Muscle Strain and Sprain Treatment in Southlake, TX

A strain is a muscle or tendon injury and a sprain is a ligament injury. Both are extremely common, both are usually managed well in primary care, and both are frequently mishandled by resting them for far too long.

What happens at the visit

The examination does most of the work. We look at where it hurts, how it moves, whether the joint is stable, whether you can bear weight, and whether the pattern fits the story you are telling.

We use validated decision rules for ankles, knees and feet, which identify who genuinely needs an X-ray based on specific findings. Most ankle injuries do not need imaging, and applying the rules avoids a great deal of unnecessary radiation and cost.

We image when there is inability to bear weight, point tenderness directly over bone, deformity, or a mechanism that makes fracture likely.

Treatment that reflects current evidence

The old advice was rest, ice, compression and elevation, with emphasis on rest. That has shifted, and for good reason.

• Protect briefly, then move. Early gentle motion within pain limits produces better outcomes than immobilization. Prolonged rest weakens muscle, stiffens joints and delays return to function.
• Compression and elevation help swelling in the first few days.
• Ice for comfort in the first 48 hours. It controls pain and swelling and does not appear to speed healing itself.
• Load progressively. Tissue heals in response to gradual, controlled loading. This is the part that gets skipped and it is the part that prevents reinjury.

Medication

Acetaminophen is a reasonable first choice. NSAIDs help pain and swelling and are fine for short courses, though there is some evidence that heavy early use may slightly slow tissue healing, so we use them for comfort rather than around the clock for two weeks.

Topical NSAIDs work well for superficial joints like ankles, knees and hands, and they avoid most of the stomach and kidney risk, which matters if you have kidney disease or take a blood thinner.

We do not prescribe opioids for routine sprains and strains.

Physical therapy

For anything moderate or recurrent, physical therapy is the highest-value referral we make.

The goal is not just pain relief. It is restoring strength, balance and proprioception, the joint’s sense of its own position, which is what actually prevents the next sprain. Ankle sprains recur at high rates specifically because people stop when the pain stops and never restore balance.

Back and neck strains

The most common strain we see, and the advice is the same and the most counterintuitive.

Stay active. Bed rest makes acute back pain worse and prolongs it. Imaging in the first six weeks, without red flags, finds incidental abnormalities and leads to worse outcomes rather than better ones.

Red flags that change this: bowel or bladder changes, saddle numbness, progressive weakness, fever, unexplained weight loss, or a history of cancer. Those get worked up immediately.

When we refer

Joint instability, inability to bear weight after a week, a suspected complete tendon rupture, locking or giving way, or no meaningful progress after four to six weeks of appropriate treatment.

In older patients, a fall causing a fracture is also a bone health event and prompts a look at osteoporosis, not just the injury itself.

Ongoing joint problems are covered on our knee and joint pain page. Same-day appointments are on our sick visits page. See our primary care Southlake practice overview.