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.

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


Back Strain: Accelerate Your Recovery with These Tips

Musculoskeletal Health with Dr D. 

Back Strain: Treatment Guidelines for Back Strain

Most back strains do not require specific treatment, because they usually recover spontaneously in relatively short period of time. There are, however, certain strategies that may help you recover faster and make the process less painful. For full list of detailed recommendations on optimizing your recovery process please follow this link.

Mobility: swimming and walking

One of the most important things to keep in mind, is that during the acute phase, it is of outmost importance to stay mobile. While short term bed rest may help to relieve some of the pain initially, staying in the bed more than 24-48 hrs leads to worse outcomes and prolongs the recovery time.

While becoming more mobile is important, you will need to initially modify your daily routine to avoid high impact activities, lifting heavy objects and twisting movements. The best way start increasing physical activity is walking for few minutes several times a day and eventually transitioning to recreational swimming in a slow pace. Swimming is excellent exercise for recovery from back injuries. It’s weightless nature eliminates gravity and pressure on the spine and takes the muscles and joints through full range of motion. Both activities will keep the muscles engaged without additional strain, and get them slowly ready for more physically demanding exercises.

Heat

Heat plays important role in the treatment of back pain. It improves local blood circulation which enables the injured tissue to heal faster while decreasing muscle stiffness and pain. Applying heat to the painful area after the initial 48 hrs from the onset of the injury also helps with stretching. Additionally, heat reduces pain and makes movement easier when getting out of the bed in the morning. Heating pad should not be applied directly on the skin. While it can be used  several times a day, it should never be applied for longer than 20 minutes at a time. Never sleep on your heating pad!!

Stretching, Massage and Acupuncture

Gentle stretching of the back muscles after using heating pad is important to slowly start elongating the tight muscles. Never push beyond the level of gentle stretch. If stretching is painful, you need to pull back. Gentle massage around the painful area can be very relaxing and soothing. You do not need to spend money on massage therapist, but if you can afford it, this might be a good time to splurge on couple sessions. Getting a simple massage from your partner at least once a day for the first few days can be equally if not more effective. Alternately, you can try self-acupressure using a tennis ball while leaning against the wall and finding the tender spots in your back. Both massage and acupressure help to promote local blood circulation and loosen up the tight muscles which results in increased mobility and less pain. If acupuncture is available to you, getting few treatment sessions can be very helpful to promote relaxation of the tight muscles, increase local blood circulation and decrease pain. For more information about acupuncture please follow this link.

The role of pain medication

While pain medication will not help you to recover faster, they can help to make the process more bearable. Motrin, naproxen or Alleve can be used in mild to moderate pain, to take the edge off the pain. Stronger pain medication, prescribed by your provider, may be necessary when pain is more severe.

 

Goals for pain management

It is very important to understand, that complete pain relief is neither realistic, nor the goal of pain medication or any treatment modality discussed in this article. Pain is a protective mechanism. It makes us start paying attention to our body and prevents us from causing further damage. Additionally, there is no single best remedy. Patience in combination with several treatment strategies placed in the context of a comprehensive treatment protocol, has been shown to lead to the best and fastest recovery.

 

To learn more about complementary therapies, visit National Center for Complementary and Integrative Health