A back strain is an injury to either a muscle or tendon, while a back sprain is the stretching or tearing of a ligament. The symptoms, causes and treatment of back strains and sprains are discussed.
The back is a complex structure of bone and muscle, supported by cartilage, tendons and ligaments, and fed by a network of blood vessels and nerves. The back—especially the lumbar, or lower back—bears much of the body’s weight during walking, running, lifting and other activities. It makes sense, then, that injuries to the lower back—such as strains and sprains—are common.
A strain is an injury to either a muscle or tendon. Tendons are the tough, fibrous bands of tissue that connect muscle to bone. With a back strain, the muscles and tendons that support the spine are twisted, pulled or torn.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
A sprain is the stretching or tearing of a ligament. Ligaments are the fibrous bands of tissue that connect two or more bones at a joint and prevent excessive movement of the joint.
Strains and sprains are very common injuries. Next to headaches, back problems are the most common complaint to healthcare professionals.
Twisting or pulling a muscle or tendon can result in a strain. It can also be caused by a single instance of improper lifting or by overstressing the back muscles. A chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.
A sprain often occurs after a fall or sudden twist, or a blow to the body that forces a joint out of its normal position. All of these conditions stretch one or more ligaments beyond their normal range of movement, causing injury.
In addition, several factors can put a person at greater risk for a back strain or sprain, including:
Playing sports that involve pushing and pulling—such as weightlifting and football—also increases the risk of a low back injury.
Symptoms of a strain or sprain include:
In some cases, the person may feel a pop or tear at the time of the injury.
Mild strains and sprains can usually be diagnosed based on a medical history—including a review of the symptoms and how the injury occurred—and a physical examination by a healthcare provider. In cases of more severe strains and sprains, especially when there is weakness or loss of function, an X-ray may be taken to rule out a fractured (broken) or herniated (bulging) disk as the cause of the back pain.
The treatment for strains and sprains is similar, and often takes place in two phases.
The goal of the first phase is to reduce the pain and spasm. This may involve rest, and the use of ice packs and compression (pressure), especially for the first 24 to 48 hours after the injury. An over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen (Motrin®), may be recommended to help reduce pain and swelling.
After the first 24 to 48 hours, returning to normal activities, as tolerated, is advisable. Extended bed rest or immobility (nonmovement) simply prolongs symptoms and delays recovery.
Most people with lumbar strain/sprain symptoms improve in about 2 weeks. If symptoms continue for more than 2 weeks, additional treatment may be required.
The most common complication of a back strain or sprain is a reduction in activity, which can lead to weight gain, loss of bone density, and loss of muscle strength and flexibility in other areas of the body.
It is not possible to prevent all back injuries, but you can take some steps to help lower the risk of a sprain or strain:
Most people with back strains and sprains have a full recovery with treatment within 2 weeks.
Call your healthcare provider if:
Last reviewed by a Cleveland Clinic medical professional on 11/09/2018.
Learn more about our editorial process.