How to Heal a Muscle Strain in the Middle of Your Back

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Muscle strains are painful injuries that usually happen after you stress one of your muscles too much or over-exercise it. They can be especially uncomfortable in your mid-back because this area is responsible for a lot of your movements and lifting. [1] Fortunately, most mid-back strains heal within 2 weeks without any lasting complications. [2] It will take some patience, but with the proper care and right amount of activity, the pain should improve significantly. If the injury doesn’t improve or gets worse, then you can visit your doctor for more treatment options.

Method 1
Method 1 of 3:

Resting and Relieving the Pain

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    Your muscles are susceptible to further injuries after a strain, so a day or 2 of rest is a good idea after you injure your back. Take it easy, lie back on the couch, and ice or heat your back to help the healing process. [3]
    • If lying back in bed or on the couch is painful, you could put a pillow under your knees to relieve the pressure on your back. [4]
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    When you first strain a muscle, cold and ice packs are the best treatment to reduce the inflammation. Wrap an ice pack in a towel and press it against the injured area. Hold it there for 15-20 minutes at a time, and repeat this treatment 3-4 times per day for 2 days after the injury. [5] [6]
    • Don’t hold an ice pack against your skin without wrapping it in a towel first. This could cause frostbite. [7]
    • You’ll probably have to lie down to keep the ice pack against your back, but make sure you don’t fall asleep. Leaving the ice pack on for too long could damage your skin. Try setting an alarm to go off in 20 minutes in case you fall asleep. [8]
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    After 2 days, muscle strains usually settle into a dull stiffness. In this case, heat is a better treatment to release that tension and make you more comfortable. [9] Hold a heating pad against your back for 15-20 minutes at a time and repeat this 3-5 times per day while your back heals. [10] >
    • If the pain is still sharp and concentrated in one spot, then you can stick with ice to relieve the inflammation. [11]
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    Acupressure mats are mats covered with clusters of short, sharp spikes, usually made of plastic. These mats can promote relaxation and help relieve neck and back pain. [12] Spread the mat out on a smooth floor and lie down slowly on top of it whenever you feel pain in your back. Rest on the mat for as long as you like.
    • Lie down slowly and try to distribute your weight evenly. This way, the spikes are less likely to dig into your back and cause pain.
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    If heat and ice aren’t enough to reduce the pain, you can take an NSAID pain reliever daily while your back heals. These medications relieve the pain, but also reduce swelling and inflammation, which helps your back heal faster. Follow the dosing instructions on the medication you use and take it as often as you’re directed to. [13] You can also try acetaminophen (Tylenol), either alone or in combination with NSAIDs. [14]
    • Common NSAIDS are ibuprofen, naproxen, and aspirin. In general, it’s best to start with the lowest effective dose (typically 200 mg every 4-6 hours) and gradually increase to a higher dose, such as 400 mg every 4-6 hours, if that doesn’t work. [15] Never take more than the recommended daily amount within 24 hours. [16]
    • Non-NSAID pain relievers like acetaminophen will also help with the pain, but they won’t reduce inflammation. Ask your doctor about using these medications if you can’t take NSAIDs, or using them in combination with NSAIDs for extra pain relief. [17]
    • It’s generally safe to take 325 mg of acetaminophen every 4-6 hours, and no more than 4,000 mg in a day. [18] [19]
    • Generally, you shouldn’t take pain medications for longer than 2 weeks at a time unless your doctor directs you to. Talk to your doctor if you still need to use medication 2 weeks after the injury. [20]
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    Magnesium citrate may help relax the tight muscles in your back. Talk to your doctor about taking a magnesium citrate supplement to help ease your pain. Since magnesium citrate can make you drowsy, it’s best to take it at bedtime. [21] [22]
    • Magnesium citrate can interact poorly with some other medications or supplements, so give your doctor a full list of everything else you’re taking before you try it. [23]
    • Most people tolerate magnesium supplements well, but you might experience side effects such as nausea, vomiting, or diarrhea. Never take more than the recommended dose. [24]
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    While doing more activities sounds counterintuitive, prolonged bed rest is actually bad for back injuries and can make them worse. After resting for a day or 2, start moving around again. Do simple household tasks that don’t require a lot of lifting or bending. Staying active like this helps keep your back loose and makes the healing process faster. [25]
    • Let your pain determine the activities you can and can’t do. If something increases your pain, then skip it.
    • Do not lift any heavy objects for at least a few days. If you have to strain at all, then the object is probably too heavy. Even if your back feels okay, it still needs more time to heal before you can lift things.
    • Don’t try to start exercising again yet. Just do light activities that don’t stress your back.
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    Always sit and stand up straight with your shoulders back. Try to maintain the normal curve of your spine. This keeps pressure off your back and reduces the pain while you heal. [26]
    • To improve your sitting posture, you can put a small, rolled-up towel between your lower back and chair to maintain the curve in your spine.
    • Maintaining good posture is a good thing to do at all times, not just when you have an injury. It can prevent future back pain.
    • Avoid prolonged sitting as much as possible. If you have to sit for a long time, try to shift your position frequently.
    • When you’re driving, use a soft pillow to support your back.
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Method 2
Method 2 of 3:

Exercising Effectively

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    Prolonged sitting puts a lot of pressure on your back, which can increase the pain from your injury. If you sit for work, then make sure you get up and walk for 5 minutes every hour or so. This prevents your back from tightening up and making the injury worse. [27] [28]
    • Do the opposite if you stand for long periods of time. Sit every hour or so, and keep a stool next to you so you can rest your foot on it.
    • It’s also a good idea to stretch out a little when you walk.
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    While you should move around and stay active in the few days after your injury, don’t push things too far. If you have a normal exercise regimen, then take at least 3-4 days off following the injury. This way, you’ll avoid making the strain worse. [29]
    • You can do some light walking if you feel up to it. This is a good way to stay active without pushing yourself too far.
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    Stretch your back gently to loosen it up. Light stretching can help your back heal faster and also prepare you for activity. Spend 5-10 minutes each day stretching your back as much as you can. Hold each stretch for 20-30 seconds to loosen your back up. [30]
    • A good, simple stretch is standing with your feet together and bending down to touch your toes. You could do a deeper stretch by sitting with your legs outstretched and reaching towards your toes. [31]
    • If you feel up to it, some twisting stretches can loosen your back. Try rotating your hips or gently twisting from side to side while standing. [32]
    • Some discomfort while you stretch is normal since you have an injury. But stop pushing yourself if the pain is hard to bear.
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    When you are ready to exercise again, start slowly and make sure you’re fully warmed-up. Spend 5-10 minutes walking or doing some light calisthenics. Then spend 5-10 minutes stretching, with a focus on your back.
    • To prevent future injuries, always follow a thorough warm-up and stretching regimen before you exercise.
    • Don’t stretch before you’ve warmed up a bit. Your muscles are less flexible when they’re cold.
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    Skip the weightlifting for at least a week after you start working out again. Get back into your regimen with low-impact cardio activities that won’t put pressure on your back. Stick with these activities for 5-7 days after your injury. [33]
    • Good low-impact activities are biking (or using a stationary bike), walking on an elliptical machine, or swimming.
    • Running is often too stressful on your back right after an injury. [34] If you want to run, start off with a very light jog. If you feel any pain, then skip the run until you feel better.
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    These exercises are important for preventing muscle strains from becoming chronic pain, but don’t rush them. Only start strength-training exercises when your back is healed. This could be 2 weeks or more, so try to be patient. [35] Take it day by day and when your back feels healthy enough, slowly start some strength training. [36]
    • The general rule for exercising your back is to do what feels okay. If anything causes pain or discomfort, then skip it.
    • Simple back exercises include rowing, overhead pulldowns, bridges, and back rotations. [37]
    • Start off with strength training 1-2 days per week to start. You can then scale that up when you feel ready.
  7. 7
    Train your core twice a week so it supports your back. A weak core could cause back injuries because it places more pressure on your back. When your back is healed, work on strengthening your core muscles with planks, crunches, leg lifts, mountain climbers. Do core exercises at least twice a week to support your back. [38]
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  1. 1
    • Use your core whenever you exercise or lift something. Tighten your abs so your back doesn’t do all the work.
    • This is especially important for preventing chronic back pain. A weak core sets you up for pain later on.
Method 3
Method 3 of 3:

Getting Medical Assistance

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    In most cases, a combination of rest, icing, heat, and light activity heals muscle strains within 2 weeks. Sometimes, however, this isn’t enough to heal your back. If home care hasn’t led to any improvement within 2 weeks, then you might have a slightly more serious injury. Contact your doctor for an exam and more treatment options. [39]
    • Your back probably won’t be fully healed within 2 weeks, but the pain should decrease. As long as the pain is improving, then your treatment is working.
    • Even serious back injuries are treatable with the proper care, so don't worry if your pain hasn't gone away.
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    On rare occasions, a muscle strain can cause more serious symptoms that require medical attention. If you experience any of the following symptoms, see your doctor right away: [40]
    • Severe, unbearable pain
    • Bowel or bladder problems
    • A fever
    • Tingling or weakness that radiates down your legs
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    After examining your back, your doctor might prescribe a round of physical therapy to increase strength and flexibility in your back. Attend your sessions and follow the therapist’s instructions for stretching and exercising your back. Most people see significant improvement after completing physical therapy. [41] [42]
    • Physical therapy commonly lasts 4-6 weeks, depending on your progress.
    • Most physical therapists will give you activities to do at home as well. Complete all of these exercises to speed your recovery.
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    If your back hurts very badly, then your doctor may prescribe medication to help you manage the pain until your back heals. Take this medication as prescribed and continue with your daily care regimen to help your back heal. [43]
    • Painkillers affect people differently and could cause drowsiness or disorientation, so don’t drive or operate machinery when you first start taking them. Wait until you’re sure you aren’t experiencing any adverse side effects.
    • Remember that the painkillers might relieve the pain, but the injury is still there. Don’t push yourself too hard or you could make the injury worse.
    • There is always a risk of dependency when you take pain medication, so always take it exactly as directed.
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      Tips

      • Be careful when lifting heavy weights. Bend at the knees instead of your back. Pick up objects slowly and carefully, and keep your core muscles engaged. Keep the object close to your body and avoid twisting your body as you lift. [44]
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      • Sleeping on your back on a medium-firm mattress may help relieve your back pain. [45] Sleeping with a pillow under your legs or lower back may also help. [46]
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      • Doctors usually don't recommend surgery for muscle strains, so it's very unlikely that you’ll need it. [47]
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      Warnings

      • If you take prescription painkillers, always follow the exact dosing instructions. These medications are addictive if you don't take them correctly.
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      • Talk to your doctor before using any over-the-counter pain medication if you have any major health conditions or concerns, such as pregnancy, liver disease, or stomach ulcers. [49]
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      References

      1. ↑ https://www.uofmhealth.org/health-library/aba5320
      2. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains
      3. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains#management-and-treatment
      4. ↑ https://my.clevelandclinic.org/health/articles/4290-low-back-pain-coping
      5. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains/management-and-treatment
      6. ↑ https://www.uofmhealth.org/health-library/hw47901
      7. ↑ https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Treating-Sports-Injuries-with-Ice-and-Heat.aspx
      8. ↑ https://www.spine-health.com/treatment/heat-therapy-cold-therapy/ice-packs-back-pain-relief
      9. ↑ https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ice-packs-vs-warm-compresses-for-pain
      1. ↑ https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut3391
      2. ↑ https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Treating-Sports-Injuries-with-Ice-and-Heat.aspx
      3. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446809/
      4. ↑ https://www.health.harvard.edu/pain/best-bets-for-back-pain
      5. ↑ https://www.health.harvard.edu/pain/where-to-turn-for-pain-relief-acetaminophen-or-nsaids
      6. ↑ https://www.aafp.org/afp/2013/0601/p766.html
      7. ↑ https://www.getreliefresponsibly.com/use-pain-medicine-safely/adult-nsaid-dosage-chart
      8. ↑ https://familydoctor.org/pain-relievers-understanding-your-otc-options/
      9. ↑ https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-prescription-acetaminophen-products-be-limited-325-mg-dosage-unit
      10. ↑ https://www.aafp.org/afp/2013/0601/p766.html
      11. ↑ https://medlineplus.gov/ency/article/002123.htm
      12. ↑ https://www.peacehealth.org/medical-topics/id/hn-2879002
      13. ↑ https://health.clevelandclinic.org/does-magnesium-help-you-sleep/
      14. ↑ https://www.drugs.com/mtm/magnesium-citrate.html#interactions
      15. ↑ https://www.aafp.org/afp/2009/0715/p157.html
      16. ↑ https://www.spine-health.com/blog/bed-rest-not-always-best-bet-beating-back-pain
      17. ↑ https://my.clevelandclinic.org/health/articles/4290-low-back-pain-coping
      18. ↑ https://www.spineuniverse.com/wellness/ergonomics/sitting-disease-its-impact-your-spine
      19. ↑ https://www.spine-health.com/blog/poor-posture-causing-your-back-pain
      20. ↑ https://medlineplus.gov/ency/article/002119.htm
      21. ↑ https://www.nhs.uk/conditions/back-pain/treatment/
      22. ↑ https://www.spine-health.com/wellness/exercise/specific-hamstring-stretches-back-pain-relief
      23. ↑ https://pubmed.ncbi.nlm.nih.gov/25736957/
      24. ↑ https://medlineplus.gov/ency/article/002119.htm
      25. ↑ https://www.spine-health.com/conditions/sports-and-spine-injuries/running-and-lower-back-pain
      26. ↑ https://medlineplus.gov/ency/article/002119.htm
      27. ↑ https://www.spine-health.com/wellness/exercise/stretching-back-pain-relief
      28. ↑ https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265
      29. ↑ https://www.henryford.com/blog/2017/02/back-pain-core-exercises
      30. ↑ https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
      31. ↑ https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
      32. ↑ https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain
      33. ↑ https://motusheals.com/physical-therapy-faq/
      34. ↑ https://my.clevelandclinic.org/health/treatments/12058-pain-relievers
      35. ↑ https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/back-pain/art-20044526
      36. ↑ https://www.spine-health.com/wellness/sleep/choosing-best-mattress-lower-back-pain
      37. ↑ https://familydoctor.org/condition/low-back-pain/
      38. ↑ https://www.hss.edu/conditions_muscle-strain.asp
      39. ↑ https://medlineplus.gov/ency/article/002119.htm
      40. ↑ https://familydoctor.org/pain-relievers-understanding-your-otc-options/

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