Medically reviewed by Dr. Brian Paris, D.C on Nov. 6, 2018.
If you haven’t already, you probably will at some point experience a pulled back muscle. They’re the most common cause of low back pain.
It could happen during a game of golf, while cleaning the garage, or even on the dance floor.
While we often tend to refer to any soft tissue pain in the back as a “pulled back muscle,” we’re really talking about two separate kinds of back injuries — strains and sprains.
In this article, I’ll show you the difference between those injuries and how to quickly recover from pulled back muscles without taking drugs like NSAIDs.
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[#1] Strains vs. sprains
What’s the difference between a strain and a sprain?
A strain happens when you injure either a muscle or a tendon. Your tendons are tough, fibrous tissues that connect your muscle to your bone.
When you are experiencing back strain, it means that you have twisted, pulled or torn the muscles or tendons that support your spine. If you stretch a muscle too much, you actually cause small tears in the muscle fibers.
A sprain, on the other hand, occurs when you stretch a ligament too far or tear it. Ligaments are the fibrous tissues that connect your bones at your joints.
Sprains and strains may not sound like serious injuries, but the back pain they cause can really hurt!
In fact, the pain can be so excruciating that some people are convinced they’ve done something terrible to their back — and that they’ll need surgery.
The good news is you definitely won’t need surgery. Pulled muscles in the back (whether it’s a strain or sprain) usually heal within days or weeks on their own.
Please note, if you have severe, constant pain that keeps you from sleeping, experience a loss of bladder or bowel control or have progressive lower extremity weakness, you may have a more serious injury to your lumbar spine and should be evaluated by a professional.
Although it’s possible to have a pulled muscle anywhere in your back, these strains and sprains most often occur in the lumbar region, or your lower back. One of the most common symptoms of a pulled back muscle is lower left side back pain.
And they’re so common they’re the second leading complaint doctors hear — after headaches. They’re also the second most common reason people miss work, after the common cold.
Key takeaway: “Pulled back muscle” is a catch-all phrase for two separate types of injury — strains and sprains.
Risk factors for pulled back muscles
While that pulled back muscle may seem to come on suddenly, chances are it was a long time coming.
You could be ignoring some very important warning signs. Which means if you’re not in pain now, you might want to sit up and pay attention.
Do you sit in a chair all day? Do you exercise incorrectly? Are you under tremendous stress? Are you dehydrated? Are you substantially overweight?
Did you honestly answer yes to one or more of those questions?
If so, then you’re at greater risk of muscle imbalances, trigger point pain, and at higher risk for injuries like a pulled back muscle.
But when you do experience pulled back muscles what do you do?
We’ll cover that more in the next section.
Key takeaway: There are several risk factors that can make you more susceptible to pulled back muscles, including stress, poor posture, being overweight and even how hydrated you are.
What NOT to do for a pulled back muscle
When your back hurts, you probably reach for a bottle of painkillers such as NSAIDs and get in bed or crash on the couch. Or you go to the doctor, who may prescribe muscle relaxants.
I’m not a fan of Big Pharma’s pills.
For one, both NSAIDs and muscle relaxants come with side effects. Some are just annoying, while others are downright dangerous.
Muscle relaxants like the popular Flexeril can cause:(i)
- dry mouth or throat
- blurred vision
- drowsiness, dizziness, tired feeling
- loss of appetite, stomach pain, nausea
- diarrhea, constipation, gas
- muscle weakness
And NSAIDs come with their own long list of dangerous side effects, the worst of which is an increased risk of heart attack or stroke.
For short-term pain relief, I recommend natural painkillers. (You can read more about my top recommendation for a natural anti-inflammatory below.)
But there are other ways to relieve the pain and speed up the healing process.
Key takeaway: Big Pharma’s solutions fall short when it comes to pulled back muscles — and may even cause serious side effects.
5 best ways to treat a pulled lower back muscle
Here are the five most important steps you can take now to help your body recover quickly from and treat a pulled back muscle:
1. Apply cold to the pulled back muscle
You should apply ice to your injury as soon as possible. The sooner you apply the ice the more it will help.
The cold will cause nearby blood vessels to constrict and also help minimize swelling and painful inflammation.
The cold also stimulates your body to rush more oxygen-rich blood full of antibodies and vital nutrients to repair the injury and carry away waste products as it attempts to warm the area.
Use an ice pack, a Ziploc bag of crushed ice, or even a bag of frozen vegetables in a pinch.
Apply the cold pack in a circular massaging motion to prevent the ice from resting in one place too long.
Be sure to place a thin towel between the compress and your skin to help prevent frostbite.
Ice can be applied up to 20 minutes at a time. Repeat over the course of the first few days, or after flare-ups.
2. Apply heat to the pulled back muscle
Try applying heat directly to the area that is strained or sprained right after the ice. This is a powerful way to “double-shock” your back muscles out of the pain-spasm cycle.
Apply 20 minutes of ice followed by 20 minutes of heat and repeat up to three times.
This should provide some relief from even severe lower back pain.
There are many ways to apply heat, including a long hot shower, ultrasound, heating pad, and pain cream.
If you want the gold standard in heat for pain relief, try a far infrared heating pad, which produces heat that penetrates much deeper than the superficial heating a standard heating pad offers.
As heat is applied, your back muscles relax and circulation increases again as your body sends fresh blood supply to cool the area back to normal. Repeat heat treatments as necessary.
3. Use natural anti-inflammatories
Think twice before you reach for that bottle of painkillers. It might kill more than just your pain.
The truth is inflammation is a normal part of the healing process. The problem with inflammation is our bodies lose the ability to turn off the inflammatory response as we get older.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help with both pain and inflammation, but they also carry significant cardiac and digestive health risks.
A better approach is to replace what your body stops producing enough of as you age… specifically, systemic proteolytic enzymes.
These are the same enzymes your body uses to naturally quell inflammation once healing is complete and clean up excess scar tissue. By giving your body what it needs to heal instead of masking the symptoms, you both reduce painful inflammation and speed up actual recovery time.
4. Rest – but not too much
Don’t rest too long. A little couch time won’t hurt, but light activity speeds recovery, so avoid lying down for long periods of time.
Growing evidence shows there is little or no benefit to bed rest over staying active.
So use this rule of thumb: listen to your body.
Ultimately, your level of pain will determine your level of activity.
If a certain activity led to a pulled muscle don’t repeat it for at least a week.
For example, if your back pain started after lifting something heavy, avoid lifting heavy objects for at least a week while your pulled back muscle heals.
Also, avoid sitting for too long. Long periods of sitting can tighten your muscles and cause lower back muscle pain and stiffness.
When you sit and stand, use good posture, avoiding slumping in your head and shoulders.
5. Stretching and strengthening exercises
You’ll want to be very careful your first couple of days, but some light stretching can often reduce pain from a pulled muscle in your lower back by relieving tension. Include both strengthening and stretching exercises.
Try this easy stretch while lying in bed. Gently raise your knees from the bed to your chest, then put a slight pressure on your knees for a light stretch in your lower back.
This stretch can help relieve muscle spasms in your back faster than waiting for them to resolve on their own. The stretch should not add to your pain.
Remember to listen to your body.
Sometimes, back support compression braces can be useful during the healing process. This help keeps your spine stable and can help you from further irritating your lower back when you twist or bend throughout the day.
Compression can also assist in reducing swelling after an injury, so compression braces may be useful.
I don’t recommend you wear a compression brace all day, though — just for a few hours or when you know you’ll be most active.
Keeping it on for too long can keep you from healing fully, as you need to be able to strengthen those muscles in order to recover.
Key takeaway: To help your body recover more quickly and reduce pain from a pulled back muscle, alternate cold and heat therapy, use natural anti-inflammatories, get some rest (but not too much!) and try gentle stretches.
How to prevent a pulled back muscle
You can avoid pulled lower back muscles by taking some simple protective steps.
Watch what you eat
Stay away from inflammatory foods, such as baked goods, processed foods, fruit juice, soda, sweetened cereals, and fast food. They make your body more sensitive to pain.
Keep fresh fruits and vegetables the main part of your diet.
Also eat foods rich in back pain-relieving omega-3 fatty acids like salmon, sardines, and walnuts.
You need protein in your diet to help repair damaged tissue and to build and strengthen the muscle.
And don’t forget to drink plenty of water to hydrate tissues and organs and allow your body to regulate its temperature throughout the day.
Many people hold emotional stress in their muscles. Frequent stress, anxiety, and tension can lead to tight muscles and muscle strains.
You may be able to prevent new or recurring back pain with simple techniques such as massage and meditation.
Studies show that massage is an effective way to reduce stress and relax tightened muscles.
And if you haven’t tried meditation, maybe you should.
As little as 10 minutes being still, breathing deep, and centering your thoughts can quiet both mind and body after a stressful day.
Support your back
What kind of support does your desk chair, car seat, or couch offer? Probably not enough.
Try using a back support cushion, or a back orthotic which cradles your pelvis and floats your spinal system to reduce all-day pressure buildup and automatically correct slouched sitting positions and promote good posture.
By improving your sitting posture you can relieve excess strain on back muscles that can make you prone to a pulled back muscle
Key takeaway: Improving your diet, reducing stress and getting the right back support can help prevent future occurrences of pulled lower back muscles.
5 takeaways about pulled back muscles
Key takeaway #1: Pulled lower back muscles (strains and sprains) can be extremely painful, but rarely require medical intervention.
Key takeaway #2: Several lifestyle factors could put you at greater risk for developing a pulled muscle in your back.
Key takeaway #3: Prescription and over-the-counter medications can often do more harm than good when treating a pulled back muscle.
Key takeaway #4: You can speed up recovery and reduce pain with a few simple at-home remedies: cold and heat therapy, natural anti-inflammatories, rest and stretching.
Key takeaway #5: To reduce your risk of pulling a back muscle in the future, focus on cleaning up your diet, reducing stress levels and making sure your back is properly supported.
Editor’s note: This article has been reviewed by a member of our medical advisory board. The content provided is for informational purposes only and should not be construed as medical advice. Please consult with your physician if you have any questions about your health.