Lower Back Muscle Strain: Symptoms, Recovery and Exercises

01What

What is a lower back strain?

It is an overstretch or small tear of the muscles or tendons of the lower back (and sometimes ligaments). The back muscles protect the spine and help you lift, bend and twist, so they can be injured by sudden loads, repetitive strain or poor posture. In most cases, doctors call it “non-specific low back pain” because no serious structural cause is found, although the pain is real and sometimes intense.

02Symptoms

Symptoms

• Dull, aching or sharp pain in the lower back, often one-sided.
• Muscle spasm and tightness.
• Pain worse with bending, twisting, lifting or coughing.
• Stiffness, especially in the morning or after sitting.
• Pain may spread to the buttock or the top of the thigh, but usually not below the knee.
• Tenderness over the muscles next to the spine.
• No numbness, weakness or bladder and bowel changes (otherwise, seek medical advice).

03Causes

Causes and risk factors

• Lifting heavy objects or lifting with a rounded back.
• Sudden twisting or awkward movement.
• Sports with repeated bending or twisting (golf, tennis, rowing).
• Prolonged sitting or poor workstation set-up.
• Weak core and hip muscles; lack of regular exercise.
• Excess weight, smoking and poor sleep.
• Stress and low mood, which increase pain and slow recovery.

04First days

What to do in the first days

• Stay as active as pain allows: short walks several times a day; avoid prolonged bed rest, which slows recovery.
• Find comfortable positions: lying on your side with a pillow between the knees, or on your back with knees bent.
• Heat packs (warm, not hot) can ease muscle spasm; cold packs may help early on for some people.
• Pain relief: paracetamol or anti-inflammatories (like ibuprofen, if suitable) at the lowest dose and for the shortest time. Ask your doctor or pharmacist.
• Gradually return to normal activities and work; light work is often better than staying off.
• Avoid heavy lifting and forceful twisting for a few days.

05Exercises

Gentle exercises that help

• Walking: 10–30 minutes, building up daily.
• Knee-to-chest stretch: lying on your back, hug one knee, hold 20 seconds, 3 repetitions each side.
• Pelvic tilts: flatten the lower back to the floor for 5 seconds, 10 repetitions.
• Cat–camel: on hands and knees, slowly round and arch the back, 10 repetitions.
• Bridge: lift the hips from the floor, hold 5 seconds, 10 repetitions.
• Bird-dog: on hands and knees, extend the opposite arm and leg, 8 repetitions each side.
• Move within comfortable limits; a mild increase in discomfort is acceptable if it settles quickly. See also lumbar stretches (Spanish) and exercises for low back pain (Spanish).

06Treatment

What treatments help according to guidelines

NICE guidelines recommend self-management advice, exercise (aerobic, strengthening or mind–body programmes such as yoga), manual therapy in combination with exercise and psychological approaches in selected people with persistent pain. They advise against routine use of opioids, paracetamol alone for persistent pain, injections, acupuncture or braces for non-specific low back pain, and against imaging unless red flags or a clear suspicion of serious pathology exist.

07Duration

How long does it last?

Most people notice clear improvement within 2 weeks and are much better within 6 weeks, though mild symptoms and recurrences are common. Pain lasting more than 12 weeks is classed as chronic, and then a broader approach to exercise, sleep, stress and activity pacing becomes more important. Staying active and maintaining a positive outlook are linked to a quicker recovery.

08Prevention

Preventing recurrence

• Exercise regularly: walking, swimming, yoga or strengthening for the trunk and legs.
• Lift smart: bend your knees and hips, keep the load close to your body and avoid twisting.
• Break up long periods of sitting; adjust your chair and screen height.
• Keep a healthy weight and sleep well.
• Manage stress and stay active even during minor flare-ups.
• Do not stop daily activities for fear of pain; confidence matters.

10Cases

Three common situations

Back pain after lifting a box, worse bending, no leg symptoms: typical strain; keep moving, use heat and simple pain relief.

Stiff, achy back after long hours at the desk: improve posture variation, take breaks, strengthen core and hips.

Back pain with leg tingling: may involve a nerve root; see sciatica symptoms (Spanish) and consult.

11Summary

Key points to remember

A lower back strain hurts but is usually benign: stay active, use heat and short-term pain relief, do gentle exercises and return gradually to normal life. Watch for red flags and see a doctor if pain is severe, spreading to the leg or not improving in a few weeks.

This guide is for general information and does not replace an assessment by your own doctor or physical therapist.