol is usually recommended for painful sprains or strains. If this does not help, you may need a stronger painkiller (such as codeine) that's only available on prescription.

Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen tablets, can also help reduce swelling and inflammation. However, they should not be used in the first 48 hours after the injury because of concerns that they may delay healing.

Your GP may also prescribe an NSAID cream or gel, such as ibuprofen or ketoprofen, to help treat pain. You should gently apply the cream or gel to the injured area and wash your hands immediately afterwards.

Ketoprofen can make your skin sensitive to light (photophobia). Avoid exposing treated areas of skin to direct sunlight or artificial sources of light, such as sunlamps or sun beds.

Follow up

Your GP may ask to see you after a few days to assess how well your injury is healing.

It is also recommended you contact your GP if:

  • your sprain or strain does not improve as expected for example, you still find walking difficult
  • your symptoms get worse, such as increased pain or swelling

Recovery

The length of time it takes to recover from a sprain or strain depends on how severe it is. 

Generally, after an ankle sprain you will probably be able to walk 1-2 weeks after the injury. You may be able to use your ankle fully after 6-8 weeks and you will probably be able to return to sporting activities after 8-12 weeks.

In cases of muscle strains, the time it can take to return to sporting activities can range widely, from 2 weeks to 6 months.


Page last reviewed: 28/05/2012

Next review due: 28/05/2014

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Comments

The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

BorisDoris said on 26 April 2013

Tobermory - where did you get your information that A&E don't use tubigrip? I had an accident in January 2013 where I broke my 5th metatarsal in my right foot & badly sprained my left ankle.

I had a boot for my right foot & tubigrip for my left foot - so not sure where you get your information from.

Likewise, my physio insisted on me wearing my tubigrip & it's only now (nearly 3 months later I'm being released from wearing it. I can definitely feel the difference without it.

Think you might need to check your facts.

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lipase said on 30 March 2013

is it generally advised to stop using a muscle if it is sprained until it becomes painless to do so and any aching has disappeared? or is it usually just advised to start moving it again after 'the first few days'?

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tobermoray said on 20 September 2012

I think this advice is to rigid in its content. General public reading this think their sprained ankle to be put in a cast for 10/7. For significant sprains that is idea but not for low grade sprains.

In the next breath you advocate tubigrip, this is rubbish. A&E stopped using tubigrip years ago. Even the companies can not provide evidenced research to support its effectiveness. Its a psychological effect and doesnt help the healing process, and again this isvery subjective and each patient should be treated as an individual as what is good for one isnt good for another. Please review what you ahve written. It opens the practitioner up to all sorts of problems if we decide that this isnt the approprite action to take.

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aelfgifu said on 09 April 2012

As a trained first aider who recently requalified I have been taught that the C in PRICE now stands for (keep it) Comfortable not Compression, because too many people don't know what they are doing when they put on a compression bandage, either it doesn't work at all or they cause further harm or cut their own blood supply off! Will the NHS change this advice?

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Surgery

Surgery is usually only required for severe muscle strains that occur in professional sports people. Without surgery, it is likely  the affected muscle will not regain its former strength, and the person’s performance may be affected.

Alternatively, surgery may be used to strengthen a muscle if a person has a repeated muscle strain in one particular muscle.

For non-sports professionals, the loss of muscle strength is usually too mild, or the risk of repeating muscle strains too low, to justify the risks of surgery.

Surgery for muscle strains includes stitching damaged muscles together and reattaching muscles to tendons.

Easy exercises

Improve your fitness without harming your joints with some easy exercises including yoga, pilates and swimming