Back Strains and Sprains

What are back strains and sprains?

Back strains and sprains are common injuries that can occur following repetitive motions, overuse or trauma. A strain is an injury to a muscle or tendon. A sprain is an injury to a ligament. Pulling, twisting or tearing of these tissues in your back can cause sprains or strains.

Your back — especially the lumbar section of your lower back — bears much of your body’s weight during walking, running, lifting and other activities. There are many potential causes for back pain. Strains and sprains are common causes for temporary pain.

What are the symptoms of a strained or sprained back?

Back strain or sprain symptoms may include:

• Pain that gets worse when you move
• Muscle cramping or spasms (sudden uncontrollable muscle contractions)
• Decreased function or range of motion (difficulty walking, bending forward or sideways, or standing straight)

In some cases, you might feel a pop or tear at the time of the injury.

What causes muscle strains or sprains in your back?

Twisting or pulling a muscle or tendon can result in a strain. It can also happen after a single instance of improper lifting or another activity that overstresses your back muscles. A chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of your muscles and tendons.

A sprain often occurs after a fall or sudden twist, or a blow to your body that forces a joint out of its normal position. All these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.

What are the risk factors for back strains and sprains?

Several factors can put you at greater risk for sprains or muscle strain in your back, like:

• Curving your lower back excessively
• Having obesity
• Having weak back or abdominal muscles
• Having tight hamstrings (muscles in the backs of your thighs)
• Playing sports that involve pushing and pulling, like weightlifting and football

How are back strains and sprains diagnosed?

Healthcare providers can usually diagnose back strains and sprains based on a physical examination and your medical history, including a review of your symptoms and how the injury occurred.

If you have severe symptoms like weakness or loss of function, your healthcare provider might take a spine X-ray or MRI. This imaging test can help rule out a fractured (broken) or herniated (bulging) disk.

How are back strains and sprains treated?

Back sprain and back strain treatments are essentially the same and often take place in two phases.

Phase one

The first phase happens over the first 48 hours after your injury. The goal is to reduce pain, spasm and swelling. Phase one usually involves:

• Rest: The less you use your injured muscles, tendons or ligaments, the quicker you’ll recover. Resting gives your body adequate time to heal.
• Ice packs: Placing an ice pack wrapped in a towel on the affected area can help reduce pain and swelling. Try doing this for 20 minutes at a time, several times a day.
• Compression therapy (pressure): Wrapping the injured area applies pressure, which helps reduce swelling and associated pain. Compression is most important during the first 24 to 48 hours after your injury.
• NSAIDs (nonsteroidal anti-inflammatory drugs): Over-the-counter medications like ibuprofen (Advil® or Motrin®) or naproxen sodium (Aleve®, Anaprox®, Naprelan®, or Naprosyn®) can help reduce pain and swelling.

Phase two

After the first 24 to 48 hours, you should try to resume normal routines and activities. Extended bed rest or immobility (nonmovement) will prolong your symptoms and delay recovery.

Most people with sprains or strained back muscles improve in about two weeks. If symptoms persist, you might need additional treatment.

How long does back strain last?

Most people with back strain make a full recovery within two weeks of starting treatment. If your symptoms last longer, let a healthcare provider know.

The most common complication of a back strain or sprain is being less active. That can lead to weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of your body.

When should I see my healthcare provider?

Call a healthcare provider if you have:

• Severe back pain and can’t walk more than a few steps
• Numbness in the injured area or down your leg
• A history of lower back pain or lumbar spine injuries
• A lump or area with an unusual shape
• Pain that interferes with your sleep
• Obvious weakness in an extremity (hands or feet) after an injury

Can I prevent muscle strains in my back?

It’s not possible to prevent all back injuries, but you can take some steps to lower your risk:

• Eat a healthy, well-balanced diet to keep your bones and muscles strong.
• Maintain a weight that’s healthy for you. Excess weight is a common risk factor for lower back (lumbar) strain and injuries.
• Exercise regularly, including stretching, to keep your joints flexible and your muscles in good condition.
• Practice safety measures to help prevent falls, like wearing shoes that properly fit, and keeping stairs and walkways free of clutter.
• Use good body mechanics when sitting, standing and lifting. For example, try to keep your back straight and your shoulders back. When sitting, keep your knees bent and your feet flat on the floor. Don’t over-reach, and avoid twisting movements. When lifting, bend your knees and use your strong leg muscles to help balance the load.
• Stop using tobacco (including smokeless tobacco and vaping). Nicotine interferes with blood flow to your muscles.