Pulled Back Muscle

A pulled back muscle can feel very debilitating.

Causes of a Pulled Back Muscle

Low back strain, or a pulled muscle in the lower back, is a common complaint. A pulled muscle in the back can be acute or chronic. What causes a pulled lower back muscle has to do with the ligaments and muscles in the back, which hold the spinal column bones in place. Overstretching these muscles could create tiny tissue tears, weakening the muscles so that the bones are no longer held correctly in place. When the spine becomes unstable, lower back pain results. The pain may not be limited to the back, however, since “nerves stretch out from the spinal cord” to other areas of the body. The pulled back muscle, or low back strain is typically caused by falling, extreme exertion, repeatedly crouching or bending, or lifting objects that are too heavy, especially if the person is not in shape. Other causes of back strain include poor posture, stress, obesity, or sitting for too long in the same position. Sometimes something as simple as a severe cough can cause back strain. Other types of back pain, besides a pulled back muscle, include arthritis, fractures, slipped discs, pinched nerves, or infections.¹

Symptoms of a Pulled Back Muscle

Muscle spasms or cramping are possible with a pulled back muscle. In addition, patients could have “decreased function and/or range of motion of the joint”, leading to trouble with “walking, bending forward or sideways, or standing straight”. There might even be a feeling of popping or tearing when the injury occurs. These types of back injuries are “the most common complaint to health care professionals”, besides headaches.² Symptoms of back strain include stiffness and pain in the back, as well as buttocks and leg pain, particularly at the back of the thigh. In addition, the pain worsens when coughing, stretching, or sneezing. Back strain and pulled muscles can be similar to other conditions, so if a patient has weakness or numbness in the legs, or bladder or bowel problems, it is very important to seek medical attention to rule out nerve damage. Medical doctors may examine the patients and use scans (CT, MRI, X-rays) if conservative treatment does not work.³

Conventional Treatments for Back Pain

Healthcare professionals generally recommend icing the back right after the injury or physical activity for about “20-30 minutes every 3-4 hours for 2-3 days”. Following that period of time, a patient can then use a hot water bottle or heating pad, as well as take a hot bath, to get relief. Doctors might recommend NSAIDs, but over-the-counter medications and prescription muscle relaxants and painkillers come with side effects. For some patients, a support belt or girdle could be useful for “short-term or for support with heavy or repetitive lifting”. Physiotherapy is recommended more than inactivity, which could worsen the situation. In the future, patients should “maintain good muscle tone” in the lower back and abdomen. Bed rest is no longer recommended; instead, light physical activity—after resting for a couple of days—has better results. Depending on the severity of the injury, the back can heal in days or weeks. Healthcare professionals will typically suggest a regular exercise routine to build strength, such as low-impact sports, stationary biking, or swimming. Regular activities should be avoided until the patient can move without stiffness and when they can bend, twist, walk, run, or jump without pain. Pushing for regular activities too soon can lead to chronic back pain. In addition, the worst sleeping position is on the stomach. Sleeping on the back, or with a pillow between the legs on the side, is best. Injuries can be prevented by bending at the knees (and not the waist) when lifting, by having good posture, and by losing weight.⁴ If symptoms continue for over two weeks, more treatment may become necessary. A complication of back sprains and strains is “reduced activity, which can lead to weight gain, loss of bone density, and loss of muscle strength and flexibility”. Other tips to prevent back injury include eating a healthy diet, stretching, wearing proper shoes that fit, preventing falls, using “good body mechanics when sitting, standing and lifting”, and stopping smoking, since “nicotine interferes with blood flow”.⁵

Complementary and Alternative Treatments

Aside from medical healthcare, chiropractic, massage, and even acupuncture can be useful for patients with back injuries. Some patients might consider cupping therapy to reduce muscle spasms by increasing blood flow to the traumatized area. A foam roller can also provide some relief for back pain.⁶ Massage is beneficial because it improves blood flow to the back, while it loosens muscles and releases endorphins. Endorphins are “the body’s natural pain killers”. Chiropractic manual manipulation also loosens the tight muscles in the back, and it promotes healing as well.⁷ It is important that massage is only done with the fingertips and that it does not press too deeply into the muscle tissue. Chiropractic also needs to be done gently, “once the initial pain of a pulled back muscle begins to subside”. These treatments not only “correct spinal misalignment”, but they can “reduce the chance of myofascial triggers near the area of injury”. Chiropractors also recommend moist heat, strengthening exercises, reducing stress, better posture, and avoiding “muscle fatigue”.⁸ A muscle strain (pull, tear) can be treated not only with ice and heat therapy, massage, acupuncture, and chiropractic, but also electrical stimulation, ultrasound, nutrition planning, laser therapy, and physical therapy.⁹ Muscle spasms could be caused by a variety of factors, such as excessive exercise, dehydration, trauma, injury, or even as a symptom of a disease such as multiple sclerosis (MS). The most common treatment a chiropractor uses for back pain is joint manipulation to “restore normal motion”. Soft tissue manipulation is also frequently used, such as “therapeutic stretching and massage therapy” in order to “reduce fluid, decrease scar tissue and provide relief”. Patients can then be taught exercises and stretches to try at home, between visits, to speed their recovery and prevent future injury.¹⁰ Muscle strains are caused by a combination of contraction and tension, not from just excess stretch. There are 3 grades of muscle strain: mild (first degree), where few fibers are torn, moderate (second degree), in which more fibers are injured and the patient experiences more pain, and severe (third degree), which is a “complete rupture of the muscle-tendon unit” and there is “significant pain”. While it is typical the muscle strains come from acute injuries, they may also arise from repetitive force. Initial inflammation typically reduces in about 72 hours. It is not uncommon for strains to occur again in the same areas of the body, since the “original strain is a weak point” and “vulnerable to re-injury”. Massage therapy techniques for muscle strain include “effleurage, stripping, broad cross-fiber sweeping”, and “deep transverse friction massage is used to develop a healthy, functional scar”. A functional scar is “at the site of the tearing” is important to “prevent scar tissue from adversely binding adjacent fibers”. The goal of massage therapy is to reduce tension in the muscle. Massage is helpful in reducing stress and increasing blood flow, as well, which is beneficial to the healing process.¹¹