How Should I Treat a Sprain?

If you've ever twisted an ankle on uneven ground or broken a fall with your wrist, you've most likely experienced a sprain of some degree. A sprain occurs whenever ligaments, tough membranes which attach muscles to bones, become torn or twisted.

The most likely joint to become sprained is the ankle, followed closely by the knee, elbow, shoulder and wrist. A minor sprain may not affect a person's mobility much, but a moderate to severe sprain can cause extreme pain, swelling and the inability to bear any weight on the affected joint.

To treat a sprain, many medical experts suggest using the RICE method. RICE stands for Rest, Ice, Compression and Elevation, and the treatment should be followed in that order. This is assuming the injury is truly a sprain, not a fracture. When in doubt, it may be better to stabilize the injury and transport the patient directly to a hospital for a more thorough exam. A sprain can occur at the same time as a fracture, however, so the RICE method can still be used until the injury is X-rayed.

The first step is rest, and that means taking all possible weight off the injured joint and resting for at least 24-48 hours. If the sprain occurs in a remote area, others may have to carry the injured person in order to prevent further damage to the ligaments. Some people may feel better within a few hours of a sprain injury, but they should not attempt to bear weight on the affected area for at least a day. Rest means rest.

Swelling and bruising around the sprain can make the pain worse and slow the natural recovery process. For the first 24 hours at least, ice packs or even bags of frozen vegetables should be applied to the sprained area at least 4-5 times a day, but no longer than 20 minutes at a time. The ice should help shrink the inflammation around the sprain, which in turn should reduce the overall pain. Taking anti-inflammatory medications such as aspirin or ibuprofen may also help reduce swelling. Bromelain, an enzyme found in pineapples, is also believed by many to reduce swelling caused by a sprain.

Once the initial pain and swelling has been addressed with rest, ice and medication, the next step is compression. An elastic bandage or sports tape can be wrapped snugly around the injured joint to provide some stability and compression. The bandage should never be wrapped so tightly that natural circulation becomes restricted, however. The compression from an elastic bandage should force the swelling down considerably, but the bandages should be unwrapped periodically to allow the skin around the area to breathe.

The final step is to elevate the sprained area if at all possible. By keeping the injured joint above the level of the patient's heart, additional fluids should not be able to pool around the site and increase swelling. Again, use good judgment when elevating an injury. The point is only to raise the injury above heart level, not to force the patient into an uncomfortable or blood-draining position. Remember, elevation does not mean traction.

If the sprain does not improve by itself within a few days, it may be necessary to transport the patient to a medical facility for more tests and possibly rehabilitation. A physical therapist may develop an at-home regimen to follow in order to strengthen the affected joint and improve mobility.