A pulled back muscle may happen suddenly while lifting a squirming child or overexerting at the gym. It may also appear over time as weak muscles steadily debilitate and trigger injuries. A pulled muscle in the back refers to one of two injuries:
- A sprain, which is when the ligaments that hold bones together are torn or stretched.1
- A strain, which is when muscles are stretched or torn.1
Both injuries may have similar symptoms, with the primary one being pain. The most common location for a pulled back muscle is in the lumbar spine, which is the lower back area. This painful injury is the most common cause of disability and lost work time among people under the age of 45.2
Pulled Back Muscle Symptoms
The soft tissue in the lower back may become damaged for many different reasons, but some of the most common may include3:
- Twisting the spine or using poor form while lifting a heavy object
- Falling in a way that puts too much pressure on the spine
- Poor posture that stresses the connective tissues in the spine
- Sports injuries caused by pivoting, twisting, or physical impact
- A sedentary lifestyle followed by sudden intense exercise, since weak muscles and ligaments are more vulnerable to injury4
A sprain or strain in the back may cause symptoms such as5:
- Dull, aching pain in the lower back
- Difficulty standing, sitting, and twisting
- Stiffness in the lower back
- Muscle spasms
- Pain that radiates to other areas—lower back sprains and strains may radiate to the hips or buttocks, while injuries in the upper back can cause neck or head pain
Although sprains and strains are different injuries, the treatment and symptoms are similar.
Pulled Back Muscle Recovery Time
A pulled back muscle may take anywhere from days to weeks to achieve a full recovery.6
Doctors assign a grade to sprains as a measure of severity. Grade 1 means that there is slight stretching in the ligament. Grade 2 means there is minimal tearing. Grade 3 means there is significant tearing.7 Strains follow a similar grading scale. More severe strains and sprains take longer to heal.8
Proper treatment may help speed recovery. To try and recover as quickly as possible, consider a proactive treatment approach that includes physical therapy and the techniques described below.9
Treatment for a Pulled Back Muscle
Except in the cases of severe injuries, most of the time, a pulled back muscle may be treated at home with RICE (rest, ice, compression, and elevation).7 Working with a physical therapist may help move along your recovery because you may have access to more advanced treatments such as cryotherapy, active compression, and contrast therapy.
The application of therapeutic cold has been proven to help reduce the pain and swelling associated with a pulled muscle in the back. It may also shorten recovery time and enable you to more quickly return to sports and other activities.10
While ice packs are one way to apply cold, they get warmer as your body heat transfers to the ice pack. By the end of a treatment session, the ice pack is no longer at a therapeutic temperature and is, therefore, less effective. Another problem is that an ice pack delivers cold only to an area limited to the size of the ice pack itself.
A cryotherapy system solves these problems by using body-conforming wraps to deliver therapeutic cold at a consistent temperature over a larger surface area. This means that you get the same therapeutic benefit throughout the duration of the treatment session, and the cold is able to reach more of your damaged tissues.
Static compression with a brace or elastic bandage may be good to help prevent excess swelling, but active compression takes it a step further by helping pump away excess fluid. With the same body-conforming wraps, air is pneumatically pumped through the wrap to mimic natural “squeeze and release” muscle contractions, helping flush away excess fluids. Active compression also helps enhance the benefits of cold therapy by promoting deeper, longer-lasting penetration of therapeutic cold.11
As you recover from a pulled back muscle, the initial inflammation may likely die down after a few days, but that doesn’t mean the injury is healed. At this point, it may be safe to start using heat therapy to help promote circulation, which brings freshly oxygenated blood and nutrients to the healing tissues.
However, applying only heat may actually cause additional swelling, which is why contrast therapy (alternating heat and cold) may be a good treatment choice. By quickly alternating between heat and cold, you get the benefits of both types of therapy without the risk of swelling that heat alone may cause.12,13
Using these treatment approaches may help you recover more quickly from a pulled muscle in the back. Although the recovery time may vary depending on the severity of the injury, shaving off any amount of recovery time is worth the effort.
- Low back strain and sprain. American Association of Neurological Surgeons. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain. Accessed May 8, 2019.
- Lumbar sprain/strain. Landmark Healthcare. http://uni.lmhealthcare.com/RoboHelp/PT OT CPG/Orthopedic_-_Lumbosacral_Non-Specific/Lumbar_Sprain_Strain.htm. Accessed May 8, 2019.
- Back pain. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906. Published August 4, 2018.
- Low back pain fact sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet. Published August 8, 2017.
- Hamilton K. Pulled back muscle and lower back strain. Spine-health. https://www.spine-health.com/conditions/lower-back-pain/pulled-back-muscle-and-lower-back-strain. Published September 8, 2017.
- Lumbar back strain. Shoreline Orthopaedics. https://www.shorelineortho.com/specialties/fractures_sprains_and_strains-lumbar_back_strain.php. Accessed May 8, 2019.
- Sprains, strains and other soft-tissue injuries. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/sprains-strains-and-other-soft-tissue-injuries/. Published July 2015.
- Muscle strain. Harvard Health Publishing. https://www.health.harvard.edu/a_to_z/muscle-strain-a-to-z. Published December 2018.
- Physical therapy in our clinic for muscle strains. Rocky Mountain Therapy Services. http://www.rmtsinc.com/Injuries-Conditions/Muscle-Injury/Muscle-Injury-Issues/Muscle-Strains/a~8609/article.html. Accessed May 8, 2019.
- Hubbard TJ, Aronson SL, Denegar CR. Does cryotherapy hasten return to participation? A systematic review. Journal of Athletic Training. 2004;39(1):88-94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC385267/.
- Quillen WS, Rouillier LH. Initial management of acute ankle sprains with rapid pulsed pneumatic compression and cold. Journal of Orthopaedic & Sports Physical Therapy. 1982;4(1):39-43. https://www.jospt.org/doi/abs/10.2519/jospt.19188.8.131.52.
- When to use hot and cold to treat a muscle injury. United Hospital Center Orthopaedics. https://wvorthocenter.com/when-to-use-hot-and-cold-to-treat-a-muscle-injury/. Published May 4, 2017.
- Halvorson GA. Therapeutic heat and cold for athletic injuries. The Physician and Sportsmedicine. 1990;18(5):87-94. https://www.tandfonline.com/doi/abs/10.1080/00913847.1990.11710045.