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Back Strains and Sprains

A strain is a muscle or tendon injury; a sprain is a ligament injury.

What is Back Strain

A muscle strain (or pulled muscle) is an overstretched or torn muscle. Back strain is the most common cause of back pain, especially lower back pain. Muscle strain is often caused by overuse of a muscle or overloading a muscle. When a muscle is stressed beyond its limits, injury occurs.

With injury comes inflammation, which is part of the healing process. Inflammation causes pain and can also trigger muscle spasms. The severity of a muscle strain can range from mild to severe.

Causes of Back Strain

Back Strain may be caused by Overload

Strained back muscles can occur when the back is overloaded - such as when lifting something too heavy. Weak muscles are more easily overloaded and injured than strong muscles but any muscle can be overloaded.

Poor lifting techniques as well as lifting objects that are too heavy can overload the back and cause injury. Pulled back muscles may also be caused by falling down or an unexpected twisting of the back.

Though the pain is usually caused by overstretching or tearing of back muscles, sometimes an irritated spinal joint triggers muscle spasms around the joint.

Back Strain may be caused by Overuse

Overusing the same muscles, whether from repetitive motion or simply holding a static position for a long period of time can cause muscle strain.

Overuse injuries may occur quickly or may take weeks or months to develop

Chronic overuse injuries (also called repetitive stress injuries), which may take weeks or months to develop, are often caused by the same muscles being used for long periods of time - even though the demand on the muscles is low. Back and neck pain often occur from sitting in a fixed position for long periods of time. The body is made to move. When one position is held too long, muscles get fatigued and strained. Switching positions shift the workload to another group of muscles, preventing one muscle group from becoming fatigued. Poor posture also causes the muscles to have to work harder to support the spine, which leads to fatigue, strain, and back pain.

*Take frequent breaks from sitting. Stand up, walk, and stretch tight muscles in the back and the neck.

Overuse injuries may also occur quickly. Activities that involve repetitive movements such raking the yard, shoveling the driveway, and doing too much of an exercise too soon can cause this type of overuse injury. Holding muscles in a fixed position - especially with high level of muscle activation - for too long can also cause muscle strain. For example, holding the head up to paint a ceiling may cause a "sudden overuse injury.

Overuse injuries that develop quickly usually also usually heal quickly - as long as the body is given a break from the activity that caused the strain. When the body is not given a chance to heal before the activity is repeated, chronic problems can result.

Symptoms of Back Strain

Symptoms of pulled back muscles include back pain and muscle weakness and sometimes back muscle spasms. The back pain may be sudden, but usually comes on gradually.

The muscles stiffen or spasm to reduce motion to prevent further injury. Muscle injuries cause inflammation - a part of the healing process. Inflammation may trigger muscle spasms. Muscle spasms are more likely to be a problem for the first couple of days after an injury - when inflammation is at its worst. Though not serious, back muscle spasms can cause significant pain. Inflammation also causes pain.

Healing time depends on the severity of the strain. Mild muscle strains usually heal within two weeks. Moderate muscle strains may take six to eight weeks to heal.

Prevention of Recurring Back Strain

Many people who experience recurring back pain have weak core muscles - the muscles that support the back. Strengthening these muscles can prevent back strain from recurring, though the time for strength exercises is after the back pain has resolved. Increase back exercises gradually to avoid overuse injuries.

Back Strain is often preventable with proper posture habits, lifting techniques, and back exercises.

Treatment of Back Strain

(Also applies to back sprain)

Back pain caused by muscle or ligament injury will usually resolve without any special treatment within 2 weeks (for mild strains) to 2 months.

Treating Pain and Inflammation

Temporary relief of back pain may be obtained with pain / anti-inflammatory medications and applying heat and cold. Relief from pain and inflammation from pulled back muscles / ligaments can be obtained by applying ice to the injury (wrap ice in cloth - do not apply ice directly to skin) for 15 to 20 minutes every 4 hours for two or three days. The cold helps reduce pain and inflammation and is also a distraction from the back pain. After four or five days, providing the inflammation has subsided, applying heat for 15 or 20 minutes at a time may be beneficial. Heat increases blood flow and helps relax tight back muscles. (Pain can cause muscles to tighten or spasm).

NOTE: Do not apply heat or cold if you have circulation problems or nerve damage unless recommended by your physician.

Your doctor may prescribe pain medications that contain codeine and/or muscle relaxants to relieve severe acute back pain, especially for the first week after the injury.

Tip: To avoid aggravating back pain, 'roll' out of bed: bend your legs at your knees and hips and roll on your side. Push yourself up with your arms as you hang your lower legs over the side of the bed.

There are also complementary treatments to help relieve pain, loosen tight back muscles, and speed healing - massage therapy, hydrotherapy, etc.

Exercise after Back Strain or Sprain?

Bed rest will actually delay recovery. But you could restrain injured muscles by rushing into an exercise program before healing has taken place. Maintain daily activities. Gentle stretching exercises for the back increase circulation to the muscles to speed healing, relieve tight muscles and help increase mobility.

Save the strengthening exercises until your back pain has gone or as recommended by your doctor or physical therapist. If you are unsure as to what exercises are safe or when to begin them, a physical therapist can create a personalized exercise program for you to follow.

People who view this page also view Post-Injury Exercise

Back Sprain

A back sprain is a ligament injury. The severity of a sprain can range from mild to severe.

Sudden movements (as in a fall or car accident) can cause injury to the ligaments because the muscles don't have time to react (contract) and keep the spine within its normal range of motion, causing ligaments to stretch or tear.

Acute pain can result from a back sprain. The pain may also gradually get worse over a couple of days as inflammation develops.

Symptoms of minor back sprains (slight tearing or overstretching of a ligament) cause minor back pain and swelling with little or no bruising. Moderate back sprains cause moderate back pain and swelling with bruising. Severe back sprains cause severe back pain, swelling and bruising and make it almost impossible to move. Like back strain, back sprains may trigger back muscle spasms.

Healing time depends on the severity of the sprain. Most back sprains heal in six to eight weeks but it can take several months for complete recovery from a severe back sprain. Ligaments take longer to heal than muscles.