Lower Back Strain

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Tired handsome bearded manual worker with closed eyes sitting on stack of wooden plank and massaging lower back while feeling pain in back, possibly from lower back strain.

A lower back strain is an injury caused by an overstretched or torn muscle in your lower back area. This injury is also commonly referred to as a pulled back muscle. Together with lower back sprains, it is also one of the biggest causes of missed work days among adults in developed countries. It therefore has a major economic impact on the societies of these countries.

Lower Back Strain Risk Factors

Generally speaking, lower back strains tend to mainly affect people aged 30 or older.

Another factor that can contribute to experiencing this injury is natural bone loss with advancing age.

Yet another is being physically unfit or overweight.

Having a job that requires plenty of lifting activity or maintaining poor posture can also be contributory factors. Lifting heavy weights with the legs straight and the back bent is poor lifting technique that can lead to lower back strains.

Athletes in certain sports that place demands on the lower back can also experience pulled back muscles. Sports like golf, baseball  and cricket tend to cause a large number of lower back strains or other back injuries.

Symptoms Of A Lower Back Strain Injury

This is one of the more painful back injuries that you can experience. The key symptoms of it are:

  • Pain and possible swelling in the lower back area;
  • Increased pain when you bend, twist, walk or run or possibly if you just stand up;
  • Muscle cramping or spasms;
  • Your lower back may feel “tender to the touch”;
  • You may also experience redness or bruising in your lower back;
  • In some cases, the pain may radiate into areas adjacent to your lower back, such as your buttocks.

If you have some or all of these symptoms, you should seek medical advice urgently. These are typical symptoms of a lower back strain.

However, these symptoms can also be “red flags” indicating the presence of more serious medical conditions. These can include problems such as a herniated disc or even a tumour. The lower back is a complex network of nerves, bones, muscles and ligaments. It is sometimes tricky to tell the exact cause of pain originating from the area.

Pain that radiates away from the lower back area (to the legs, for example) can indicate a more serious problem. For example, it may indicate the presence of nerve damage due to a herniated disc injury.

Lower back pain can also be the result of spinal cord compression due to the narrowing of the spinal canal. This injury is called spinal stenosis. Both of these conditions are potentially much more serious than lower back strains.


To diagnose the cause of your lower back pain, your doctor will review your medical history. He or she will also perform a physical examination of your lower back. The goal will be to determine the exact location of your pain and what makes it worse.

In addition to this information, your doctor may ask how the pain started. For example,  what you were doing when you got the injury?

In many cases, your doctor may initially advise a period of conservative home care. Most lower back strains respond positively to this treatment within a short period.

However, your back may not feel better after a week or two of this care. If so, your doctor may suggest further examination. At this point, he or she may do some imaging studies of your back. These may include magnetic resonance imaging (MRI) studies, X Rays or CT scans.


Your doctor will likely recommend a period of self care at home as an initial treatment for your muscle strain. This would include:

  • A period of reduced activity to allow the injured lower back muscles to heal. You should avoid any activity that will stress those muscles, such as heavy lifting;
  • However, your doctor will likely advise against complete bed rest. This may cause your back muscles to become weaker. As a result, you may be more vulnerable to back injuries in the future;
  • Possibly wearing a back belt for additional lower back or lumbar support;
  • Applying ice or a cold compress to your lower back for control of pain and swelling. Do this for periods of 15-20 minutes or so, and at intervals of 2-3 hours;
  • After a few days of ice or cold therapy your swelling may have started to recede. At this point, your doctor may suggest switching to heat therapy. This may involve using a heating pad, also for periods of around 20 minutes at a time. The Theratherm heating pad could be used for this purpose. As an alternative, you can take frequent warm baths or try using moist heat therapy;
  • To further reduce intense pain, your doctor may prescribe the use of pain relief medication such as aspirin;
  • Taking anti inflammatory medications such as Advil can also help to mitigate lower back swelling and inflammation and therefore reduce pain;
  • If you are experiencing muscle spasms, your doctor may suggest using muscle relaxants.

As part of your recovery process, your doctor may suggest a course of physical therapy. This will include back stretching and strengthening exercises. They will help you perform strenuous and demanding tasks upon your return to regular activity with less risk of reinjury.

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