Treating sprains and strains 

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

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

PRICE therapy

PRICE stands for:

  • 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 to 20 minutes every two to three 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 simple elastic bandage or elasticated tubular bandage available from a pharmacy. It should be wrapped snuggly 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 you should avoid:

  • Heat  such as hot baths, saunas or heat packs.
  • Alcohol  drinking alcohol will increase bleeding and swelling, and slow 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 do so without experiencing significant pain.

Your doctor may be able to teach you a range of exercises that will help you improve the joint's functionality.

However, an exception may be made in cases of severe ankle sprains, because 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 an additional stronger painkiller  such as codeine  that is only available on prescription.

Your GP may also prescribe a non-steroidal anti-inflammatory drug (NSAID) cream or gel, such as 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 (this is known as photophobia). Avoid exposing treated areas of skin to direct sunlight or artificial sources of light, such as sunlamps or sun beds, during treatment and for two weeks afterwards.

Oral 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 they may delay healing.

Physiotherapy

For more severe injuries, particularly muscle strains, your doctor may consider referring you for physiotherapy.

Physiotherapy involves carrying out exercises designed to improve the range of motion and return the normal function of injured area.

This may reduce your risk of experiencing long-term problems or injuring the area again.

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 a week or two after the injury. You may be able to use your ankle fully after 6 to 8 weeks, and you will probably be able to return to sporting activities after 8 to 12 weeks.

In cases of muscle strains, the time it can take to recover can vary considerably. Some people can recover within a few weeks, whereas others may not be able to return to their normal activities for several months.

Some people may experience continued problems  such as pain, intermittent swelling or instability  for months, or even years, after the original sprain or strain.

You should contact your GP if your injury does not improve as expected or your symptoms get worse. If this happens, your GP may consider referring you to an orthopaedic specialist for further assessment and treatment.

Surgery

It's uncommon for surgery to be carried out to repair sprains or strains.

Surgery is usually only required for severe muscle strains, particularly those in professional sports people. This is because, without surgery, it is likely the affected muscle will not fully regain its former strength, and the person’s performance may be affected.

For non-sports professionals and those with more minor strains, the loss of muscle strength is usually too mild, or the risk of repeated injuries too low, to justify the risks of surgery.

Surgery is rarely carried out for sprains, because it is unclear whether it is any more effective than less invasive treatments.

Page last reviewed: 13/05/2014

Next review due: 13/05/2016