Lower Back Strain

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Athlete holding her back and possibly experiencing a mild lower back muscle strain.

Lower back strains arise from muscle strains in the lower back or lumbar spine area below the rib cage.. They may involve overstretched muscle fibres, commonly referred to as pulled muscles. However, they can also involve partial or completely torn muscle fibres.

The main symptoms of lower back strains are swelling, inflammation and cramping in some cases. Among adults in North America, lower back strains and sprains account for a large proportion of missed work days. Together with the cost of treatment, they therefore have a significant impact on the economies of many countries.

Lower back strains are painful and unpleasant. However, , the good news is that most of them respond to conservative home based treatment. Usually, they are treatable by rest and self care with no need for surgical intervention.

However, lower back strain symptoms can sometimes closely resemble those of much more serious health problems. These can range from nerve damage to even cancer. It is therefore important to seek medical advice as soon as you experience symptoms resembling those of this injury.

Causes Of Lower Back Strains

Probably the main cause of lower back muscle strains is attempting to lift heavy loads. This is especially the case when this is done with an incorrect lifting technique.

Many individuals attempt to lift such a load by bending their backs to pick up the load. This then forces them to use their lower back muscles to lift the load. In many cases the lower back muscles and ligaments are not properly stretched or are not strong enough.

If so, the result can be overstretching or tearing. The result will then be a lower back muscle strain or ligament sprain.


Individuals with lower back strains will experience some or all of the following symptoms:

  • Pain and stiffness in the lower back. This may be accompanied by pain in the buttocks and down the backs of the thighs (in the hamstring area);
  • The pain may intensify when the individual bends or stretches. It may also become worse when he or she coughs or sneezes.
  • The lower back may be tender to the touch;
  • Individuals with muscle strains may also experience muscle spasms in the lower back area.

As mentioned above, these symptoms are also possible indicators of much more serious medical problems than a lower back muscle strain. It is therefore important to rule out these other possible causes. Do this by contacting a healthcare professional for a diagnosis and medical advice.


To diagnose the cause of the patient’s injury, doctors will ask about his or her medical history. They will usually perform a physical examination of the patient’s lower back to understand the exact location of the pain. The patient may be asked when the pain started and what he or she was doing at the time.

In rare cases, the back pain does not go away after an initial period of conservative home based self care. If so, the doctor may order an imaging scan. This may be an X Ray, MRI or CT scan.

Home Based Treatment

At the end of the examination the doctor may conclude that the patient has suffered a lower back strain. If so, (s)he will usually recommend a period of home based care. This may include:

  • Temporarily refraining from activities that could stress the back muscles e.g. heavy lifting. In cases of intense pain, a short period of bed rest may be recommended.
  • However, the patient should be careful not to spend too long a period in a state of bed rest. If it continues for more than a day or 2,  it may weaken the back muscles. This could then lead to further problems in the future;
  • Applying ice to the lower back for 2-3 days initially or until any swelling has receded. A cold compress can also be used instead. Apply the ice or compress for periods of about 20 minutes at a time and at intervals of 2-3 hours..
  • Once the swelling has gone down, the patient can switch to using a hot compress for heat treatment. This will improve blood flow through the lower back. As an alternative, (s)he can try an electric heating pad or even a soak in a warm bath. Moist heat therapy is another option to be considered at this point;
  • To further reduce the pain and swelling, doctors may suggest taking Non Steroidal Anti Inflammatory Druds (NSAIDs) such as Advil. These should be taken only occasionally (e.g. when the pain is severe) as they can sometimes have undesirable side effects;
  • Muscle relaxants may also be helpful in reducing any muscle spasms that the patient may be experiencing;
  • Wearing a lower back brace or back belt to provide additional support to the area and improve healing progress. It may also be useful to wear this type of brace even after the injury has healed. It may be especially helpful when lifting heavy loads;
  • Physical therapy may be useful to stretch and strengthen the lower back muscles. This will help to reduce the risk of recurrence of the injury.

Recovery Period From A Lower Back Strain

If the strain is a mild one, recovery may require as little as 2-3 days of home based treatment. However, a more serious strain (e.g. one with tearing of the muscle) may need a few weeks of recovery time.

To ensure a complete recovery, it’s important to be patient and not try to return to normal activity prematurely. Wait until there is complete freedom of movement without pain. If you return to normal activity before you are fully healed, you could re-injure yourself.  You could also possibly end up with a chronic back injury.

Preventing A Lower Back Strain

To reduce the risk of experiencing this unpleasant injury, we suggest the following:

  • Follow a regular program of exercising and stretching the back muscles;
  • When lifting heavy objects, follow proper technique and bend at the knees instead of with the back;
  • Reducing body weight can help to ease the strain on the lower back;
  • Improving your posture by sitting or standing with your shoulder straight and help back. Avoid slouching as this puts extra stress and pressure on the lower back. It therefore increases the risk of another strain.

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