Back Strain: Symptoms, Causes and Treatment Strategies

Musculoskeletal Health with Dr D. 

Back Strain: Symptoms, Causes and Treatment Strategies

Back strain is probably the most common form of acute back pain. It affects the muscles and their tendons which attach them to various structures in the back. In general, muscle strain refers to a small tear in the muscle or its tendon. Most muscle strains tend to develop in the lower back area where the muscle changes into the tendon, but they can develop anywhere.

SciaticaDisc HerniationSpinal StenosisFacet Joint Pain

Symptoms

A strain of the back muscles mostly causes localized pain in the area of the muscle/tendon injury accompanied by stiffness, limited range of motion and difficulties maintaining straight posture. Timing is very important when it comes to muscle strain.

 

Most muscle strains usually happen while lifting something very heavy or doing a sudden movement. Many individuals experiencing back pain due to muscle strain may feel a popping sensation at the moment of the injury which usually prompts them to seek medical attention.

 

They may have difficulties straightening their back up after the onset of the pain and usually maintain a semi bent position to avoid severe pain. That is not to say that muscle strain cannot come gradually. Even in this case, however, the individual can usually remember the moment when he felt sudden uncomfortable pain in the back which became progressively worse with activities.

Most individuals will also complain of muscle cramps in the area of their lower back. Additionally, coughing and sneezing usually brings on bouts of severe pain during acute back strain. The back muscles which tend to be the most affected by muscle strain are those right next to the spine.

 

Frequently, however, the pain can also be felt around the base of the spine and in the buttock area. Occasionally, pain may radiate into the buttocks. Under normal circumstances, pain due to back strain does not radiate down to the legs.

 

Pain radiating down to the legs is usually associated with nerve compression, but it is also frequently seen as a result of trigger points in the gluteal (buttock) muscles.  Back strain is not a serious condition and most individuals with acute back strain recover spontaneously within 1 to 2 weeks.

Causes

When muscle strain is caused by a sudden movement, it is generally a result of preexisting tightness in the back muscles which has developed over a period of time. Tight muscles are less flexible. Decreased flexibility results in limited ability to respond to sudden demands for muscle extension beyond the normal daily activity.

 

Therefore when the muscle is required to suddenly extend beyond its limits, such as when catching a falling object or catching ourselves from falling down, a strain can develop in the muscle or the tendon. To prevent further injury, the body triggers protective mechanism which manifests as muscle spasm.

 

The final outcome is stiffness and significantly limited range of motion with great amount of pain when trying to move in any direction.

Back strain can, however, develop also due to muscle overuse. In this case, the muscles and/or their tendons become strained due to repetitive movements in absence of sufficient time for recovery and repair.

 

Activities involving excessive forward bending of the spine constitute one of the most common misuses of the back leading to increased vulnerability to a variety of injuries. The forward bend position stretches the muscles and tendons of the back to a point where very little control can be exercised over the spine’s position.

 

Therefore lifting objects in forward bend positions can easily strain these muscles and their tendons. Additionally, forward bend position creates an uneven pressure on the spinal discs making them significantly more prone to injury.

 

Poor posture

Poor posture is one of the main underlying causes for the development of back strain. It generally refers to either too large or too small curvature in the area of the lower back. Over a period of time, poor posture leads to muscle imbalance and strain of the muscles/tendons in the back.

 

Spending extensive period of time in uneven position such as being twisted sideways or bent forward, also puts great stress on the spinal discs predisposing them to injury.

 

Poor physical fitness

poor physical fitness, excessive weight, sedentary lifestyle and lack of flexibility are also among the leading factors predisposing individuals to back strain. The result is poorly conditioned back muscles that lack sufficient strength and endurance to respond to increased physical demand when called upon.

 

This is why sudden unexpected movement, or performance of new repetitive task requiring the use of back muscles, easily result in back strain.

 

More information is available on this page.

Summary

Main Symptoms

Sudden onset

Localized pain  & stiffness

Limited range of motion

Difficulties maintaining straight posture

Muscle cramp in the area of the lower back

Causes

Sudden movement

Tight muscles and lack of flexibility

Muscle overuse

Activities involving excessive forward bending of the spine

Lifting objects in forward bend position

Poor posture

Working in uneven position - twisted sideways or bent forward

Poor physical fitness,

Excessive weight

Sedentary lifestyle

by Dr. Michal Domeny DNP, L.Ac, CD/N

Back Pain and Physical Therapy

Physical Therapy and Back Pain

Physical therapy is frequently used as a part of an overall treatment protocol to treat acute or chronic back pain. The goal of physical therapy is to relieve pain, help the body in the healing process, and restore normal functional pain-free movement. A physical therapist can prescribe specific rehabilitation exercises alone or in combination with dry needling, TENS, heat application, soft tissue release or gentle manipulations.  Physical therapy is generally initiated if an injury is not spontaneously recovering with conservative treatments within 2-6 weeks. In case of severe acute back pain, however, a referral to physical therapy can be initiated right away.

Treatment optionsAcupunctureDry NeedlingAcupressureHome Treatment Protocol

Physical therapy did not help my back pain

Many patients frequently complain that physical therapy has not worked for them. They refuse to follow up with the referral made by their provider and demand Xrays or MRIs to find out why their back continues to hurt. While X-ray or MRI is not necessary in the majority of chronic or acute back pain, physical therapists frequently order these studies if the patient's condition is not responding to the treatment protocol. Imaging studies can also be ordered if the physical therapist feels that it will help them create a more specific treatment plan. Imaging studies, however do not cure back pain. It is critical to realize that any treatment modality only works if the patient is an active participant. When it comes to physical therapy, the reality is that most patients are not compliant with the prescribed treatment plan. It is not enough to come to physical therapy once or twice a week for half an hr session and expect to see major improvements. Adherence to prescribed exercise at home as instructed by the physical therapist is the key. Physical therapy sessions at the clinic should be used primarily as an opportunity to assure the correct form and assess the progress.  To get the most from physical therapy, the majority of work has to be done at home.

 

Key factors in the treatment of chronic back pain

While most acute back pain eventually resolves on its own, chronic back pain tends to fluctuate between days with more or less pain. To increase the number of days without pain or with only slight discomfort, something fundamental has to change. There are many factors that impact the successful treatment of back pain.  Two of the most important factors are elimination of aggravating factors and correcting muscle imbalance. Physical therapists are medical professionals with extensive training in skeletomuscular disorders and thus best suited to help patients accomplish both.

Individualized treatment and workout plans

Physical therapists can review with patients their daily routine and help them identify the major aggravating factors that continue to flare up their back pain or prevent the maximal recovery.  They will thoroughly asses the patient’s condition and create an individual exercise treatment plan. Physical therapists can help the patient tailor a specific work out routine that will help them achieve their personal fitness goals without aggravating their back pain. Additionally, physical therapists are the top authority to teach patients the correct execution of individual exercises to prevent future injuries. Incorrectly performed exercises continue to be the leading cause of many exercise-related injuries. Incorrectly performed exercises can lead to permanent joint or back injury.

 

Summary

Physical therapy is an integral part of any comprehensive treatment approach to chronic back pain. In some cases, physical therapy can be, however, beneficial also in acute cases of back pain. Physical therapists often incorporate variety of techniques and tools when designing their individual treatment plan. Imaging is usually not needed in most cases of uncomplicated chronic and acute back pain but imaging studies can be ordered by the physical therapist if it is indicated. Physical therapists are top experts in designing individual workout routines that will help patients achieve their fitness goals without risking further injuries. Lastly, physical therapy only works if patients become active participants.

by Dr. Michal Domeny DNP, L.Ac, CD/N