Low Back Strain Symptoms and Treatment

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Muscle strains and lumbar sprains are the most common causes of low back pain. A low back muscle strain occurs when the muscles of the back are abnormally stretched too far. A lumbar sprain occurs when the ligaments, the tough bands of tissue that hold bones together, are torn from their attachments.

Differentiating a strain from a sprain can be difficult, as both injuries will have similar symptoms. Many doctors refer to both injuries as a category called "musculoligamentous injuries" of the lumbar spine. In general, it doesn't matter what you call the problem because the treatment and prognosis for both back strains and sprains is the same.

Nearly everyone will experience low back pain at some point in their life; it is the second most common cause of missed days of work in the United States—only a common cold causes more missed work. Almost all of these low back injuries are due to injuries of the muscle or ligament.

Symptoms of Low Back Strain
Verywell / Gary Ferster

Warning Signs

If you don't know the cause of your back pain, you should have it evaluated by a doctor. Some warning signs of a serious injury to the spine include:

  • Loss of control of bladder or bowels
  • Progressive lower extremity weakness
  • Pain that wakes you from sleep
  • Severe, constant pain

While most back pain is caused by a muscle strain or ligament sprain, there are serious conditions that require more immediate treatment. If you are unsure of the cause of your symptoms, you should be evaluated by a physician.

Low Back Muscle Strains

The spine is supported by large muscles called the paraspinal muscles. These muscles both support the spinal column as well as the weight of the upper body. The five lumbar vertebrae are connected by tough ligaments that help to maintain the position of the spinal column.

These muscles, ligaments, and bones all work together to provide control and strength for nearly all activities. The lumbar spine and its muscles are needed for most all movements and activities. For this reason, the lumbar spine is prone to injury, and when an injury has been sustained, people have difficulty performing many activities.


Most lumbar muscle strains and sprains cause symptoms isolated to the low back, usually they do not cause problems in the legs like some other spine conditions. The most common symptoms of a lumbar strain or sprain are:

  • Pain around the low back and upper buttocks
  • Low back muscle spasm
  • Pain associated with activities, and generally relieved with rest

When the lumbar spine is strained or sprained, inflammation of the soft-tissues results. This inflammation causes pain and can cause muscle spasm. People are often surprised at how painful and debilitating a lumbar strain or sprain can be—these are not minor injuries. They often cause severe symptoms for a few days and may not completely resolve for weeks or months. That said, over 90% of patients are completely recovered from an episode of lumbar muscle strain or sprain within one month.

We do know some factors that tend to influence the development of this type of problem, but often these symptoms strike in unexpected situations. Most commonly, patients who develop a lumbar strain or sprain are doing an activity that places their back at risk. This may be a sudden forceful movement, lifting a heavy object, or twisting the back in an unusual manner. Knowing how to properly lift can help to prevent many back injuries.

Some well-known factors that contribute to low back pain include:

  • Poor conditioning
  • Obesity
  • Smoking
  • Improper use/lifting technique

If you have persistent problems with your lumbar spine, consider these issues. If you smoke, are overweight, or do not perform regular back strengthening exercises, then you have steps that you can take to help control your symptoms.


Treatment of a lumbar strain can usually be accomplished with some simple steps. The most challenging aspect of treatment is that it often takes time to find relief and symptoms can last weeks or even months. However, there are some aspects of treatment that can help ensure future episodes of injury are less likely.

It may be that the best treatment for typical, muscular back pain is time. Unfortunately, speeding the healing process has not been shown to be terribly effective with most any standard treatment, and certainly potential harmful treatments should be avoided. In particular, medications, especially potentially addictive medications, should not be used for treatment of back pain. The best recommendation, based on scientific data that has compared hundreds of treatments to find the most beneficial and safe treatment, is to encourage people to move gently. Whether this is with physical therapy or other activities, light, gentle movement is the best way to heal muscular back pain.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Association of Neurological Surgeons. Low Back Strain and Sprain.

  2. National Institute of Neurological Disorders and Stroke. Low Back Pain Fact Sheet.

  3. American Association of Neurological Surgeons. Cauda Equina Syndrome.

  4. American Association of Neurological Surgeons. Spinal Pain.

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.