What can I do to help the pulled muscle in my low back?
A pulled muscl
e, no matter where it occurs, is just another name for a muscle strain. A muscle pull or strain occurs when all or an isolated portion of a muscle is stretched beyond its normal limits. This results in some degree of muscle tear, from a few micro-tears of muscle fibers to a massive ripping of an entire muscle (torn muscle). Regardless of the location of the muscle strain, treatment does not differ much; a pulled back muscle should receive treatment that is fundamentally the same for a muscle tear in the leg or neck.
Causes of a pulled back muscle
Lower back pain and muscle spasms that start from pulled muscles in the lower back are usually caused by any type of sudden or excessive movement that puts undue stress on lower back muscles and ligaments.
Frequent causes of a pulled back muscle include:
- Reaching or lifting from a position of mechanical disadvantage
- Lifting anything heavier than the strength capacity of the individual
- Lifting while in a twisted posture
- Lifting and twisting at the same time
- Lifting prior to adequate preparation
- Lifting or working when fatigued
- Any sudden impact, movement or fall
- Sports-related injuries are a common cause of a pulled back muscle, especially with those sports that involve considerable low back twisting (bowling and golf), or those activities in which sudden and unexpected impact, twisting, compression and exertion occur.
Evaluation or grading of a pulled muscle
Most episodes of acute lower back pain are caused by a variable amount of muscle tearing and back strain that affects the muscles and/or ligaments of the low back. A lumbar muscle strain might not sound like a serious problem, the amount of lower back pain that results can be surprisingly severe. Besides that, it not treated correctly from the onset it can lead to a series of low back episodes well into the future that weaken the back with each occurrence and eventually lead to osteoarthritis.
Even a small area of a torn or pulled muscle can result in considerable pain and even muscle spasm can occur as a defensive measure. Muscle strains are graded I, II, or III depending on the location and severity of the injury to the muscle, based on the signs and symptoms that are produced:
- Grade I (Mild) Muscle Strain– Mild discomfort, usually no or very limited and brief disability; usually muscle spasm, swelling, and bruising.In a grade I pulled muscle strain, either a muscle or its tendon is overstretched. Small tears to muscle fibers may or may not occur. You may have mild pain with or without swelling. Recovery is often uneventful and rapid.
- Grade II (Moderate) Muscle Strain – Moderate discomfort, usually limits ability to perform high level activities; slight to moderate muscle spasm, swelling, and bruising.In a grade II pulled muscle, the muscle or its tendon is overstretched with greater tissue injury than grade I, but no complete muscle tear occurs. The area of injury is tender to light touch.
- Grade III (Severe) Muscle Strain – Significant pain due to severe injury, movement limited and disability common; significant muscle spasm, swelling, and bruising common.Grade III muscle pull is the most serious because most of the muscle fibers are torn, and sometimes completely torn or ruptured. Recovery is slow and re-injury occurs easily.
Treatment of a strained or pulled muscle
Grade II and grade III muscle strains should be attended by a doctor who may or may not refer to a therapist for follow-up. A grade I pulled back muscle usually can be treated at home with simple home care remedies, such as applying rest, ice, compression, elevation (RICE). This format of therapy for a minor muscle tear is usually sufficient and should result in gradual and consistent improvement on a daily basis; if daily progress is not noted or regresses without a good reason, a grade I muscle pull should be seen by a doctor for evaluation.
Outline of treatment of a pulled muscle:
- Rest…but not too much – Providing adequate rest time for an injured muscle to heal and recuperate is the first line of treatment, right after ice applications. Instinctively an injured person wants to stop using the involved part of the body. Rest is recommended during the early phase of recovery phase, usually one to five days depending on the severity of injury, the body part that is involved, and history of prior injury. Start moving again as soon as the worse of the pain begins to subside.
- Ice –Rapid use of an ice pack is always appropriate for a pulled muscle; the sooner the better. The speed of recovery is greatly assisted by the prompt of cold to the area of muscle strain, as well as and degree of pain, swelling and bleeding reduction. Ice applications should never be done for longer than 20 minutes at a time, without a 60 minute rest period to allow the tissue to warm up.
- Compression – This does not mean immobilization; compression means the firm application of a compression (ACE) bandage around that body part where the muscle tear has occurred. Complete immobilization is not only unnecessary most of the time, but it can delay recovery and lead to a poor outcome of care. True immobilization should only be done under medical supervision. Conversely, snug wrapping with an elastic bandage that is applied to patient tolerance is appropriate if no coldness, numbness or discoloration of skin occurs due to the compression, and is removed for a half hour every few hours and is not worn overnight.
- Elevation – Raising the injured area above the level of heart will assist bringing the swelling under control. Sometimes this is difficult or impossible to do, as when it is a pulled back muscle that is the being treated. Elevation is best done for a torn muscle in the arm or leg.
- Stretching of the involved part – Early in treatment while resting the pulled muscle in back it is appropriate to begin gentle stretching of the involved area as long as it does not create pain; most often, very light stretching feels good, and is an indicator that the muscle stretching is not being done too aggressively. A sustained light stretch will increase blood flow into the area of the torn muscle as well as increase flow of edema fluid out the area.
- Anti-inflammatory medications – Even though anti-inflammatory drugs and pain medication for a pulled muscle can reduce swelling and alleviate painful symptoms, they should not be done too early in care. If all pain or most pain is artificially reduced by heavy drug usage the injured person will not have pain to act as a guide to know how much activity and weight-bearing is appropriate; a person who is so heavily drug that no pain is felt will often do too much, too early, for too long, since pain can no longer be used to judge appropriate activity levels. Further, even over-the-counter pain medications have potential side effects that should be avoided; consult with your doctor or pharmacist before using anti-inflammatory medications for a pulled muscle in lower back or elsewhere.
- Strengthening exercise – After recovery has started (less pain, greater ability to bear weight on the injured part, less swelling, etc.) gentle and graduated muscle strengthening exercise is appropriate. The muscle tear and the enforced rest period after an injury very soon act to weaken the involved muscle tissue. Err on the side of doing too little and too light exercise, than too much. The increased activity of exercise done appropriately speeds recovery and assures a better tissue healing.
- Massage – light tissue massage done with only the fingertips (that does not press deeply into the muscles) will promote blood flow in torn muscle of the lower back. This will loosen tight lower back muscles to assist healing and release endorphins, the chemical messengers that act as the body’s natural pain killers.
- Chiropractic – light and gentle spinal manual manipulation is a good option once the initial pain of a pulled back muscle begins to subside. A chiropractic adjustment to correct spinal misalignment will loosen tight back muscles, reduce the chance of myofascial triggers near the area of injury, and promote healing in the lower back.
- Moist heat application – Applying heat in conjunction with cold applications can be very effective therapy to increase blood flow in and edema fluid out of the area of muscle injury. Try alternating hot and cold applications soon after pain starts to subside to bring additional circulation to the area of the pulled muscle.
- Reduce stress – Many people keep their emotional stress and tension in their muscles, leading to tight muscles that do not respond fast enough or well enough to lifting or falling accidents. This leads to easy development of pulled back muscles and muscle strains anywhere in the body. Think of the way a baby falls (or someone who is drunk) when the muscles are relaxed and does not get injured. This can be accomplished with something as simple and easy as stopping for 10 minutes to be still, do some deep breathing while centering your thoughts to the sound you make as the air goes in and out of your nose.
- Better back posture – Support your back while it is recovering as you lie down, sit or stand. Critically look at your sofa, kitchen chair, desk chair and car seat to see if they offer good support; if not, try using a back support cushion, or a back orthotic, that cradle and support the pelvis and support the low back. Improving posture while lying, sitting and standing will relieve stress on injured back muscles to assist recovery.
- Avoid muscle fatigue – Strictly observe time limits while walking or doing any type of exercise for the torn muscle tissue because it will be prone to easy and rapid fatigue. A fatigued muscle is more likely to be reinjured and to heal less rapidly. After recovery is well underway, and for the weeks or months after recovery is achieved it is still important to avoid heavy exertion to the injured tissue because this tendency for re-injury takes time to reverse. Those who do heavy manual labor and athletes should avoid fatigue and use caution by slowly easing into a full level of activity, and being mindful how the area of past injury feels during use.
- Warm-up slowly and deliberately – Before each day of work or before beginning
any sport activity, those who do heavy manual labor and athletes should gradually begin to use the previously injured area in a slow and deliberate way. Stretching tight tissue and bringing increased blood flow to the area of the torn muscle will help loosen the muscle and prevent additional injury. - Be patient – All healing and recovery process take time and require patience. During this time do not assume too much, so you do not injure yourself by being too hasty.
Symptoms of a pulled back muscle
Back pain symptoms associated with muscle strain can range from a vague mild ache to a sudden and overwhelming pain. Common symptoms of a pulled muscle in the lower back usually display a combination of several of the following:
- Pain localized to the muscle tear in the lower back; this low back pain does not radiate into the leg as sciatica can radiate down to the toes
- Lower back muscles that are tender to even light pressure
- Pain of rapid onset that is marked to the moment of the muscle tear
- Easy and frequent muscle spasms of the involved area
- Pain relief while resting
- Pain worsening while using muscles, such as for standing, walking or rolling over in bed
- Easy aggravation and re-injury of the initial injury
- Absence of numbness or tingling symptoms which would indicate spinal nerve irritation
When to get medical care for a pulled muscle
See a back specialist or chiropractor, or go a hospital’s emergency department for a pulled muscle if:
- You hear a “clicking” or “popping” sound during the injury that strained your back muscle
- The pain you feel is greater than average
- The pain does not respond to the usual over-the-counter meds that usually help you
- There is more than a little swelling of the injured area
- Any degree of fever is present
- You have an open wound s a result of the injury
- These home remedies do not begin to reduce your back pain and muscle tightness in 48 hours
A pulled back muscle can be a painful and serious problem that will stop you in your tracks, and can lead to further problems if it is not handled correctly from the onset. Use these simple and effective steps to keep a pulled muscle in the back from becoming a larger problem.