Recognizing a Back Strain

Golfer holding his back in pain
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A back strain occurs when you injure one or more of the muscles or tendons that support or move your spine. Back strains are among the most common types of back injuries.

Back Strain Symptoms and Causes

You have many muscles in your back, and tendons attach muscles to bones. During a back strain injury, you can stretch one or more of these structures.

Back strain typically causes an achy pain that's usually limited to the injured area. But the pain can also travel down into the buttock area.

You may also notice decreased flexibility of your movement. Your joints can become "guarded" if moving them is painful. Over time, constant muscle stiffness or intermittent muscle spasms can develop.

The strain can also lead to inflammation. The American Association of Neurological Surgeons says this inflammation can cause pain and/or back muscle spasms.

Often, back strain occurs when muscle or tendon fibers become torn or overstretched. Most of the time, back strains are caused by lifting heavy objects with a bent or twisted spine. 

Diagnosis

If you have back pain, your doctor will evaluate you to identify the cause. That's because your treatment can differ depending on whether you have a strain, a sprain, a herniated disk, or a bone fracture.

Your evaluation will include a physical exam and imaging tests such as X-ray or magnetic resonance imaging (MRI).

A sprain affects ligaments, which connect bones to each other. Other sources of low back pain include bulging or ruptured discs or bone fractures (including stress fractures). All of these can occur suddenly due or may develop gradually due to problems like overuse.

Sciatica is a condition in which lower extremity pain occurs due to pressure on a nerve. And radiculopathy, which can affect the lower or the upper extremity, causes pain or a sensation that feels like "electricity" or "pins and needles" down one leg or arm.

How to Treat a Muscle Strain

The good news is that most back strains heal with time. 

Doctors recommend modified activity as the quickest way to get over a mild to moderate back strain. Your doctor may advise you to avoid heavy lifting or activities like running for the first few days after your back strain. 

You can also ice the area and take an anti-inflammatory medication to reduce inflammation.

If the pain lingers past 10 days or so, you should talk to your doctor about it. If your back spasms make it difficult to move or exercise, your doctor may recommend physical therapy and/or prescribe a muscle relaxant for you. 

Muscle relaxers do not repair the injury, and they often cause sedation, which can interfere with your ability to drive and manage your day to day activities. But they may relax your muscles so you can stretch them and use them more effectively during physical therapy.

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  1. American Association of Neurological Surgeons. Low back strain and sprain.

Additional Reading
  • Chou, R., Pharmacological management of low back pain. Drugs. March 2010.

  • 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.
  • Magee, D.J. Orthopedic Physical Assessment. 4th edition. Saunders Elsevier. 2006. St. Louis, Mo.