Injury Tip Sheet: Back Sprains and Strains

Injury Tip Sheet:  Back Sprains and Strains

Learn what you need to know to help treat and prevent this source of back pain.

Kathy Weber, M.D., M.S. Daphne R. Scott, PT, Dsc Chicago, IL

Fast facts

  • Strains and sprains are the most common causes of low back pain
  • Sprains and strains are the most common workplace injury in the United States
  • Symptoms and treatment for both strains and sprains are often the same

What you need to know

What are sprains and strains?

  • Both involve overstretching or tearing of tissue
  • A sprain is defined as an overstretching  or tearing of a ligament while a strain is an overstretching or tearing of a muscle or tendon.
  • Ligaments are tough, fibrous bands of tissue that connect the bones in joints to each other; tendons connect the muscles to the bones.


Signs & symptoms

  • Pain and/or muscle spasms in the lower back
  • Often there is pain and limited range of motion in the lower back
  • Pain often increases with movement
  • In severe cases, there may be mild swelling in the involved muscle of the lower back


When should I see a doctor or other professional?

  • You should see a doctor if you have persistent pain despite icing, over-the-counter anti-inflammatory medications (if appropriate), or associated weakness, numbness in the lower back or legs.
  • If there is a change in normal bowel or bladder function.
  • If you have a history of previous lower back injuries



  • Strains or sprains can also be the result of sudden twisting, lifting, or pulling
  • Sprains and strains can result from overusing muscles or ligaments


Risk factors

  • Any sport that requires sudden jerks of movement, such as weightlifting or football, can increase the risk of a back injury
  • People who are overweight and/or deconditioned are more susceptible to sprains and strains
  • Individuals with excessive arching of their lower back or poor posture place additional strain on those muscles making strains and/or sprains more likely


What you can do


  • Use proper lifting techniques
  • When initiating a weight lifting program start out slow with light weights, focus on proper technique, and increase the weight and intensity of your program gradually to allow the body adequate time to adapt
  • Maintain a healthy weight by eating a balanced diet and a regular exercise program.
  • Improve strength conditioning in the muscles surrounding the spine to help strengthen the core and reduce stress placed on the discs and surrounding tissues.


Recommendations for treatment and rehab

  • Self-treatment for sprains and strains includes ice and heat therapy, compression, and the use of over the counter anti-inflammatories (if appropriate) to reduce swelling and control pain
  • Immobility is not recommended after the first 24-48 hours.  It can reduce overall mobility and lengthens recovery time.
  • If symptoms continue for more then two weeks physical therapy may be ordered by your doctor.


What can I do to stay active?

  • Remain active with movements that do not increase pain or make symptoms worse
  • Avoid all activities that increase pain
  • Begin with gentle pain-free back stretching
  • Once the pain has improved stationary sitting upright cycling of walking may be activities that may be tolerated since they load the spine less
  • Avoid activities such as running or other cardiovascular equipment impact activities that require more stabilization since they typically aggravate back sprains/strains


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