A Physical Therapy Guide to Lumbar Muscle Strain
If you've ever pulled a muscle or threw out your back, you've probably dealt with a muscle strain. Lumbar muscle strain is a common injury that can occur from strenuous activities involving the lower back, such as sports, manual labor, gardening, or lifting a child.
If you are experiencing pain in your lower back, muscle strain may be the culprit. In this guide, we will discuss the symptoms, causes, diagnosis, and treatment of lumbar muscle strain. We will also provide tips on how to prevent this injury from occurring.
When low back pain from a muscle strain strikes, did you know that it's best to keep your body moving?1 It can feel intimidating and leave you unsure of what to do. Learn how a CityPT physical therapist can be your invaluable guide for both short and long-term back pain relief.
- Understanding Lumbar Muscle Strain
- Symptoms of Lumbar Muscle Strain
- What are the Most Common Causes of Low Back Muscle Strain?
- Diagnosing Lumbar Muscle Strain
- What to Expect from Physical Therapy for Lumbar Muscle Strain
- What If Conservative Treatment Doesn't Work?
- Preventing Lumbar Strain
- Is It Time to Seek Treatment?
The lumbar spine is composed of 5 vertebral bones, many different muscles and ligaments, and other local connective tissue, all of which work together to provide support and stability for the spine. When one of these structures is overloaded and elicits pain, it results in mechanical low back pain.2
A muscle strain is defined as a partial or complete tear in a muscle or tendon. When the injury occurs in the lumbar spine region, it is referred to as a lumbar muscle strain. Posterior spinal muscles (the muscles that run along the back that you can easily palpate) can all be susceptible to a tear.
The most common symptom of a lumbar muscle strain is pain in the lower back region. This pain can range from mild to severe and may be accompanied by muscle spasms. These symptoms often start acutely, but can also become chronic if not addressed. Other symptoms may include:3
- Tenderness when pressure is applied to the affected area
- Swelling or heat
- Stiffness or decreased range of motion in the lower back
- Pain with active muscle use
- Pain with passive stretching of the affected muscle(s)
Warning: If you experience symptoms of extreme muscle weakness, numbness/tingling of the groin or legs, or changes in bladder or bowel control, seek medical care as soon as possible to rule out more sinister causes of low back pain, such as cauda equina syndrome.
Let's review the most common causes of lumbar muscle strain:
- A strong, even violent, muscle contraction of the lumbar muscles, typically associated with heavy lifting or sudden twisting
- Acute trauma or injury, such as a fall or car accident
- Sudden movements that place too much stress on the lower back muscles, such as during a tennis or football match
- Posture and muscular imbalances that place extra strain on the lumbar muscles, such as with slouching at a desk or sleeping in an awkward position
- Chronic stress on the lumbar muscles from activities such as manual labor or prolonged sitting/standing
Risk Factors for Muscle Strain
There are several risk factors that can increase your chances of developing a lumbar muscle strain. These include:4
- Limited physical conditioning
- Muscle fatigue
- Participation in sports or other high-impact activities
- Changes in posture and body mechanics
- Previous injury to the lower back or spine
- Age (strains are more common in those over 40 years old)
- Chronic health conditions that cause inflammation, such as diabetes and heart disease
If you visit your doctor or a CityPT physical therapist with symptoms of lumbar muscle strain, they will first ask about your medical history, current symptoms, and lifestyle. They will then perform a physical examination. This will likely include tests such as:
- Active and passive range of motion testing
- Muscle strength testing
- Neurological testing
- Reflex testing
- Joint mobility assessment
- Joint and muscle palpation
- Postural assessment
Imaging tests, such as an X-ray, MRI, or CT scan, may also be ordered if the healthcare provider suspects a more serious back condition is causing your symptoms, such as a fracture.
When dealing with a lumbar strain, visiting a CityPT physical therapist first can help you get on track quickly and cost-efficiently. No need for costly imaging, prescriptions, or referrals — just schedule an appointment directly with a low back pain specialist today.
A CityPT therapist will work with you to develop a personalized rehabilitation program. This will likely include a combination of the following:
- Education: Your most valuable tool to learn about your pain and the underlying causes. Plus, any advice for optimizing posture, body mechanics, ergonomics, and lifestyle habits.
- Manual Therapy: Hands-on techniques, such as joint mobilization and soft tissue massage to help reduce pain, inflammation, and muscle spasm.5
- Exercise: Targeted strengthening and stretching exercises to help improve the range of motion while also protecting the injured area from further strain.
- Modalities: Use of heat, ice, electrical stimulation, or other modalities to help reduce pain and inflammation.
If your symptoms do not improve with conservative treatment, the standard protocol for addressing pain from a muscle strain is not well-defined. In general, surgery is not a recommendation to "fix" mechanical back pain. However, your doctor may be able to prescribe medications and injections for short-term relief.
At CityPT, you have direct access to clinicians with more time and better communication tools to provide you with "above-standard care" — an emphasis on more time to get to know you, creating personalized action plans, and being highly accessible online and in-person.
There are several things you can do to promote optimal tissues, which can help reduce your risk of lumbar muscle strain or any bodily injury:
- Stay physically active and maintain a healthy weight: This will help keep the muscles and ligaments around the spine strong and flexible.
- Use proper body mechanics: When lifting, carrying or doing other activities that put stress on the back.
- Be mindful of your posture with daily activities: Keep your spine in balance with sitting, standing, walking, and sleeping (this will vary slightly with each person).
- Stretch regularly: Especially before participating in activities that put stress on the back. Hamstring stretches are particularly important.
- Warm up before sports or vigorous exercise: Prime your back muscles for heavy use with brisk walking or jogging. This increases body temperature and blood flow, getting your muscles ready to work.
- Perform strengthening exercises: To build core muscles, such as the abdominals and buttocks. These muscles help support the spine.
- Quit smoking: Smoking increases the risk of developing back problems.
- Make healthy lifestyle choices: This includes eating a healthy diet, practicing stress management, and getting enough sleep.
Low back pain caused by muscle strain is very common. Chances are it will go away on its own. However, there is also a good chance that it will return. To get the relief you need now, and break the cycle of on-again, off-again back pain— do yourself a favor and get professional guidance from a movement expert.
This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide (or any guide) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.
Malmivaara A, Häkkinen U, Aro T, Heinrichs ML, Koskenniemi L, Kuosma E, Lappi S, Paloheimo R, Servo C, Vaaranen V, et al. The treatment of acute low back pain--bed rest, exercises, or ordinary activity? N Engl J Med. 1995 Feb 9;332(6):351-5. doi: 10.1056/NEJM199502093320602. PMID: 7823996. https://pubmed.ncbi.nlm.nih.gov/7823996/ ↩
Scully, R., Rao, R. (2017). Lumbar Strain and Lumbar Disk Herniation. In: Eltorai, A., Eberson, C., Daniels, A. (eds) Orthopedic Surgery Clerkship. Springer, Cham. https://doi.org/10.1007/978-3-319-52567-9_103 ↩
Li H, Zhang H, Liu S, Wang Y, Gai D, Lu Q, Gan H, Shi Y, Qi W. Rehabilitation effect of exercise with soft tissue manipulation in patients with lumbar muscle strain. Nigerian journal of clinical practice. 2017;20(5):629-33. https://pubmed.ncbi.nlm.nih.gov/28513525/ ↩