First Aid for Intense Pain from a Pulled Lower Back Muscle

A pulled muscle in your lower back can send intense flareups of pain, spasm, and stiffness, causing many people to end up in the emergency room. When this injury happens, it’s smart to know what you can do to immediately and effectively bring down the pain to a tolerable level while also helping your body heal.

As a general guideline, rest during the initial day or two after your injury, moving slowly and gently to allow your muscle tissue to recover and begin the regeneration process. You may use a back brace intermittently for additional stability. ¹ Delos D, Maak TG, Rodeo SA. Muscle injuries in athletes: enhancing recovery through scientific understanding and novel therapies. Sports Health. 2013;5(4):346–352. doi:10.1177/1941738113480934 ^{, 2} Järvinen TA, Järvinen M, Kalimo H. Regeneration of injured skeletal muscle after the injury. Muscles Ligaments Tendons J. 2014;3(4):337–345. Published 2014 Feb 24.

Below you will find effective treatments that you can employ at home to soothe your muscle soreness.

Use cold first, then switch to heat therapy

During the initial few days after the strain injury, your muscle tissues begin to repair. The healing process causes inflammation to occur within the healing muscle fibers. The use of cold and heat therapy can help reduce inflammation in the following ways:

• Cold therapy is surprisingly effective in reducing pain, muscle spasm, swelling, and inflammation. ¹ Delos D, Maak TG, Rodeo SA. Muscle injuries in athletes: enhancing recovery through scientific understanding and novel therapies. Sports Health. 2013;5(4):346–352. doi:10.1177/1941738113480934 ^{, 3} Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2014;127(1):57-65. doi:10.1080/00325481.2015.992719 ^{, 4} Tiidus PM. Alternative treatments for muscle injury: massage, cryotherapy, and hyperbaric oxygen. Curr Rev Musculoskelet Med. 2015;8(2):162–167. doi:10.1007/s12178-015-9261-3 An ice pack, ice cubes wrapped in a towel, or a bag of frozen vegetables can be used to cool down your muscle fibers.

  See Ice Massage for Back Pain Relief

• Heat therapy serves to facilitate blood, oxygen, and nutrient flow into your muscle fibers to promote healing, recovery, and pain relief. ³ Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2014;127(1):57-65. doi:10.1080/00325481.2015.992719 A hot water bottle or heat pack can be used to deliver heat to your muscles. Low-level continuous heat is another option, such as from an adhesive heat wrap.

  See Benefits of Heat Therapy for Lower Back Pain

It is best to use cold therapy during the initial day or two after your injury followed by heat therapy. Avoid using cold therapy for too long, because excessive cooling may slow down the natural healing process of the muscle tissue. ¹ Delos D, Maak TG, Rodeo SA. Muscle injuries in athletes: enhancing recovery through scientific understanding and novel therapies. Sports Health. 2013;5(4):346–352. doi:10.1177/1941738113480934 ^{, 3} Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2014;127(1):57-65. doi:10.1080/00325481.2015.992719 ^{, 4} Tiidus PM. Alternative treatments for muscle injury: massage, cryotherapy, and hyperbaric oxygen. Curr Rev Musculoskelet Med. 2015;8(2):162–167. doi:10.1007/s12178-015-9261-3

See How to Apply Heat Therapy

It is important to use heat and cold as tolerated, intermittently for 15 to 20 minutes at a time, and with a 2-hour break in between—to avoid skin and/or nerve damage. Heat therapy can be used for longer, provided the heat is a low-level, such as with a commercial heat wrap.

Massage your lower back

Massaging by gently stroking or kneading your lower back can help promote blood flow, relax your sore muscles, relieve stiffness, ⁵ Koren Y, Kalichman L. Deep tissue massage: What are we talking about? Journal of Bodywork and Movement Therapies. 2018;22(2):247-251. doi:10.1016/j.jbmt.2017.05.006 and spur the release of endorphins—your body’s natural pain-fighting hormone.

If you’re unable to visit a massage therapist, physical therapist, or other qualified health professional, try a DIY massage by securing two tennis balls with duct tape and placing them between your chair and lower back. Gently move your back from side-to-side to enable kneading of the sore muscles as they come in contact with the secured tennis balls.

See Massage Therapy for Lower Back Pain

Take a natural muscle relaxant

Muscle relaxants can be effective in relieving muscle pain by decreasing spasms. Effective natural muscle relaxants include extracts of:

• Tart cherry
• Chamomile
• Valerian
• Peppermint
• Curcumin (turmeric)

Valerian and chamomile also help promote good sleep, so it’s a good idea to use them before bedtime. Many of these natural options have powerful anti-inflammatory and healing properties as well, so taking them provides additional benefits. ⁶ Meamarbashi A. Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness. Avicenna J Phytomed. 2017;7(1):16–26. Supplements of magnesium may also help relieve muscle spasms.

Natural muscle relaxants are typically safe and commonly consumed in the form of supplements or tea. If you opt for prescription muscle relaxants, such as baclofen, benzodiazepines, cyclobenzaprine, or carisoprodol, they have a potential for substantial side effects, risks, and a possibility for misuse or abuse.

See Side Effects and Risks of Muscle Relaxers

Perform gentle stretches

Returning to normal activity after an initial period of relative rest is crucial for the repair of your muscle tissue. In addition to performing your routine activities, gently stretch the muscle a few times during the day to help elongate and strengthen the tissues, and promote healing. ⁷ Apostolopoulos NC, Lahart IM, Plyley MJ, et al. The effects of different passive static stretching intensities on recovery from unaccustomed eccentric exercise – a randomized controlled trial. Applied Physiology, Nutrition, and Metabolism. 2018;43(8):806-815. doi:10.1139/apnm-2017-0841 Simple stretches for your lower back can be done at home or while at work. Be sure to stretch as tolerated and avoid high-intensity exercises, which may cause further damage to your muscle tissue.

Incorporating stretching exercises as a part of your normal routine can help strengthen and stabilize your lower back, reducing the risk of muscle strains and other injuries in the future. For many, it’s best to learn a stretching exercise with the guidance of a physical therapist, chiropractor, physiatrist, or other qualified health professional.

See Stretching for Back Pain Relief

Try these therapies to see what works best for the pain in your pulled lower back muscle. You may need to combine 2 or more methods a few times per day to alleviate your lower back pain. If your back-muscle pain persists for several weeks, worsens over time, or spreads into your leg(s), consult a doctor for a thorough evaluation and diagnosis.

Learn more:

Pulled Back Muscle and Lower Back Strain

Pulled Back Muscle Treatment