Lower Back Strain Injuries Causes, Symptoms & Treatment
A lower back strain occurs when the muscles or tendons that support the spine are overstretched or torn due to excessive force or repetitive stress. Lower back muscle strain is one of the most common causes of low back pain, particularly among athletes and physically active individuals. With appropriate lower back strain treatment, most people recover within a few weeks.
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A strained lower back develops when the soft tissues—muscles and tendons—connected to the vertebrae of the spine are twisted, overstretched, or overloaded. These structures play a vital role in stabilizing the spine and supporting movement. During sports, heavy lifting, or sudden movements, the lower back muscles can exceed their capacity, leading to injury.
Lower back strain injuries can range from mild muscle tightness to more severe muscle or tendon tears. While pain and stiffness are common, most lower back muscle strains heal well with conservative care, allowing athletes and active individuals to return to activity safely.
What causes Lower Back Strain Injuries?
Lower back strain injuries typically occur when the muscles of the lumbar spine are subjected to excessive stress.
How It Happens
A lower back muscle strain often develops when the back muscles are forced to work beyond their normal limits. This may occur due to:
- Sudden twisting or bending movements
- Lifting heavy objects improperly
- Rapid changes in direction during physical activity
- Hyperextension of the spine
These movements can cause small tears in the muscle fibers or tendons, resulting in a strained lower back.
Common Causes
- Repetitive overuse of the lower back muscles
- Poor posture or prolonged sitting
- Inadequate warm-up before physical activity
- Muscle fatigue or weakness
- Suddenly, awkward movements
Chronic repetitive stress and poor spinal mechanics significantly increase the risk of lower back strain injuries.
Sports Commonly Associated with Lower Back Strain
Lower back spinal strain injuries are especially common in sports that involve rotation, lifting, or repeated impact, including:
- Racket sports (tennis, racquetball, squash) – due to repeated twisting motions
- Hockey – frequent bending and body contact
- Football – collisions, sprinting, and sudden directional changes
- Rugby – tackling and forceful engagement
- Basketball – jumping, landing, and rapid movements
- Baseball – rotational stress during throwing and batting
- Weightlifting – improper lifting techniques or excessive loads
Athletes in these sports are at higher risk of developing a lower back muscle strain.
Symptoms
A strained lower back commonly causes localized pain and stiffness. Symptoms may vary in severity depending on the extent of the injury.
Common symptoms include:
- Pain that worsens with movement, especially bending or twisting
- Tenderness over the affected muscles
- Muscle spasms, which can restrict movement
- Stiffness and reduced flexibility in the lower back
Importantly, lower back strain injuries usually do not cause:
- Pain radiating down the legs
- Numbness or tingling in the legs
- Weakness in the legs
The absence of these symptoms helps distinguish a lower back muscle strain from nerve-related conditions.
When to see a doctor
You should see a doctor if you experience symptoms of a lower back strain:
- Do not improve after one week
- Interfere with daily activities or sports participation
- Continue to worsen despite rest
Seek immediate medical attention if you experience:
- Pain radiating down the leg
- Numbness, tingling, or weakness
These symptoms may indicate a more serious condition, such as a herniated disc, sciatica, or nerve involvement, rather than a simple strained lower back.
Diagnosis
Most lower back strain injuries can be diagnosed through:
- A detailed medical history
- Physical examination to assess tenderness, stiffness, and range of motion
Imaging studies such as X-rays or MRI scans may be ordered to rule out fractures, disc injuries, or other causes of low back pain.
Non-operative treatment
Lower back strain treatment is always non-surgical. The goal is to reduce pain, allow muscle healing, and restore normal movement.
Conservative treatment options include:
- Rest from activities that strain the lower back
- Ice therapy to reduce swelling during the first 24–48 hours
- Heat therapy to relax tight muscles after acute pain subsides
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are used to relieve pain and inflammation
- Muscle relaxants to reduce spasms in more severe cases
- Physical therapy, including stretching, strengthening exercises, and sports massage
A structured rehabilitation plan is essential for proper lower back strain treatment and prevention of reinjury.
(Refer to the PDF Exercise Program below)
Recovery
Most individuals with a lower back muscle strain begin to feel improvement within 24–48 hours. As pain decreases, gentle movement and light activity are encouraged.
Key recovery points:
- Prolonged bed rest should be avoided, as it can delay healing
- Gradual return to activity helps restore strength and flexibility
- Your doctor or physical therapist will guide your return-to-play plan
With proper care, most people recover fully within a few weeks and can safely resume sports and daily activities.
Dr. Jay Kimmel is a board-certified orthopedic surgeon specializing in sports medicine, arthroscopic surgery, and shoulder and knee disorders. He completed his orthopedic training at New York-Presbyterian/Columbia University Medical Center and a Sports Medicine Fellowship at Temple University.
Dr. Kimmel previously served as the Director of the Connecticut Sports Medicine Institute at Saint Francis Hospital and has held faculty appointments as Clinical Assistant Professor in the Departments of Orthopedics and Family Medicine at the University of Connecticut. He has extensive experience caring for athletes as a team physician for high school and collegiate programs and continues to teach in the athletic training departments at Westfield State University and Springfield College.
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/MonthFrequently Asked Questions
Can untreated low back strain lead to chronic pain or complications?
Yes. Ignoring a lower back muscle strain can lead to persistent pain, muscle weakness, and recurring injuries.
What are common signs that a lumbar muscle pull was misdiagnosed?
Radiating leg pain, numbness, tingling, or leg weakness may suggest nerve involvement rather than a strained lower back.
How long should I wait before seeking treatment for lower back tightness?
If symptoms persist beyond one week or limit daily activities, you should seek medical evaluation.
What is the expected recovery timeline for a low back strain?
Most lower back strain injuries improve within a few days and resolve fully within 2–6 weeks with appropriate lower back strain treatment.