Lumbar strain: A stretching injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is one of the most common causes of low back pain.
The injury can occur because of overuse, improper use, or trauma. It is classified as “acute” if it has been present for days to weeks. If the strain lasts longer than 3 months, it is referred to as “chronic.”
Lumbar strain most often occurs in persons in their forties, but can happen at any age.
The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues.
The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, x-ray testing is only helpful to exclude bone abnormalities.
The treatment of lumbar strain consists of resting the back (to avoid re-injury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles.
Long periods of inactivity in bed are no longer promoted as this treatment may actually slow recovery. Spinal manipulation for periods of up to 1 month has been found helpful in some patients that do not have signs of nerve irritation.
Future injury is avoided by using back protection techniques during activities and support devices as needed at home or work.
The majority of episodes of acute lower back pain are caused by damage to the muscles and/or ligaments in the low back.
While a muscle strain doesn’t sound like a serious injury, the resulting lower back pain can be surprisingly severe and is the cause of many emergency room visits each year.
There are two common types of lower back strain:
- A muscle strain happens when the muscle is over-stretched or torn, resulting in damage to the muscle fibers (also called a pulled muscle).
- A lumbar sprain happens when ligaments are stretched too far or torn. Ligaments are very tough, fibrous connecting tissues that connect bones together.
For practical purposes, it doesn’t matter if it is a muscle strain or a ligament sprain that is causing the pain, since the treatment and prognosis for both are the same.
When the muscles or ligaments in the low back are strained or torn, the area around the muscles will usually become inflamed.
The inflammation leads to back spasm, and it is the back spasm that can cause both severe lower back pain and difficulty moving.
Common Causes of a Pulled Back Muscle
Lower back pain from muscle strain usually is caused by any type of movement that puts undue stress on the lower back. Frequent causes include lifting a heavy object, lifting while twisting, or a sudden movement or fall.
Sports injuries are also a frequent cause of a pulled back muscle, especially with sports that involve twisting (such as golf), or any types of sudden impact or jarring motions.
Pulled Back Muscle Symptoms
Symptoms may range from a mild ache to sudden debilitating pain. Typical symptoms of a lower back pulled muscle include some combination of the following:
- The pain is usually localized in the lower back, meaning that it doesn’t radiate into the leg (as in sciatica)
- The lower back may be sore upon touch
- Pain usually comes on suddenly
- There may be accompanying muscle spasms
- The patient usually feels better when resting, and may find standing or walking difficult.
- The severe back pain may resolve quickly, but a lower level of pain, or intermittent flare-ups of pain, may continue for a few weeks or months.
Fortunately, back muscle strains usually heal with time, with most healing within a few days and almost all resolving within 3 to 4 weeks.
The large muscles in the low back have a good blood supply, which bring the necessary nutrients and proteins for healing to take place.
If the lower back muscle pain is severe, the patient may be advised to rest, but for no more than one or two days.
Initial Treatments for Pulled Back Muscles
Typical first line treatments include some combination of:
- Pain medication (such as acetaminophen), to interrupt transmission of pain signals to the brain
- Anti-inflammatory medication (such as ibuprofen, or possibly oral steroids), to reduce the local inflammation that is a cause of the pain
- Muscle relaxants, which may be prescribed on a short-term basis to relieve severe lower back pain associated with muscle spasms.
- Massage, which can help promote blood flow in the lower back (to help with healing), loosen tight lower back
- Chiropractic. Gentle manual manipulation is an option to help loosen tight back muscles and promote healing in the lower back.
- Ice or cold packs. Application of some type of cold pack can help reduce inflammation, which is helpful immediately following the injury.
- Heat therapy. Application of heat to the lower back is helpful longer term to stimulate blood flow and healing to the injured area.
If an episode of low back pain lasts for more than two weeks, the muscles may start to weaken. Because using the lower back muscles is painful, the natural tendency for most patients is to avoid using them.
However, lack of activity leads to disuse atrophy (muscle wasting) and subsequent weakening, which in turn causes more low back pain because the muscles are less able to help hold up the spine.
Back Exercises as Muscle Strain Treatments
As a general rule, people who are active and well-conditioned are much less likely to suffer from low back pain due to muscle strain, as regular exercise stretches the muscles so they are less likely to strain, tear or spasm.
There are three types of muscles that support the spine:
- Extensors (back muscles and gluteal muscles)
- Flexors (abdominal muscles and iliopsoas muscles)
- Obliques or Rotators (side muscles)
While some of these muscles are used in everyday life, most do not get adequate exercise from daily activities and tend to weaken with age unless they are specifically exercised.
More about Exercises for the Back and Abdominals
A complete exercise program for the low back should consist of a combination of:
- Stretching for Back Pain Relief
- Back Strengthening Exercises
- Low-Impact Aerobic Exercise
Finally, a regular, sustained program of hamstring stretching will help reduce and prevent back muscle tightness and injury.
The hamstring muscle runs through the back of each thigh. Tightness in this muscle limits motion in the pelvis which can strain the lower back.
Regular hamstring stretching can gradually lengthen these muscles and reduce the stress felt in the lower back.