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Writer's pictureMurray Kovesy

Lower Back Strain - Causes and Treatment

Updated: May 3, 2020



Lower back strain is acute pain caused by damage to the muscles and ligaments of the back. It is often referred to as a pulled muscle. Most commonly, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries can also be combined with damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints. Common causes of sprain and strain include: Lifting a heavy object or twisting the spine while lifting, sudden movements that place too much stress on the low back such as a fall, poor posture over time, sports injuries especially in sports that involve twisting or large forces of impact.

The back is supported by a large, complex group of muscles that hold up the spine, including the extensor, flexor, and oblique muscles. The soft tissues surrounding the spine enable bending forward, lifting, arching, and twisting movements. Lumbar muscle strain occurs when a back muscle is over-stretched or torn, which damages the muscle fibers. When one of the ligaments in the back tears, it is referred to as a sprain. Movements that put stress on the back can result in pulled muscles.

Symptoms of lumbar muscle strain include sudden onset of pain, localised pain that does not radiate into the leg, and tenderness in the lower back. Muscle strain can by accompanied by muscle spasms, as the body tries to stabilise the injury. Acute pain from a lower back strain can resolve in a short amount of time, but low levels of pain or flare-ups can continue for weeks or months after the initial injury. After two weeks, back muscles can atrophy from lack of use and cause more pain. There are many treatment options for lower back muscle strain, including exercise, which will prevent atrophy. For practical purposes, it does not matter whether the muscle or ligament is damaged as the symptoms and treatment are the same.

Whats the Treatment for Low Back Strain?

Low back strain can be a painful and depressing injury. But the good news is that most cases heal on their own when given adequate recovery time. To speed the healing, you should:

  • Ice your back to reduce pain and swelling as soon as you injure yourself. Do it for 20-30 minutes every 3-4 hours for 2-3 days. You can also ice your back after physical activity.

  • Apply heat to your back, but only after 2-3 days of icing it first. Use heat on your back only after the initial swelling has gone down. You could use an electric heating pad, heatbag, a hot water bottle or you could soak in a hot bath.

  • Take non-steroidal anti-inflammatory drugs (NSAIDs) in severe acute pain stages. It will help with lower back pain and swelling. Always consult with your GP or physical therapist or advice. However, these drugs have side effects. They should be used only occasionally and for short periods of time. Prescription painkillers and muscle relaxants are sometimes necessary with associated injuries.

  • Get physical therapy to help with muscle spasm and tightness. An exercise program can help help to build up strength again. Movement is sometimes best for this type of injury. Do not stay in bed or on the couch all day as that will make it worse.

  • Maintain good muscle tone in your abdominal and lower back muscles.

No matter what people tell you, bed rest doesn't work. People used to think that the best treatment for low back strain was to lie on your back until you felt better. But studies show it doesn't help. In fact, after taking it easy for a day or two, you should usually start light physical activity.

How Can I Prevent Low Back Strain?


Here are some tips to help you avoid low back strain:

  • If you feel any low back pain during physical activity, stop.

  • If you feel low back pain within a day of stepping up your workout, take it easy for a few days.

  • Get your back in shape. Exercise and stretch your back muscles regularly.

  • Strengthen your core muscles to stabilise your back and maintain proper posture. A regular strength training routine to maintain a strong core is beneficial for trunk stability, balance and preventing injuries of the lower back especially twisting movements.

  • Find the right sleeping positing. Avoid sleeping on your stomach. Sleep on your back or your side, and use a pillow under or beneath your legs. Sleeping on your stomach is often the worst position as it puts pressure on your back and even more pressure on your neck as your having to turn to one side.

  • When picking up something heavy, bend at the knees, not at the waist. Having the correct lifting technique by squatting can save your back from injury and going into acute muscle spasm.

  • Lose weight if you are overweight. Extra kilograms around the stomach shifts your centre of gravity forward and this puts mechanical stress on the lower back.

When Will My Lower Back Strain Feel Better?

Recovery time depends on how serious your low back strain is. Mild cases may resolve in a couple of days. It can take many weeks for more serious strains but can have ongoing flare-up episode of back pain for months. Remember that everyone heals at a different rate.

Once the back pain is gone, you will probably want you to start a regular exercise routine. This will get your back muscles stronger and more limber. It will help you recover, and reduce your odds of low back strain in the future. Your will want to take up low impact sports, like swimming or using a stationary bike. Whatever you do, don't rush things. Don't try to return to your previous level of physical activity until:

  • You can move as easily without stiffness as you did before your injury.

  • You feel no pain when you bend, twist, walk, run, and jump.

If you start pushing yourself before your low back strain is healed, you could end up with chronic back pain and permanent injury.

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