Low Back Pain from Muscle Strain

The majority of episodes of acute lower back pain are caused by damage to the muscles and/or ligaments in the low back. Even though a muscle strain doesn’t sound like a serious injury, the low back pain can be surprisingly severe and is the cause of many emergency room visits each year.

• A muscle strain happens when the muscle is over-stretched or torn, resulting in damage to the muscle fibers (a pulled muscle).
• A lumbar sprain happens when ligaments are stretched too far or torn. Ligaments are very tough, fibrous connecting tissues that connect the muscles to the bones and joints.

For practical purposes, it doesn’t matter if the ligaments or muscles are the source of the lower back pain, since the treatment for all of them is the same.

When the muscles or ligaments in the low back are strained or torn, the area around the muscles can become inflamed. With inflammation the muscles in the back can spasm and cause both severe lower back pain and difficulty moving. Pain is often relieved with rest.

Lower back pain from muscle strain occurs most frequently from lifting a heavy object, lifting while twisting, or a sudden movement or fall. The pain is usually localized (doesn’t radiate to the leg), and there may be muscle spasms or soreness upon touch. The patient usually feels better when resting.

Low back pain treatment

Fortunately, muscle strains usually heal with time (a couple of days or weeks) because muscles in the low back have a good blood supply to bring the necessary nutrients and proteins for healing to take place.

If the pain is severe, the patient may be advised to rest, but for no more than one or two days. Pain medication, ice application and/or heat application may all help alleviate the pain.

If an episode of low back pain lasts for more than two weeks, the muscles may start to weaken since using the muscles hurts, the tendency is to avoid using them. This process leads to disuse atrophy (muscle wasting), and subsequent weakening, which in turn causes more low back pain because the muscles are less able to help hold up the spine.

Exercise helps prevent acute low back pain

As a general rule, people who are active and well-conditioned are much less likely to suffer from low back pain due to muscle strain, as regular exercise stretches the muscles so they are less likely to strain, tear or spasm.

There are three types of muscles that support the spine:

• Extensors (back muscles and gluteal muscles)
• Flexors (abdominal muscles and iliopsoas muscles)
• Obliques or Rotators (side muscles)

While some of these muscles are used in everyday life, most do not get adequate exercise from daily activities and tend to weaken with age unless they are specifically exercised. See Abdominal and back exercise recommendations.

A complete exercise program for the low back should consist of a combination of :

• Stretching
• Strengthening
• Aerobic conditioning.

For more information, please see Back Exercise and Fitness Health Center

• Peter F. Ullrich, Jr., MD

May 25, 2007

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