Lumbar Strain: What It Is and How to Treat It

You’ve probably heard someone say they “threw out their back,” or maybe you were the one saying it. More than 80% of people experience at least one episode of low back (lumbar) pain during their lifetime. This popular phrase often describes a lumbar strain, a common cause of low back pain that can occur for a variety of reasons during everyday activities, exercise, or sports. Even something as simple as bending or twisting in a certain way can trigger it.

Thankfully, lumbar strains aren’t cause for major concern. But they can seem more serious than a muscle strain in other parts of the body. “A lumbar strain feels different because it's in the core, where all your movement and stability stem from,” says Samantha Stewart, PT, DPT, a physical therapist at Hinge Health. “So, you’ll notice pain or limitations from a lumbar strain with everything you do.”

But don’t panic: Your back is strong and resilient. “A lumbar strain is not permanent or something you must adapt your lifestyle to,” reassures Dr. Stewart. Lumbar strains will get better with conservative, at-home treatments like exercise that can also help prevent future back problems.

Read on to learn what lumbar strains are, what causes them, and how to treat and prevent them, including specific exercises for back pain relief from Hinge Health physical therapists.

What Is a Lumbar Strain? 

The back is divided into three sections along the spine:

• The cervical spine, or neck and upper back area

• The thoracic spine, or midback

• The lumbar spine, or lower back

A strain, also called a pulled muscle, is an overstretching of a muscle or tendon, the cord-like structure that attaches a muscle to a bone. “A lumbar strain occurs when you overstretch one of the muscles or tendons in the low back region,” says Dr. Stewart.

The lumbar area of the spine consists of five lumbar vertebrae. Between each vertebrae are small paraspinal muscles that stabilize the spine and are often the source of a lumbar strain. Other lower back muscles that can result in a lumbar sprain include the latissimus dorsi muscles (lats for short) and the iliopsoas muscles (hip flexors). While the lats are technically in the mid back, connective tissue extending from the muscles supports the lumbar spine. “If you strain the lats, you’ll often feel it in the lower back,” says Dr. Stewart. Hip flexors are often associated with the thigh, but they also attach to the lower back, so when strained, they can cause pain in either or both areas.

Lumbar Strain Symptoms 

A telltale sign of a lumbar strain is that “you can tie it directly to some kind of activity that you've done,” says Dr. Stewart. “You may reach down to pick something off the floor, and something doesn’t feel right after you come back up.” Here are some of the common symptoms you may experience if you have a lumbar strain: 

• Pain, discomfort, or achiness in the lower back

• Muscle tenderness or spasm

• Lower back muscle tension

• Limited mobility 

• Stiffness 

While most lumbar pain is nothing to be overly concerned about, if pain persists for more than a week without improvement or extends into your legs, you should talk to a doctor or physical therapist. Other symptoms that warrant medical advice include weakness, numbness, or tingling in the legs or groin area and pain accompanied by unexplained weight loss, fever, or bladder or bowel problems.

Lumbar Strain Causes

Lumbar strains occur due to an activity that stretches the muscles in your lower back beyond their usual ability. They can happen during household, exercise, sports, and recreational activities. They can even happen during an activity you do regularly with no problem. Here are reasons you may experience a lumbar strain.

• Doing too much, too soon. Spikes in activity that are beyond what you normally do day-to-day can lead to a lumbar strain. This can include spending an entire day cleaning your house, working in the yard or garden, or participating in a sporting or recreational activity, like a charity race, challenging hike, or friendly, but competitive game of basketball or volleyball.

• Muscle weakness. Your lower back is part of your core, encompassing muscles from your diaphragm to your pelvis and from your abdomen to your back. “If one part of the core isn't doing its job, another part has to kick in and help,” says Dr. Stewart. This overcompensation can lead to lumbar strains.

• Muscle tightness. When surrounding muscles like the hip flexors in your thighs are tight, they can place more stress on your lower back when you move. Stiffness limits your mobility, making it easier to strain a muscle when moving beyond your limited range of motion, such as when reaching down to unload the dishwasher or tag someone out at first base.

The good news: You can get out ahead of a lot of these causes. Addressing them, which we’ll cover below, can protect you from straining your lower back and other areas of your body in the future.

Lumbar Strain Treatment

While you might be inclined to rest an achy back, bed rest is not actually advised when treating most types of back pain, including a lumbar strain. “Even though you don't feel like moving, movement is what will make your back feel better,” says Dr. Stewart. 

These treatment options will help you ease the pain so you can return to all the activities you enjoy sooner. 

• P.E.A.C.E and L.O.V.E. This new self-care model replaces the R.I.C.E. method (rest, ice, compression, and elevation), putting the focus on movement — instead of rest — when recovering from injuries like a lumbar strain.

• Ice and heat. Use whichever provides the most relief for you. You may see recommendations to ice first, but there’s no definitive research on which is best. You can even alternate using an ice pack and heating pad for 20 minutes at a time. The most effective treatment is what feels better for you and enables you to keep moving. 

• Gentle movement. Exercises that gently stretch and strengthen muscles in your lumbar spine (like the ones below) can help manage a low back strain. Muscles get tighter and weaker with inactivity, prolonging recovery and setting you up for future injuries.

• Back brace. A brace can be helpful if it provides pain relief so you can stay mobile and return to work, but it should be a temporary fix. “I’ve seen people who get a lumbar strain and think they need to wear a back brace 24/7,” says Dr. Stewart. “It’s a temporary assist. Our goal is to create an internal back brace by strengthening the core.”

• Physical therapy. A physical therapist can create a personalized stretching and strengthening plan that helps you heal from a lumbar strain and strengthens all the muscles of the lumbar spine to protect you from future back injuries.

The above exercises are all done on the floor to protect your back and make you feel more comfortable as you move. “These moves keep you in your comfort zone,” says Dr. Stewart. “You're not working against gravity. You're not standing and thinking about balancing. With added support from the floor, you can start to reintroduce movement comfortably.” These exercises gently stretch and strengthen the muscles that are impacted by a lumbar strain.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

How to Prevent Lumbar Strains

“Prevention is about looking at risk factors and addressing them ahead of time,” says Dr. Stewart. “The biggest risk factors for a lumbar strain are a lack of balance in the low back area, as well as weakness or tightness.” Here’s what you can do to reduce your risk of a lumbar strain.

• Strengthen your core muscles. When they’re strong and working effectively, they provide an internal back brace to protect your low back during a range of activities. Start with the four exercises below.

• Maintain flexibility. You’ll move more effectively and safely when you’re limber and have full range of motion in your back. The exercises below target key muscles that, when tight, can contribute to low back strains.

• Pay attention to how you move. Your back is designed to bend, twist, and lift, but sometimes you may not do it in the safest way. You may be tired, rushing, or in an awkward position, making you more prone to a strain. Be intentional about how you’re moving to protect your lower back. For example, squat down and bend your knees when lifting something heavy, and keep the object close to your body.

• Don’t overdo it. When you’re tackling big tasks — moving, spring cleaning, painting your house, or an all-day golf or tennis event — that you’re not used to doing, take breaks. “That may mean setting a timer to rest while mowing the lawn, for example,” says Dr. Stewart.

• Warm up first. Warm-ups aren’t just for workouts. They can help prepare your body for all types of activity including housework, yard work, and recreational activities, like throwing a frisbee or playing tag with your kids. Research shows that warming up before activity can prevent injuries.

After you’ve recovered from a lumbar strain, add the above exercises to your routine. They’re more challenging than the pain relief exercises, further stretching and strengthening the muscles that support your lower back to prevent future injuries.

PT Tip: Don’t Wait to Move

You can start the exercises above to relieve a lumbar strain the same day you hurt your back. “A lot of times, people can ice or heat the injured area, and then do the movements almost immediately afterward to try and help reset things,” says Dr. Stewart. “The worst thing you can do is not move. That will perpetuate the problem and make it last longer.” Instead, focus on controlled movements, working in a comfortable range of motion to relax the area. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Lumbar Strain. (n.d.). Cedars-Sinai. Retreived from https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/lumbar-strain.html 

2. Back strains and sprains. (2018, November 9). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains 

3. Chou, R. (2021, September 20). Patient education: Low back pain in adults (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics 

4. Herman, K., Barton, C., Malliaras, P., & Morrissey, D. (2012). The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review. BMC Medicine, 10(1). doi:10.1186/1741-7015-10-75