Muscle Spasms, Sprains and Strained Muscles
The back is a complex structure of bone and muscle, supported by cartilage,
tendons, and ligaments, and fed by a network of blood vessels and nerves.
The back—especially the lumbar, or lower back—bears much of
the body’s weight during walking, running, lifting, and other activities.
It makes sense, then, that injuries to the lower back—such as strains
and sprains—are common.
What is a strain?
A strain is an injury to either a muscle or tendon. Tendons are the tough,
fibrous bands of tissue that connect muscle to bone. With a back strain,
the muscles and tendons that support the spine are twisted, pulled, or torn.
What is a sprain?
A sprain is the stretching or tearing of a ligament. Ligaments are the
fibrous bands of tissue that connect two or more bones at a joint and
prevent excessive movement of the joint.
What are the symptoms of a back strain or sprain?
Symptoms of a strain or sprain include:
- Pain that worsens with movement
- Muscle cramping or spasms (sudden uncontrollable muscle contractions)
- Decreased function and/or range of motion of the joint (difficulty walking,
bending forward or sideways, or standing straight)
In some cases, the person may feel a pop or tear at the time of the injury.
What causes a back strain or sprain?
Twisting or pulling a muscle or tendon can result in a strain. It can also
be caused by a single instance of improper lifting or by overstressing
the back muscles. A chronic strain usually results from overuse involving
prolonged, repetitive movement of the muscles and tendons.
A sprain often results from a fall or sudden twist, or a blow to the body
that forces a joint out of its normal position. All of these conditions
stretch one or more ligaments beyond their normal range of movement, causing injury.
In addition, there are several factors that put a person at greater risk
for a back strain or sprain, including excessively curving the lower back,
being overweight, having weak back or abdominal muscles, and/or tight
hamstrings (muscles in the back of the thighs). Playing sports that involve
pushing and pulling—such as weightlifting and football—also
increases the risk of a low-back injury.
How common are back strains and sprains?
Strains and sprains are very common injuries. Next to headaches, back problems
are the most common complaint to health care professionals.
How are back sprains and strains diagnosed?
Mild strains and sprains can usually be diagnosed based on a medical history—including
a review of the method of injury and the symptoms—and a physical
examination by a health care provider. In cases of more severe strains
and sprains, especially when there is weakness or loss of function, an
X-ray may be taken to rule out a fractured (broken) or herniated (bulging)
disc as the cause of the back pain.
How are back strains and sprains treated?
The treatment for strains and sprains is similar, and often done in two
phases. The goal of the first phase is to reduce the pain and spasm. This
may involve rest, and the use of ice packs and compression (pressure),
especially for the first 24 to 48 hours after the injury. An over-the-counter
nonsteroidal anti-inflammatory drug, such as ibuprofen (Motrin®),
may be recommended to help reduce pain and swelling.
After the first 24 to 48 hours, returning to normal activities as tolerated
is advisable. Prolonged bed rest or immobility prolongs symptoms and delays
recovery. Most people with lumbar strain/sprain symptoms improve in about
2 weeks. If symptoms continue for more than 2 weeks, additional treatment
may be required.