Medical News Today
Pulled muscles, or strains, are common in the lower back because this area supports the weight of the upper body.
Anyone can get a lower back — or lumbar — strain, which can be very painful and make normal movement difficult.
In this article, we discuss the symptoms and causes of a pulled muscle in the lower back and explain what treatment options are available.
Symptoms of a pulled lower back include:
- loss of function and restricted movement
- difficulty walking, bending, or standing straight
- swelling and bruising
- muscle cramping or spasms
- sudden pain in the lower back
Overstretching or tearing ligaments, which are bands of tissue that hold the vertebrae of the spine in place, can cause a sprain. A strain is a tear in either a muscle itself or one of the tendons that attach the muscles to the spinal column.
Strains happen when a person stretches the muscles or muscle fibers beyond their normal range of movement.
Causes may include:
- lifting heavy objects
- sports that require pushing and pulling, such as football or soccer
Other risk factors include:
- having overweight or obesity
- bending the lower back excessively
- a weak back or abdominal muscles
- poor posture
- tight hamstrings
Anyone who strains a muscle in the lower back should rest to avoid further damage. However, they should not stop moving altogether. Gentle movements that cause no pain can help expedite the healing process.
Ice packs and anti-inflammatory medicines can help relieve swelling and pain, and a doctor may also prescribe muscle relaxants.
According to Johns Hopkins Medicine, after a person pulls their lower back, they should:
- apply an ice pack for the first few days for 15–20 minutes, multiple times a day, to reduce any swelling
- switch to a heat pack after a few days, using it for 15 minutes at a time to help reduce the pain
- take aspirin or ibuprofen to help with the pain and swelling
The following exercises might also help.
However, it is essential to avoid moving any further than is comfortable and to stop the exercise if it puts pressure on any other part of the body.
- Kneel on all fours with the knees under the hips and the hands under the shoulders.
- Keep the back and neck straight and bend the elbows slightly.
- Move the buttocks slowly back toward the heels.
- Hold the stretch while taking one deep breath in and out and then return to the starting position.
- Repeat 8–10 times.
- Lie on the back with a flat cushion under the head.
- Bend the knees, keeping the feet straight and hip-width apart.
- Keep the upper body relaxed with the chin tucked in.
- Slowly flatten the lower back into the floor and lift the tailbone.
- Slowly perform the reverse movement, tilting the pelvis toward the heels.
- Repeat 10–15 times.
- Lie on the front with the chest flat on the floor, taking the weight of the body on the forearms.
- Slowly push through the forearms to lift the chest and then the belly off the floor. Keep the hips and pelvis on the floor.
- Relax the back and use the arms to do the pushing.
- Hold at the top for 5–10 seconds and then return to the starting position.
- Repeat 8–10 times.
If the pain has not eased after 1–2 weeks, a person should see a doctor.
In some circumstances, a person may need to go to the emergency department or call 911. It is important to seek medical help if:
- a person hears a crack when they sustain the injury
- the injured part of the back is numb, discolored, or cold to the touch
- a fever of 101°F (38.3°C) accompanies the pain
- a person has lost control over the bladder or bowels
- a person is unable to stand
- urinating is painful or produces bloody urine
- there is severe pain in the abdomen
Most lower back strains and sprains should recover in 2 weeks, and according to the American Association of Neurological Surgeons (AANS), more than 90% of people recover fully in 1 month.
A person should avoid vigorous exercise for 8 weeks to reduce the risk of damaging the back further.
To avoid putting strain on the back, a person should:
- stretch before exercising
- avoid slouching or hunching over
- wear comfortable, low-heeled shoes
- maintain a moderate weight
- sit in a chair with lumbar support
The following tips may also be beneficial:
Lift objects carefully
A person can help avoid pulling the muscles in the lower back by ensuring that they take care when lifting heavy objects.
To lift objects safely, a person should:
- Keep the object close to the waist: This positioning can reduce the amount of pressure on the back.
- Maintain a stable position: Keeping the feet apart with one leg slightly forward can help with balance.
- Avoid bending the back when lifting: A person should not bend their back when lifting an object.
- Avoid twisting: A person should avoid twisting the back while lifting heavy objects.
Yoga may also help relieve pain and strengthen the back. According to a 2016 systematic review, yoga may be an effective treatment option for chronic lower back pain.
By strengthening the back and improving flexibility, this practice may help prevent a person from pulling the muscles in the lower back.
How is lumbar strain diagnosed?
A doctor is likely to perform a physical examination to diagnose a lumbar strain.
If they need to do further tests to examine the cause of the lumbar strain, the doctor may request:
- an X-ray
- a CT scan
- an MRI scan
They might also order an electromyogram to examine the muscle and nerve function or a radionuclide bone scan to look at the blood flow to the bone, as well as cell activity.
According to the AANS, a pulled muscle is the most common cause of lower back pain. However, this symptom has other possible causes.
If the pain is on the right side of the back, it may be due to appendicitis. A person should seek emergency medical help if they suspect that this is the cause of their lower back pain.
Other symptoms of appendicitis may include:
- appetite loss
- low grade fever
- swollen abdomen
Other causes of pain on either side of the lower back, or both sides, include:
- slipped disk
- kidney infection
- kidney stones
A pulled muscle in the lower back can be painful. However, with the right treatment at home, most strains get better after a few weeks.
A person should see a doctor if they hear a crack when the injury occurs, or if they develop a fever or experience incontinence afterward.
Factors such as carrying extra weight and having weak muscles can make a person more likely to experience sprains or strains. It is important to lift heavy objects carefully and warm up before doing exercise.