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Low Back Sprains and Strains

Low back sprains and strains are types of mechanical back pain. The term mechanical implies a spinal structure(s) is the pain source. A common cause of a sprain or strain is excessive physical demand on the spine's ligaments or muscles. Although pain can be severe, and even temporarily disabling, most low back sprains and strains are easy to treat and do not require spine surgery.

  • A sprain is a stretch or tear of a ligament
  • A strain is a stretch or tear of a muscle

Ligaments and muscles help maintain spinal stability. Ligaments are sturdy fibrous bands of connective tissue that connect two or more bones together and help stabilize the spine's joints. Tendons attach muscle groups to bones. Tendons are more flexible than ligaments.

Your ligaments, tendons and muscles work together to keep your spine stable during activity and rest. That is one reason why regular stretching and exercise is important. Did you know that most of your body’s weight is absorbed and distributed through your lumbar spine? It is true. Simply being in good physical shape, minding your posture and body mechanics can go a long way to help you prevent low back sprain or strain.


  • Excessive flexion: bending forward too far or too much
  • Excessive extension: bending backward too far or too much
  • Excessive force to the spine: heavy lifting

Many different movements and activities can stress the spine's soft structures. Some include:

  • Not warming up before playing sports
  • Carrying something heavy
  • Bending forward at the waist to pick up an object
  • Twisting and bending simultaneously
  • Pulling or pushing
  • Falling down


Symptoms usually begin suddenly and are provoked with movement.

  • Lumbar pain can be intense, throbbing, aching
  • Localized swelling, feeling stiff
  • Pain may be felt in the buttocks and/or legs (sciatica)
  • Skin area tender to the touch
  • Low back muscle spasms

A rare, but urgent medical situation is loss of bowel or bladder function.

Accurate diagnosis

Consult an expert, especially if back pain develops suddenly, quickly worsens, or you have a pre-existing back disorder. An accurate diagnosis is essential to an effective and successful treatment plan.

Your medical history and physical and neurological examinations are very important. You and your doctor discuss your symptoms, when they developed, and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.

A x-ray or CT scan may be ordered to confirm the doctor's diagnosis and rule out a more serious condition such as spinal fracture. Sometimes, but rarely, electromyography (EMG) is performed to diagnose a muscle problem.

Treatment options

Non-operative therapies are used to treat low back sprain and strain. Your doctor may combine two or more therapies to maximize the success of your treatment.

  • Activity modification; rest, avoid pain-causing movements
  • Apply ice wrapped in a towel for 15 minutes every 3 to 4 hours (First 24-48 hours after injury)
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Pain medication
  • Muscle relaxing medication
  • Short-term bracing supports the spine, may help relieve pain
  • Physical therapy
  • Chiropractic
  • Acupuncture


If physical therapy is prescribed, take advantage of learning about good posture and body mechanics. The following suggestions can help prevent re-injury and benefit your overall health.

  • If you smoke or use tobacco, stop
  • Maintain a healthy body weight
  • Stretch and strengthen your body regularly
  • Eat well
Gary Kraus, MD,
Neurosurgeon, is Board Certified
Meet Gary Kraus, MD
Masaki Oishi, MD,
Spine Fellowship at the University
Meet Gary Kraus, MD
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