Muscle strain or low back pain

Overview

Back pain is one of the most common medical problems in the United States. It can be a dull, constant ache or a sudden, sharp pain that makes it hard to move. It may start suddenly from lifting something heavy or a fall, or come on slowly.

Most of the time it comes from a strained muscle or ligament, and doctors often can't find one exact cause. The good news is that most back pain goes away on its own within a few weeks. Staying gently active helps you heal faster than resting in bed.

Symptoms

Back pain from a strain is usually felt in the lower back and may spread to the buttocks.

• Back pain, dull or sharp, often in the lower back
• Muscle pain or tightness after activity
• Pain that gets worse with lifting, bending, or twisting
• Stiffness, especially in the morning

Less common

• Pain that spreads into the buttocks or hip
• Muscle spasms
• Pain going down the leg (can be sciatica)

How it usually goes

• Days 1–3: Pain is often worst. Use cold packs and keep moving gently.
• Weeks 1–2: Most people feel much better and can do more.
• After 4 to 6 weeks: See a healthcare professional if it isn't getting better. Pain that lasts 3 months or more is chronic back pain.

When to get medical care

Causes

Most low back pain comes from strained muscles or ligaments, from lifting something heavy, a sudden twist, poor posture, or overuse.

Other causes include a herniated disc, arthritis, narrowing of the spine (spinal stenosis), and, rarely, infection, a fracture, or cancer. Kidney problems can also cause pain in the back or side.

Who is more likely to get it

• Age, since back pain becomes more common in your 30s and 40s
• Lifting, twisting, or bending at work or home
• Not being active, or weak core muscles
• Being overweight
• Smoking

Possible complications

• Chronic low back pain: Pain that lasts 3 months or more
• Sciatica: Pain, numbness, or tingling down one leg
• Cauda equina syndrome: Rare emergency; bladder or bowel changes and numb groin

Diagnosis

A healthcare professional can usually figure out what's going on by asking about your pain and examining your back. Most people with new back pain don't need X-rays or scans.

Questions you may be asked

• When and how the pain started, and whether you were injured
• Where it hurts, and whether pain goes down your leg
• Whether you have numbness, tingling, or weakness in your legs
• Whether you have trouble peeing or controlling your bowels
• Whether you have a fever, unexplained weight loss, or a history of cancer

The exam

They'll check how you move and bend, press on your back, and test the strength, feeling, and reflexes in your legs.

Tests

Tests are usually only needed if there are warning signs or pain lasts:

• X-ray, CT, or MRI: After a bad fall or injury, with nerve problems, or for pain that doesn't get better after several weeks.
• Blood tests: If an infection or another illness is possible.

Treatment

Most new back pain gets better with home care. Doctors recommend trying treatments that don't use medicine first, like staying active, heat, and exercise.

Self-care

• Stay active: don't stay in bed all day; limit only what makes the pain worse, and add activity slowly
• Use cold packs in the first days, and heat later to relax muscles
• Take a pain reliever if you need it (see Medicines)
• Avoid heavy lifting, bending, and twisting until it feels better
• Try gentle stretches and walking as the pain eases

Medicines

Medicine can ease pain while you stay active. Ask a pharmacist if you take other medicines.

Medicine names link to drug information from the U.S. National Library of Medicine (MedlinePlus). OwieClear doesn't give doses: follow the label or your healthcare professional.

If pain isn't getting better after a few weeks, your healthcare professional may suggest physical therapy, a stronger medicine for a short time, or other treatments like massage, spinal manipulation, or acupuncture. Surgery is only for certain problems, like a herniated disc pressing on a nerve, and isn't right for most back pain.

How it compares

Prevention

These habits help protect your back:

• Exercise regularly, including stretching and core strengthening
• Lift with your legs, keep the load close, and don't twist
• Keep a healthy weight
• Sit and stand with good posture, and take breaks from sitting
• Don't smoke

Which doctor treats this

• Urgent care or the ER can treat it first. For minor problems, your primary care provider can help.
• They may send you to a physical therapist, or a sports medicine doctor.
• A physical therapist can help with exercises to rebuild strength and motion.

Back to school, work, or sports

• School or desk work is often OK within days. Jobs with lifting may need light duty for a while.
• Go back to sports only when your doctor says it's OK and you have full motion and strength without pain.

Children, pregnancy, and older adults

• Children and teens: Back pain is less common in children. See a healthcare professional for back pain that lasts, wakes a child at night, or comes with fever or weight loss.
• Pregnancy: Back pain is common in pregnancy. Ask which pain relievers are safe; ibuprofen and naproxen usually aren't recommended.
• Older adults: Back pain after a minor fall can be a broken bone from weak bones. Get checked.

Outlook

Most people with new back pain feel better within a few weeks, and many within days. Back pain can come back, so regular exercise and good lifting habits help.

Getting ready for your visit

A little preparation helps.

What to bring

• When and how the pain started
• What makes it better or worse
• Medicines you've tried
• Any numbness, tingling, weakness, or bladder or bowel changes

Questions to ask

• Do I need an X-ray or MRI?
• What activities are safe for me now?
• Would physical therapy help?
• When should I come back if it isn't better?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Muscle strain or low back pain