While a pulled back muscle or strain may seem like a minor injury. The resulting pain and muscle spasms can be surprisingly severe. In this video, I'll describe what causes the pain with a strained muscle and what you can typically expect in terms of healing.
Muscle strain and ligament sprain are common causes of back pain. This is diagnosed when the muscles, tendons, or ligaments together called the soft tissues in the low back become stretched or torn. There are few differences between a muscle strain and a ligament sprain. With a muscle strain, the fibers in a muscle tear from being overstretched or overused. It’s commonly called a pulled muscle.
With a sprain the ligaments are overstretched or torn, but ligaments are tough, fibrous tissues that connect bone together. A specific diagnosis of a ligament sprain or a muscle strain in the lower back is usually not needed, as they have the same symptom pattern and receive the same treatment.
When the soft tissues in the low back are stretched or torn, the surrounding area typically becomes inflamed. Inflammation is the body's natural response to injury. It causes increased blood flow to the injured tissue in order to heal and restore it. Common symptoms include some combination of muscle spasm, tenderness, swelling, cramping, difficult moving, and stiffness, and overall moderate to intense back pain.
Recommended treatment may include one or two days of rest and reduced activities, followed by some therapies to reduce pain and inflammation. On the other hand, if the pain intensity is not severe and walking is comfortable, it's best to keep moving. For example, the application of an ice pack to the affected area for 20 minutes at a time, repeated about every two hours, is highly effective. Be sure to protect your skin from an ice burn by placing a towel or some other barrier between the ice pack and your skin. The cold therapy reduces local inflammation.
However, some people prefer heat as heat applications can reduce muscle spasm. Again, protect your skin with a barrier and never apply heat for more than 20 minutes at a time. Non-steroidal anti-inflammatory medications such as ibuprofen can also reduce inflammation. These come with risks and complications, so follow your doctor's instructions. Physical therapy and/or chiropractic are also very helpful, not only to alleviate the current symptoms, but more importantly, to actually reduce the rate of reoccurrence. So in other words, in order to prevent this from happening again, we must make sure that the muscles become fit to handle the stresses that we're applying to them. Core strengthening exercise training is a great example of this.
Patients often wonder how long will the pain last? Or when do I know if I should see a doctor? Usually these sprains and strains will resolve within several days to 1 to 2 weeks. If after 1 to 2 weeks, you don't see resolution or a trend toward resolution. That would be a good time to seek health care attention, because this could be due to some underlying problem that will not resolve and should be addressed sooner than later."
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