Pulled muscles, or strains, are common in the lower back because this area supports the weight of the upper body. Exercises, cool packs, and pain relief medication can treat a pulled muscle in the lower back.
Anyone can get a lower back or lumbar strain. They occur when a muscle or tendon tears, and can be very painful. A strain may make movement difficult until a person recovers.
In this article, we discuss the symptoms and causes of a pulled muscle in the lower back and explain what treatment options are available.
Anyone who strains a muscle in the lower back should rest to avoid further damage. However, they should not stop moving altogether. Where possible, try to continue with some activity. Gentle movements that cause no pain can aid the healing process.
Ice packs, heat, and medicines can also help relieve swelling and pain. People can try:
- wrapping an ice pack, or bag of frozen peas, in a towel and applying to the back
- wrapping a heat pack in a towel and applying to the area
- taking aspirin or ibuprofen to reduce swelling and pain, unless otherwise instructed by a doctor
Do not apply ice or heat packs directly to the skin, as this could cause burns.
The following exercises might also help treat a pulled muscle in the lower back. However, this depends on the cause, severity of the pain, and whether a person has the strength to move slowly and carefully. Sudden movements could make the pain worse.
Only perform exercises that feel comfortable and stop if they cause any pain.
Bottom-to-heels stretch
- Kneel on all fours with the knees under the hips and the hands under the shoulders.
- Keep the back and neck straight and bend the elbows slightly.
- Move the buttocks slowly back toward the heels.
- Hold the stretch while taking one deep breath in and out and then return to the starting position.
- Repeat 8–10 times.
Pelvic tilts
- Lie on the back with a flat cushion under the head.
- Bend the knees, keeping the feet straight and hip-width apart.
- Keep the upper body relaxed with the chin tucked in.
- Slowly flatten the lower back into the floor and lift the tailbone.
- Slowly perform the reverse movement, tilting the pelvis toward the heels.
- Repeat 10–15 times.
Back extensions
- Lie on the front with the chest flat on the floor. Put the hands on the floor either side of the chest.
- Slowly push through the hands and arms to lift the chest and then the belly off the floor. Keep the hips and pelvis on the floor.
- Relax the back and use the arms to do the pushing.
- Hold at the top for 5–10 seconds and then return to the starting position.
- Repeat 8–10 times.
To avoid putting strain on the back, a person should:
- stretch before exercising
- avoid slouching or hunching over
- wear comfortable, low-heeled shoes
- maintain a moderate weight
- sit in a chair with lumbar support
The following tips may also be beneficial:
Lift objects carefully
A person can help avoid pulling the muscles in the lower back by ensuring that they take care when lifting heavy objects.
To lift objects safely, a person should:
- Keep the object close to the waist: This positioning can reduce the amount of pressure on the back.
- Maintain a stable position: Keeping the feet apart with one leg slightly forward can help with balance.
- Avoid bending the back: A person should keep the back straight when lifting an object, instead bending at the knees to lift it.
- Avoid twisting: A person should avoid twisting the back while lifting heavy objects.
Practice yoga
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People considering yoga should speak with a doctor or physiotherapist before trying it for a current lower back strain. As a preventative method, start slowly and build up strength before attempting more challenging poses.
People who are prone to lower back injuries may prefer to do yoga with the advice of a yoga instructor, as there are some postures they may need to avoid.
A person can try the following yoga exercises:
Most lower back strains and sprains should recover in 2 weeks, and according to the American Association of Neurological Surgeons (AANS), more than 90% of people recover fully in 1 month.
A person should avoid vigorous exercise for 8 weeks to reduce the risk of damaging the back further.
If a person twists or pulls a muscle in the lower back, they will feel a sudden pain in one particular area. This may lead to:
- restricted movement
- difficulty walking, bending, or standing straight
- swelling and bruising
- muscle cramping or spasms
According to the AANS, a pulled muscle, or strain, is the most common cause of lower back pain.
A strain is a tear in either a muscle itself, or in one of the tendons that attach the muscles to the spinal column. Strains happen when a person stretches the muscles or muscle fibers beyond their typical range of movement.
Another cause is a sprain, which occurs when a person overstretches or tears a ligament. Ligaments are bands of tissue that hold the vertebrae of the spine in place.
Causes may include:
- twisting
- overstretching
- lifting heavy objects
- sports that require pushing and pulling, such as football or soccer
Other risk factors include:
- bending the lower back excessively
- a weak back or abdominal muscles
- poor posture
- tight hamstrings
If the pain is on the right side of the back, it may be due to appendicitis. A person should seek emergency medical help if they suspect that this is the cause of their lower back pain.
Other symptoms of appendicitis may include:
- appetite loss
- vomiting
- nausea
- constipation
- low grade fever
- swollen abdomen
Learn more about pain in the lower right back.
Other causes of pain on either side of the lower back, or both sides, include:
If the pain has not eased after 1–2 weeks, a person should see a doctor.
In some circumstances, a person may need to go to the emergency department or call 911. It is important to seek medical help if:
- a person hears a crack when they sustain the injury
- the injured part of the back is numb, discolored, or cold to the touch
- a fever accompanies the pain
- a person has lost control over the bladder or bowels
- a person is unable to stand
- urinating is painful or produces bloody urine
- there is severe pain in the abdomen
A doctor is likely to perform a physical examination to diagnose a lumbar strain. If they need to do further tests to examine the cause of the lumbar strain, the doctor may request:
They might also order an electromyogram to examine the muscle and nerve function or a radionuclide bone scan to look at the blood flow to the bone, as well as cell activity.
A pulled muscle in the lower back can be painful. However, with the right treatment at home, most strains get better after a few weeks.
A person should see a doctor if they hear a crack when the injury occurs, or if they develop a fever or experience incontinence afterward.
Factors such as carrying extra weight and having weak muscles can make a person more likely to experience sprains or strains. It is important to lift heavy objects carefully and warm up before doing exercise.