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Back Sprains and Strains

    At a Glance

    • A sprain is a stretch or a tear in a ligament. A strain is a stretch or tear in a muscle or tendon.
    • Sprains and strains are the most common back problems.
    • They are classified in degrees: first (slight), second (partial), and third (complete).
    • In most cases, sprains and strains tend to heal on their own; the key is to avoid re-injury.

    Symptoms of Sprains & Strains in the Back

    When the muscles and associated structures in the back and neck are injured, the symptoms can vary from a mild discomfort to sharp and severe pain, depending on the nature and degree of the injury. Decreased function and range of motion, pain that worsens with movement, and muscle cramping may also accompany a sprain or strain.

    Swelling of the sprained or strained area usually occurs, but may not appear for hours after the initial injury. Damage to muscle, tendons and ligaments also cause internal bleeding, resulting in a bruise.

    Pain and swelling cause the body to favor and attempt to protect the injured part of the back. This can result in muscle spasms around the strain or sprain. Surrounding muscles may knot up.


    Anatomy & Causes

    When the body is put under physical stress, muscles and joints are often forced to move in ways they were not designed for. The most common form of physical stress is excessive stretching, which results in a strained muscle or tendon and/or a sprained ligament.

    Strain. A muscle is composed of smaller bundles of muscle fibers called fascicles, which are composed of individual muscle fibers linked together. When these fibers slide together, the muscle shortens; when they slide apart, the muscle lengthens.

    Muscles attach to bone either directly or with a tendon. A muscle/tendon unit is attached to the sides of each joint in the body. When the muscle/tendon contracts, the joint moves.

    A strain is caused by an overstretched muscle or tendon. This pulls apart their fibers, making them unable to contract. The strain can occur to the muscle, the tendon, or the muscle-tendon intersection.

    Sprain. Thick bands of tissue called ligaments surround joints and attach to the bone on each side of a joint. Ligaments stabilize the joint and restrict its movement to one direction only. A stretched or torn ligament is a sprain.

    Segmental Dysfunction is a sprain of the facet joint and joint capsule. Some practitioners believe it is also a manifestation of an internal visceral problem possibly involving the lungs, intestines or other organ structures. Segmental dysfunction is deeper than a trigger point, which tends to be more superficial and mobile.

    Other terms for sprains and strains include thrown back, pulled muscle, torn muscle, muscle spasm, fasciitis, and muscle cramps.

    Sprains and strains are classified into subcategories:

    • A first-degree sprain (ligament) or strain (muscle or tendon) is a slight tear or abnormal stretch.
    • A second-degree sprain or strain is a partial or incomplete tear.
    • A third-degree sprain or strain is a complete tear or rupture.


    Overuse accounts for most sprains and strains. The most common reason for an overuse injury is increasing the stress on the tissues too rapidly. That’s why people who are out of shape and do things they are not used to doing tend to strain their muscles/tendons and sprain their ligaments.

    Overuse can gradually occur with many repetitive motions. These types of repetitive motion sprains and strains often occur on the job. Improper technique in exercise or sports can also cause a repetitive-motion sprain or strain.

    Traumatic injuries may result from a fall or a car crash or some other accident. The sufferer usually has bruising or swelling and is unable to move the back normally. This is commonly referred to as a “Whiplash Injury”.

    Frequently Asked Questions

    What muscles should I develop in my back to help provide more support for my spine?
    How do I know if I have a pulled muscle?
    What is the difference between a strain and a sprain?
    Is it more difficult to treat a sprain/strain in the back?
    more faqs »


    Learn about Sprain and Strain treatment options.


    In cases of severe pain or when a traumatic injury has occurred, x-rays and a magnetic resonance imaging (MRI) scan can be helpful to rule out other potential serious problems.

    The overwhelming majority of patients with acute and chronic sprain or strain injuries to the back and neck get better over time. It usually takes four to six months. The key is to avoid re-injury and participate in an ongoing back wellness and health maintenance program.

    Care for the patient should employ a team approach to optimize recovery. This should involve communication among all health-care providers to avoid confusion and contradictory approaches. Most therapeutic approaches to sprains and strains incorporate several treatments.


    Non-Surgical Treatments

    • Heat, Ice & Rest
    • Massage Therapy
    • Physical Therapy
    • Over the Counter and Prescription Medications
    • Core Exercise
    • Water Exercise.


    Pain Management

    • Trigger Point Injection
    • Prolo or Scelro Facet Injections
    • Radio Frequency Nerve Ablation


    Surgical Treatments

    • Radio Frequency or Laser Nerve Ablation surgery may be required in cases of severe sprains or strains.

     Non-Surgical Treatments

    Pain Management

    Surgical Treatments

    OTC Medicine
    Massage and Massotherapy
    Water Exercises
    “Core” Exercise Program Including Pilates and Yoga
    Aerobic Conditioning and Personal Training
    Spinal Manipulation
    Trigger Point Injection
    Prolo or Sclero Facet Injection
    Facet Block and Radio Frequency Nerve Ablation
    Laser Facet Ablation


    Frequently Asked Questions

    Do I need imaging studies for a correct diagnosis?
    more faqs »