How to Heal a Muscle Strain in Your Back

How to Heal a Muscle Strain in Your Back


Medically reviewed by Misty Seidenburg

You’ve probably pulled a back muscle at some point. Pain and muscle spasms after lifting something heavy or bending or falling in an awkward way are telltale signs of a muscle strain. But a pulled muscle isn’t always the result of a sudden injury.

You can also develop a muscle strain from sustained awkward postures or a sedentary lifestyle that leads to weakened sluggish back muscles. Excess weight and pregnancy also put excess stress on back muscles, making them more prone to injury.

Fortunately, you don’t have to live with back pain from a pulled muscle. Here are the most effective ways to treat a muscle strain at home and with the guidance of a licensed physical therapist.

What Is a Muscle Strain?

A muscle strain, or a pulled muscle, is an injury to the muscles or the tendons, which are the fibrous bands of tissue that connect muscles to bones. Minor strains may involve overstretching of the tissues, while more severe strains involve partial or complete tears of the muscles or tendons. A muscle strain is a common cause of back pain.

What Does A Muscle Strain in the Back Feel Like?

The discomfort of a pulled back muscle ranges from a minor nuisance to pain that is downright debilitating, making it difficult to sit, stand, and bend.

General signs and symptoms of a muscle strain include:

  • Pain
  • Tenderness
  • Redness
  • Bruising
  • Swelling
  • Limited motion
  • Muscle weakness
  • Muscle spasms

Muscle strain pain can also vary depending on where in the back the injury occurred.

If you pull a muscle in the upper back or shoulders, you may have:

  • Muscle spasms in the upper back
  • Tightness and knots in the upper back and shoulders
  • Pain between the spine and shoulder blades
  • Pain when moving the shoulders

If you pull a muscle in the lower back, you may have:

  • Stiffness and aching in the lower back muscles
  • Muscle spasms in the lower back
  • Pain when walking, sitting, or standing
  • Pain that radiates down into the hips and legs

How to Treat a Back Muscle Strain at Home

A muscle strain in the back can often be treated at home, and these tips generally apply to pulled muscles throughout the body. The most recent school of thought for treating soft tissue injuries involves the catchy acronym: P.E.A.C.E and L.O.V.E.

The P.E.A.C.E and L.O.V.E protocol differs from the well-known RICE or PRICE approach to treating soft-tissue injuries in that it addresses every stage of tissue repair and avoids treatments that may interfere with the healing process.

  • Protection: Avoid activities that cause pain in the first few days after an injury.
  • Elevation: Elevate the injured limb above the heart if possible (not applicable with back strain.)
  • Avoid anti-inflammatories: This sounds counter-intuitive but avoid ice and anti-inflammatory medications that can reduce tissue healing.
  • Compression: Use taping or an elastic bandage to reduce swelling.
  • Education: Let nature take its course and avoid unnecessary, unproven treatments.


  • Load: Gradually increase load while listening to your body. Pain should be your guide.
  • Optimism: Stay confident and positive to keep your brain in the right mindset for healing.
  • Vascularization: Resume activity with pain-free cardiovascular activities that increase blood flow.
  • Exercise: Take an active approach to recovery with exercise to restore strength and mobility.

Treating Muscle Strains with Physical Therapy

If your pain and mobility challenges do not improve with at-home care, or you are hesitant about resuming activity that may worsen your injury, it may be time to try physical therapy.

Your muscle strain treatment plan might include:

  • Therapeutic exercise to stretch and strengthen the injured muscles and those surrounding them
  • Manual therapy including soft tissue mobilization with or without instruments to break up tough, fibrous tissue
  • Heat and other pain-management modalities to treat symptoms
  • Posture and alignment correction to promote healthy movement and reduce stress on affected tissues
  • Education on how to prevent reinjury in the future with stretching, healthy lifestyle habits, and good posture

Every treatment plan is unique and depends upon the patient’s degree of strain and their symptoms. Schedule a physical therapy assessment to address your back pain and take the first steps toward healing.

When to Be Concerned About Back Pain

Even if you suspect a pulled muscle, it’s good to be aware of the possible signs of a more severe condition. Contact your healthcare provider if you have constant pain, stabbing pain, leg pain or numbness, a fever, or you cannot stand or walk. It’s best to be cautious and see your provider to rule out serious conditions and obtain an accurate diagnosis.

For strains, sprains, and other musculoskeletal conditions, physical therapy may be the key to relief.  Find a physical therapy clinic near you.

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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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