A strained or pulled lower back muscle is a common, but painful, injury. Treating these overstretched or torn soft tissues is typically straightforward, and it helps if you act fast. Here’s how:
Stop what you’re doing
When your back pain suddenly flares up, discontinue the physical activity that you’re doing. Don’t push through your workout or continue to do chores around the house. Your immediate priority is protecting your lower back from further injury. Overusing a strained back muscle may worsen the damage and delay the recovery.
Consider nonsteroidal anti-inflammatory drugs (NSAIDs)
Typically when a lower back muscle is stretched or torn, the surrounding area becomes inflamed. The body’s natural response is to rush blood to the injured area, which causes swelling and can sometimes trigger spasms.
Certain over-the-counter medications can help to reduce the inflammation. These nonsteroidal anti-inflammatory drugs (NSAID) include ibuprofen (Advil, Motrin) and naproxen (Aleve). Taking these medications may temporarily reduce swelling and provide relief. Talk to your doctor or pharmacist and follow the label’s directions before you use these medications.
Applying ice to your lower back is another way to keep the inflammation and swelling down. Applying ice can also decrease tissue damage and ease your soreness.
If you don’t have an instant ice pack on hand, you can:
- Take a small plastic bag and fill it with ice (and include water to smooth out the bumps).
- Grab a bag of frozen vegetables from the freezer.
- Put a wet sponge in the freezer. Once it’s frozen, put in a small plastic bag.
- Fill a sock with rice and place it in the freezer.
Whatever you use, wrap it in a towel first to protect your skin from ice burn.
Apply cold therapy for no more than 20 minutes at a time with at least 2 hours rest between applications.
Lie on your back to sleep or rest
Sometimes a back muscle strain can make it difficult to sleep. Find a firm surface—such as a floor, recliner, or mattress—and lie on your back to minimize stress on the spine.
If you’re on a mattress or floor, use pillows to recline. Place two or three pillows behind your upper back and a pillow under your knees to elevate them. This position, as opposed to lying on your stomach, may be most comfortable when managing a lower back strain.
If needed, get plenty of rest in this position for the next day or two. And remember to take short walks occasionally to reduce discomfort and stiffness.
Change it up after a day or two of rest
After 24 to 72 hours, you may consider:
- Switching from ice to heat. Place a heat pack or electric heating pad against your lower back. The warmth will soothe your strained muscles and increase blood flow to the injured area. Heat therapy can also reduce stiffness so you can more easily get up and exercise. Apply heat for up to 20 minutes at a time and use a barrier to protect your skin.
- Gentle exercises and stretches. Don’t stay immobile for too long; your muscles could become weaker, leading to more pain and stiffness. Get up and walk around, even if for just a few minutes at a time. Incorporate gentle back-strengthening exercises into your day to restore your mobility and protect your back against future injury.
Some pain and stiffness are expected for the next couple of weeks as your muscles heal. If symptoms don’t improve or they continue to interfere with daily activities, contact your health care provider.