Most mild to moderate sprains and strains can be treated at home using:
- a self-care techniques called PRICE therapy, and
- by avoiding HARM
These are described in more detail below.
PRICE therapy
PRICE stands for protection, rest, ice, compression and elevation. Advice relating to each of these areas is outlined below.
- Protection - protect the injured area from further injury - for example, 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 that 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 crepe bandage, a simple elastic bandage, or an elasticated tubular bandage. It should be wrapped snugly around the affected area but it should not be too tight. Remove the bandage before you go to sleep.
- Elevation - keep the injured area raised and supported on a pillow to help reduce the 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 that 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 to the above advice about immobilisation may be made in cases of severe ankle sprains.
Research conducted in 2009 found that people whose ankle joint was immobilised for 10 days with a cast placed under their knee, recovered normal ankle function more quickly than those who were treated using exercise soon after the injury occurred.
Immobilising strained muscles
The advice for muscle strains is different. For the first few days after the injury you are advised to immobilise your injured muscle and keep it still.
You may be given a brace, cast or splint to help keep the muscle as still as possible. As most strains involve the leg muscles, you may need to use crutches for a few days. However, the length of time that you should keep your muscle immobile will depend on how severe your injury is.
The aim of immobilising the muscle is to allow it to start healing so that 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
If you experience pain from a strain or sprain, paracetamol is the first type of painkiller that will usually be recommended. If paracetamol does not help to relieve your pain, a stronger painkiller, such as codeine which is only available on prescription, may be required.
Oral non-steroidal anti-inflammatory drugs (NSAIDs) can also help to reduce swelling and inflammation. However, NSAIDs should only be considered for use 48 hours after the injury has occurred because if they are used before this time they may adversely affect the healing process.
Ibuprofen is not recommended if you have a history of asthma or kidney disease, or if you have, or have had in the past, stomach problems such as a peptic ulcer.
If your pain is severe, your GP may prescribe you a stronger painkiller, such as codeine, to be used alongside paracetamol. Codeine can cause drowsiness and it is advisable not to drink alcohol when you are taking it.
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 areas of your skin to which you have applied cream or gel to direct sunlight or artificial sources of light, such as sunlamps or sun beds.
Follow up
If you have a sprain or strain, your GP may ask to see you again a few days after your initial diagnosis to assess how well your injury is healing and whether any further treatment is required.
It is also recommended that 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
Following a sprain or a strain, the length of time that it will take for you to recover will depend on the severity of the injury.
Depending on the severity of your injury, after an ankle sprain you will probably be able to walk one to two weeks after the injury. You may be able to use your ankle fully after six to eight weeks and you will probably be able to return to sporting activities after eight to 12 weeks.
In cases of muscle strains, the time it can take to return to sporting activities can range widely, from two weeks to six months.
