Sprains and Strains
Description Emergency Treatment Referral ICD-10 code: S03.4-5/S13.4-6/S23.3-5/S33.5-7/S43.4-7/S53.4/S63.5-7/S73.1/S83.4-6/S93.4-6/T11.2/T13.2/ T14.3 DESCRIPTION Clinical features include: pain, especially on movement tenderness on touch limited movement history of trauma May be caused by: sport injuries slips and twists overuse of muscles abnormal posture Note: In children always bear non-
ICD-10 code: S03.4-5/S13.4-6/S23.3-5/S33.5-7/S43.4-7/S53.4/S63.5-7/S73.1/S83.4-6/S93.4-6/T11.2/T13.2/ T14.3
DESCRIPTION
Clinical features include:
- pain, especially on movement
- tenderness on touch
- limited movement
- history of trauma
May be caused by:
- sport injuries
- slips and twists
- overuse of muscles
- abnormal posture
Note: In children always bear non-accidental injuries (assault) in mind.
EMERGENCY TREATMENT
Immobilise with firm bandage and/or temporary splinting.
Children
- Paracetamol, oral, 10–15 mg/kg/dose 6 hourly when required. See: dosing Table.
Adults
- Paracetamol, oral, 500mg -1 g 4–6 hourly when required (to a maximum of 4 g in 24 hours).
- Maximum dose: 15 mg/kg/dose.
AND
Children >12 years of age and adults
- NSAID, e.g.:
- Ibuprofen, oral, 200–400 mg 8 hourly with or after a meal.
REFERRAL
- Severe progressive pain.
- Progressive swelling.
- Extensive bruising.
- Deformity.
- Joint tenderness on bone.
- No response to treatment.
- Severe limitation of movement.
- Suspected serious injury.
- Recurrence.
- Previous history of bleeding disorder.
- Consider rehabilitation services for sprains, strains, and overuse injuries to improve joint stability and assist with pain management.
Click here for the NEMLC Recommendations for medicine amendments (2020-4 review cycle).
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4_Version 1.1_October 2024
Chapter 21: Emergencies and Injuries
Drugs mentioned
ICD-10 codes
- S03.4Sprain and strain of jaw
- S03.5Sprain and strain of joints and ligaments of other and unspecified parts of head
- S13.4Sprain and strain of cervical spine
- S13.5Sprain and strain of thyroid region
- S13.6Sprain and strain of joints and ligaments of other and unspecified parts of neck
- S23.3Sprain and strain of thoracic spine
- S23.4Sprain and strain of ribs and sternum
- S23.5Sprain and strain of other and unspecified parts of thorax
- S33.5Sprain and strain of lumbar spine
- S33.6Sprain and strain of sacroiliac joint
- S33.7Sprain and strain of other and unspecified parts of lumbar spine and pelvis
- S43.4Sprain and strain of shoulder joint
- S43.5Sprain and strain of acromioclavicular joint
- S43.6Sprain and strain of sternoclavicular joint
- S43.7Sprain and strain of other and unspecified parts of shoulder girdle
- S53.4Sprain and strain of elbow
- S63.5Sprain and strain of wrist
- S63.6Sprain and strain of finger(s)
- S63.7Sprain and strain of other and unspecified parts of hand
- S73.1Sprain and strain of hip
- S83.4Sprain and strain involving (fibular)(tibial) collateral ligament of knee
- S83.5Sprain and strain involving (anterior)(posterior) cruciate ligament of knee
- S83.6Sprain and strain of other and unspecified parts of knee
- S93.4Sprain and strain of ankle
- S93.5Sprain and strain of toe(s)
- S93.6Sprain and strain of other and unspecified parts of foot
- T11.2Dislocation, sprain and strain of unspecified joint and ligament of upper limb, level unspecified
- T13.2Dislocation, sprain and strain of unspecified joint and ligament of lower limb, level unspecified
- T14.3Dislocation, sprain and strain of unspecified body region