Recognizing a Back Strain

Golfer holding his back in pain
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Your low back is in some way involved in nearly everything you do, which means it's susceptible to injury. One of the most common is back strain. But what is it, exactly, and how is it different from a sprain?

A back strain occurs when you injure one or more muscles that move the spine. This is in contrast to a sprain, which affects ligaments. Both strains and sprains can be sudden, acute injuries or come on over time because of repetitive motion. 

Back strains are one of the most common types of back injuries, if not the most common.

Back Strain Causes

Most of the time, back strains are caused by lifting heavy objects with a bent or twisted spine. Whatever you do to strain your back, it's likely that the muscle fibers will become torn or overstretched, which will lead to inflammation. The American Association of Neurological Surgeons says this inflammation can cause pain and/or back muscle spasms.

Back strains cause a type of pain called mechanical back pain. This simply means that your pain is coming from one of your spinal structures, in this case, your muscles. The pain is usually limited to the area that is injured, but it can also go into the buttock area.

Unlike sciatica (which is a term that patients and doctors alike often use to describe a syndrome that can be caused by a number of things including, but not limited to a herniated disc,) back strain does not affect your nerves. In sciatica, which affects the lower extremity, and/or radiculopathy, which can affect the lower or the upper extremity and is a specific medical term, pain, pins, and needles, and/or other electrical sensations down one leg or arm is not one of the symptoms of back strain.

But, as mentioned above, muscle strain is, as is decreased flexibility. Your joints likely will seem "guarded" because of the muscle spasms, and moving them will probably be painful.

How to Treat a Muscle Strain

Experts and doctors recommend modified activity as the quickest way to get over mild to moderate back strain. At the very least, avoid heavy exertion for the first few days. You can also ice the area, and take aspirin to help control inflammation.

The good news is that most back strains heal with time. But if the pain lingers past 10 days or so, it's probably a good idea to check with your doctor. If your back spasms make it difficult to move or exercise, she may prescribe muscle relaxants. These have the advantage of reducing pain enough to let you participate fully in physical therapy (which is the real progress maker, in my opinion).

The drawback to muscle relaxers is that they don't really get you back into the swing of your life any faster than not taking them. Chou, in his 2010 review entitled, "Pharmacological management of low back pain," which was published in the March 2010 issue of the journal Drugs found that taking muscle relaxers is associated with sedation.

And Bernstein, et. al. in their study, "The use of muscle relaxant medications in acute low back pain," published in the 2004 issue of Spine found that taking muscle relaxers was not associated with faster recovery from a low back injury.

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Article Sources
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  • Low Back Strain and Sprain. American Association of Neurological Surgeons Patient Information website. Last Update Sept. 2005.

  • Back Strain Treatment. Medline Plus Encyclopedia. Last updated: Oct 2005.
  • Bernstein, et. al. The use of muscle relaxant medications in acute low back pain. Spine. June 2004.
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