How Do You Know If You Have Pulled a Back Muscle?
A pulled back muscle usually causes a sudden, sharp pain. It is directly linked to a movement, such as lifting, twisting or bending. The area feels stiff and tender to touch. The pain typically gets worse with movement and eases with rest. If it does not improve within a few weeks, or you develop nerve symptoms, further investigation may be needed.
Key points
- A muscle strain hurts most with movement and usually improves within two to six weeks.
- Pain that shoots down your leg, or comes with numbness, is more likely a nerve or disc problem than a simple strain.
- Repeated strains may point to an underlying muscle imbalance or alignment problem.
- Most strains do not need a scan, but pain that lasts beyond six weeks is worth investigating.
Almost everyone will pull a back muscle at some point. It is the most common cause of sudden lower back pain, and it usually settles on its own. The hard part is telling a simple strain apart from something that needs more attention.
What does a pulled back muscle feel like?
A pulled muscle in the back typically causes pain in one spot that is linked to movement. You can often point to it with one hand. It tends to feel very different from deeper, nerve-type pain.
Pain often comes during or right after a specific movement, like lifting, twisting or reaching.
Your back muscles tighten to protect the injured area. Bending or turning feels restricted.
Cramping or twitching you cannot control in the nearby muscles is common in the first few days.
The pain is clearly mechanical. It flares when you move and settles when you sit or lie down.
You may also notice swelling or tenderness right over the muscle. The pain usually stays in the back rather than travelling down a leg.
What causes a pulled muscle in the back?
A back muscle strain happens when muscle fibres are stretched or torn beyond their normal range. Common triggers are heavy lifting, awkward twisting, sudden movements and overuse.
Lifting with a rounded back, or twisting while carrying a load.
Jumping into intense activity without warming up properly.
Hours of sitting or standing in one position weakens and tires the muscles.
When one side works harder than the other, the risk of injury rises over time.
Sometimes the cause is less obvious. Repeated minor strains can signal an underlying muscle imbalance. They can also signal an alignment problem in the spine, pelvis or hips that puts extra load on certain muscles.
Is it a pulled muscle or a slipped disc?
This is one of the most common questions people search for, and for good reason. The two can feel alike at first, but they behave differently.
A muscle strain tends to stay in the back. The pain is dull or aching. It is clearly linked to movement and does not travel down into the leg. You can usually point to the sore spot with one finger.
A disc problem often sends pain, tingling or numbness into the buttock or leg. You may feel weakness in the foot, or a burning feeling along the path of a nerve. The pain can be worse when sitting or coughing.
If your pain stays in one place, started with an obvious movement and slowly improves over a couple of weeks, a strain is the most likely explanation. If it spreads, or comes with nerve symptoms, it is worth looking into further. You can read more about when to see a specialist.
How long does a pulled back muscle take to heal?
Most mild to moderate back muscle strains improve clearly within two to four weeks. A bigger tear may take six weeks or longer to feel back to normal.
What helps recovery
- Keep moving gently. Bed rest for more than a day or two can slow healing. Light walking and gradual stretching help muscles recover.
- Use heat, not ice, after the first 48 hours. Warmth relaxes tight muscles and encourages blood flow to the area.
- Pain relief from the pharmacy. Anti-inflammatories or paracetamol can help you stay mobile in the early days. Speak to a pharmacist if you are unsure.
- Return to activity step by step. Build back up slowly rather than going straight back to what caused the injury.
If you are still in a lot of pain after six weeks, or the strain keeps coming back, that pattern may suggest something beyond a simple pull. Repeated strains sometimes point to a muscle imbalance or a structural problem such as spondylolysis, a stress fracture often mistaken for a strain.
Pain lasting more than six weeks, or strains that keep returning, may be worth investigating further. You can book an assessment if the pain continues.
When should you get urgent help for back pain?
Most pulled muscles are not serious. However, some symptoms need urgent medical attention. Contact your doctor or go to the nearest emergency department straight away if you have any of the following:
- Numbness or tingling around your groin or between your legs (saddle area).
- Loss of bladder or bowel control, or difficulty passing urine.
- Sudden weakness in one or both legs.
- Severe pain that does not let up and does not ease in any position, especially at night.
- Back pain after a significant fall, accident or injury.
These can be signs of a condition that needs immediate treatment. Do not wait to book a scan or plan a trip. Get urgent medical care first.
Does a pulled back muscle need a scan?
A simple muscle strain usually does not need a scan. Your body heals the fibres over a few weeks. A scan in the early stages rarely changes what you do about it.
A scan becomes useful when pain lasts, keeps returning, or when you want to rule out something else. A standing whole-body assessment can show alignment problems in the spine, pelvis or hips that may be overloading certain muscles. When you stand, your body carries its normal load. Problems that hide on a lying-down scan, where gravity is removed and muscles relax, can become visible.
At ScanAlign in London, the EOS system takes a full standing image from head to feet using about 90% less radiation than a standard X-ray, around ten times less. This is helpful for people with recurring strains, because it can show whether one area of the body is making up for misalignment somewhere else.
When MRI is the better choice: EOS shows bones, joints and alignment clearly. For soft tissue detail such as discs, nerves or the muscle fibres themselves, MRI is usually the better tool. Your treating specialist or therapist can advise which suits your situation.
If you are about to start treatment, or change the one you are on, a detailed diagnosis is worth getting first. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.
Frequently asked questions about pulled back muscles
A pulled muscle typically hurts in one specific area, is linked to a clear movement, and improves slowly over days. If pain shoots down a leg, comes with numbness or does not improve after a few weeks, it may be worth investigating further.
Most strains improve within two to four weeks. More severe tears may take up to six weeks. If pain continues beyond that, there could be an underlying factor keeping the muscle under stress.
In the first 24 to 48 hours, a cold pack can help reduce early inflammation. After that, warmth tends to help more because it relaxes the muscles and encourages blood flow to the area.
Gentle movement is usually better than bed rest. Staying active helps the muscle heal and prevents stiffness. Avoid the specific activity that caused the strain, but try light walking and careful stretching.
A pure muscle strain normally stays in the back. Pain that travels into the buttock or leg may suggest nerve irritation or a disc problem rather than a simple strain. It is worth speaking to a specialist or therapist if this happens.
Repeated strains can point to a muscle imbalance, poor alignment, or an underlying structural problem that puts extra load on certain muscles. A standing alignment assessment can help find out whether something in your posture or skeleton is playing a part.
Most simple strains do not need a scan. If the pain is not improving after about six weeks, keeps returning, or you want to rule out another cause, a scan can be helpful.
A strain is actual damage to the muscle fibres. A spasm is an involuntary contraction, a cramp, which often comes with a strain as the body tries to protect the injured area. Spasms can also happen on their own from tiredness or dehydration.
No. ScanAlign is a private, self-pay clinic. You do not need a referral from your doctor. You can book a free video consultation to discuss whether a standing alignment assessment is right for you.
Yes. EOS uses about 90% less radiation than a standard X-ray, around ten times less. You stand naturally while the image is taken. The process is quick and comfortable.
Still unsure about your back pain?
A free video consultation with our team can help you decide whether a scan in London is the right next step.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. Back pain. nhs.uk. Available at: https://www.nhs.uk/conditions/back-pain/
- Casazza BA. Diagnosis and treatment of acute low back pain. American Family Physician. 2012;85(4):343-350.
- National Institute for Health and Care Excellence (NICE). Low back pain and sciatica in over 16s: assessment and management (NG59). 2016, updated 2020.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.