Treat a Back Strain

Back sprains and strains are very common musculoskeletal injuries in people, primarily because the human spine is not designed to accommodate many modern activities and behaviors, such as playing sports, performing repetitive actions at work and sitting for prolonged periods of time. Whereas sprains are injuries to ligaments and joints, a strain is an injury to either muscles or tendons — the fibrous tissues that connect muscles to bones.[1] The most commonly strained part of your spine is the lumbar (lower) region because of all the weight and force it must bear. Most back strains are self-healing, which can be sped up if you follow the at-home advice below. However, in some cases, professional treatment is necessary.

Steps

Treating a Back Strain at Home

  1. Rest and give it some time. Most back strains (also called muscle pulls) happen when you lift too much weight, perform a movement too often, move awkwardly or experience an accident (a fall, car accident or athletic injury, for examples).[2] As soon as you feel the pain of a strained muscle, stop doing the activity that caused it and rest. Usually two or three days is enough time for most mild-to-moderate back strains to heal or feel significantly better.
    • About 80 to 90 % of acute low back strains resolve within the first 12 weeks, regardless of the treatment prescribed.[3]
    • Pain from muscle strains is usually described as dull, achy and/or throbbing — sometimes sharp with movement.
    • Muscles recover quicker if you rest them from vigorous or repetitive activity, although complete inactivity (such as bed rest) can make back muscles even more stiff. Some movement, such as slowly walking and/or doing household chores, increases circulation and helps back muscles heal faster.
    • Get up and slowly walk around for a few minutes every hour.[4]
    • If your back strain takes longer than a few weeks to settle down, then that's an indication of a more serious back injury that needs professional attention.
  2. Apply ice to a new injury. If your back strain is new (acute, within 48 to 72 hours of an injury) and not something that is constantly recurring, then inflammation is likely involved and contributing to your pain. Applying cold therapy (ice or something frozen) to acute musculoskeletal injuries is greatly beneficial because it constricts the small blood vessels around the injury and prevents inflammation from building up.[5] Preventing inflammation reduces swelling, which reduces pain and stiffness. Apply the cold therapy for about 15 minutes at a time (or until numb) every hour until the pain and inflammation are significantly reduced. A few days of cold therapy may be needed if you acute injury is moderate-to-severe.
    • Effective forms of cold therapy include crushed ice, ice cubes, frozen veggies and frozen gel packs.
    • Whatever form of cold therapy you use, never apply it directly to your skin due to the risk of frostbite or irritation. Instead, wrap the cold item up in a thin cloth before applying it.
    • Moderate-to severe muscle strains are usually intensely painful and involve bruising below the skin's surface due to torn muscle fibers and damaged blood vessels. Applying cold therapy will typically limit bruising and cause it to dissipate quickly.
  3. Apply moist heat to an old or recurring injury. If your injury is chronic (lingering for a few months) or constantly recurring, then applying moist heat may be more appropriate and effective than using cold therapy. Chronic muscle strains are not typically too inflamed; rather, the injured muscle tends to be weakened, too tight and in need of more nutrients (such as oxygen) via blood flow. Thus, applying moist heat can expand local blood vessels, increase blood flow and reduce muscle tension or spasms.[6] Moist heat is a much better choice than dry heat (from an electric heating pad, for example) because it doesn't dehydrate muscle tissue or other tissues such as skin.
    • An effective and convenient way of using moist heat on your back strain is by buying a microwavable bag that contains some kind of grain (wheat, rice, corn) mixed with herbs and essential oils.
    • Zap the herbal bag in your microwave for 1-2 minutes, then apply it to your sore muscle(s) for 15-20 minutes, 3-5x daily, until the pain and tension fades away.
    • As an alternative, run a warm bath and add Epsom salt, which contains lots of muscle-relaxing magnesium. Soak in the salty bath for 20-30 minutes on a nightly basis to get relief and to promote better sleeps.
  4. Consider taking anti-inflammatories. Over-the-counter non-steroidal anti-inflammatories (NSAIDs) are particularly helpful for acute and chronic back strains because they reduce swelling and pain.[7] They are often better choices than regular painkillers (such as acetaminophen), because analgesics don't impact inflammation. Widely available NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve) and aspirin. Always take NSAIDs on a full stomach and limit their use to less than 2 weeks because they are irritating to your stomach and kidneys. Keep in mind that NSAIDs are for symptomatic relief only.
    • Ibuprofen and aspirin are not usually appropriate for young kids, so always ask your doctor before giving any medications to your children.
    • Some medicinal lotions and creams contain NSAIDs, which are absorbed through the skin and into the strained muscle(s) without risking stomach irritation.
    • If your back strain is chronic (long-term), then taking muscle relaxants (such as cyclobenzaprine) is an alternative worth exploring. These medications reduce muscle tension and spasms, although they don't reduce inflammation or have a big impact on pain.
  5. Try some light stretches. After resting and dealing with the inflammation / pain for a few days, doing some light stretches may be helpful for your back strain as long as your pain isn't severe. Muscle stretching is helpful for recovering from strains because it lengthens the muscle fibers (preventing spasms) and promotes better blood flow.[8] Stretches for the low back generally involve trying to touch your toes, either while standing or sitting. Try the "hurdler's position" while seated and one leg off to the side. Actually touching your toes is not important; feeling a nice pull or stretch in your low back muscles while reaching for your toes is the important thing.
    • Start with 3 back stretches each day and hold them for 20-30 seconds each time while taking deep breaths. The stretches should become easier day by day. Don't "bounce" the stretches.
    • Stop stretching immediately if your muscle pain significantly increases or the type of pain suddenly changes (from achy to electric pain, or numbness extending into the lower extremity, for example).
    • Make sure you back muscles are warmed up prior to stretching. Cold muscles get tight and are more prone to injury.

Getting Professional Help for Back Strains

  1. Make an appointment with your family doctor. If resting and applying the above home remedies does not significantly reduce your back strain within a few weeks, then call your doctor and make an appointment. Your doctor can examine your back and take x-rays if they think your injury is not primarily a strain. Other relatively common causes of back pain include arthritis, joint sprains, compression fractures, nerve irritation and herniated discs.[9] If you pain is severe, your doctor can give you a prescription for stronger medications.
    • X-rays primarily show the condition of bones, such as your spinal vertebrae and pelvis. MRI, CT scan and diagnostic ultrasound can show the condition of soft tissues such as muscles, tendons, ligaments and nerves.
    • Your doctor may order a blood test if they think your back pain might be caused by rheumatoid arthritis or a spinal infection (osteomyelitis or meningitis).
    • Your family doctor is not a back specialist, but they are a good medical professional to see first in order to rule out the serious causes of back pain.
  2. See a chiropractor. Chiropractors are back (spinal) specialists and use manual (physical) techniques to restore normal function to the joints and muscles of the back. A chiropractor can thoroughly examine your spine, take back x-rays and analyze your posture while standing, sitting and walking. Chiropractors use a variety of therapies tailored toward healing muscle strains, such as electronic muscle stimulation, therapeutic ultrasound and infrared (heat) therapy. If spinal joints are also involved with your injury, then your chiropractor can use spinal adjustments to establish normal position, motion and function of the joints.
    • Traction of your spine and back muscles with an inversion table may also help your back strain. Many chiropractors have inversion tables, which positions you upside down (safely) and allows gravity to decompress your spine and stretch your back muscles.
    • Although a single appointment with a chiropractor can sometimes completely relieve your back strain, typically three to five treatments are needed to notice significant results. Keep in mind that your health insurance provider may not cover chiropractic care.
  3. Try a back massage. Most back strains respond well to deep tissue massage because it reduces muscle spasms, dissipates inflammation, alleviates pain and promotes relaxation.[10] Make an appointment with a registered massage therapist and start with a 30-minute session focusing on your sore back muscles. Allow the therapist to go as deep as you can take it without wincing. More sessions and perhaps longer sessions may be needed to notice significant results, so be patient and follow the therapist's recommendations.
    • Alternatively, ask a friend, partner or spouse to massage your back muscles. There's lots of video instruction on the internet that teaches the basics of massage therapy, although they are no substitute for professional training.
    • If you can't convince someone to massage your achy back, then consider using a tennis ball or foam roller instead. Depending on where your back strain is, use your bodyweight to roll over the tennis ball and/or foam roller until you feel the pain melt away.
    • Always make sure that you do not roll on the foam roller directly on your lower back. Angle your body slightly while rolling to prevent hyperextension of the low back.
    • Drink lots of water after a massage in order to flush inflammatory by-products and lactic acid out of your body.
  4. Get a referral to a physical therapist. If your back strain persists for more than a few months, then ask your doctor for a referral to a physical therapist for some back rehabilitation. A physical therapist can show you specific stretches and strengthening exercises to help your chronic back strain to recuperate.[11] Your therapist may use a combination of free weights, machines with pulleys, rubber bands and exercise balls to strengthen your back muscles. Back extensions (the opposite of sit-ups or crunches) are the most common back strengthening exercise.
    • Physical therapy is usually needed 2-3x per week for 4-8 weeks to positively impact chronic back strains.
    • Other general back-strengthening exercises include rowing, swimming and doing squats with weights.

Tips

  • Lose weight if you are overweight. Extra weight can weaken back muscles and leave you more susceptible to back strains.
  • To prevent back strains, establish a warm-up routine prior to engaging in any strenuous physical exercise.
  • To avoid back strains, lift heavy objects by bending at the knees, keeping your back straight and using your legs.
  • If you sit at a desk all day and think that's related to your back strain, then ask your boss for a new ergonomic chair for your desk.
  • To reduce the risk of back strain, quit smoking. Smoking impairs blood flow and results in oxygen and nutrient deprivation to muscles.

Related Articles

Sources and Citations

  1. ↑ https://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/back-strains-and-sprains
  2. ↑ http://www.emedicinehealth.com/muscle_strain/article_em.htm
  3. ↑ http://www.medscape.com/viewarticle/438232_2
  4. ↑ http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm
  5. ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm
  6. ↑ http://www.sportsinjuryclinic.net/treatments-therapies/heat-treatment
  7. ↑ http://www.drugs.com/health-guide/muscle-strain.html
  8. ↑ http://web.mit.edu/tkd/stretch/stretching_5.html
  9. ↑ http://www.niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp
  10. ↑ http://www.pacificcollege.edu/news/blog/2015/02/19/benefits-massage-lower-back-and-neck-pain
  11. ↑ http://www.csp.org.uk/your-health/what-physiotherapy

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