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

Muscle strains are painful injuries that usually happen after you stress one of your muscles too much or over-exercise it.[1] They can be especially uncomfortable in your mid-back because this area is responsible for a lot of your movements and lifting.[2] Fortunately, most mid-back strains heal within 2 weeks without any lasting complications.[3] 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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    Rest for 24-48 hours after the injury. 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.[4]
    • 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.[5]
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    Hold an ice pack against the area within the first 24-48 hours. 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.[6] [7]
    • Don’t hold an ice pack against your skin without wrapping it in a towel first. This could cause frostbite.[8]
    • 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.[9]
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    Switch to a heating pad 48 hours after the injury. 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.[10] 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.[11] >
    • If the pain is still sharp and concentrated in one spot, then you can stick with ice to relieve the inflammation.[12]
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    Try an acupressure mat to get pain relief. 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.[13] 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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    Take acetaminophen or NSAID pain relievers to manage the pain and inflammation. 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.[14] You can also try acetaminophen (Tylenol), either alone or in combination with NSAIDs.[15]
    • 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.[16] Never take more than the recommended daily amount within 24 hours.[17]
    • 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.[18]
    • It’s generally safe to take 325 mg of acetaminophen every 4-6 hours, and no more than 4,000 mg in a day.[19] [20]
    • 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.[21]
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    Use magnesium citrate 200-400 mg before bed to relax your muscles. 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.[22] [23]
    • 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.[24]
    • 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.[25]
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    Return to simple household tasks after 48 hours. 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.[26]
    • 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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    Maintain good sitting and standing posture to support your back. 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.[27]
    • 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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    Get up and walk every hour if you sit for long periods of time. 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.[28] [29]
    • 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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    Take 3-4 days off from exercising when you strain your back. 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.[30]
    • 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.[31]
    • 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.[32]
    • 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.[33]
    • 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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    Warm up and stretch thoroughly before exercising. 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.[34]
    • 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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    Start with low-impact aerobic activities to restart your workout regimen. 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.[35]
    • 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.[36] 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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    Incorporate back-strengthening exercises when you feel up to it. 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.[37] Take it day by day and when your back feels healthy enough, slowly start some strength training.[38]
    • 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.[39]
    • 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.[40]
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    • 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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    Contact your doctor if the pain doesn’t improve within 2 weeks. 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.[41]
    • 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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    See a doctor right away for severe pain, numbness, or tingling. 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:[42]
    • Severe, unbearable pain
    • Bowel or bladder problems
    • A fever
    • Tingling or weakness that radiates down your legs
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    Complete a round of physical therapy to strengthen your back. 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.[43] [44]
    • 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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    Take prescription painkillers exactly as your doctor instructs you to. 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.[45]
    • 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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Warnings

  • If you take prescription painkillers, always follow the exact dosing instructions. These medications are addictive if you don't take them correctly.
    ⧼thumbs_response⧽
  • 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.[51]
    ⧼thumbs_response⧽
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References

  1. ↑ https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/overuse-injury/art-20045875
  2. ↑ https://www.uofmhealth.org/health-library/aba5320
  3. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains
  4. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains/management-and-treatment
  5. ↑ https://my.clevelandclinic.org/health/articles/4290-low-back-pain-coping
  6. ↑ https://my.clevelandclinic.org/health/diseases/10265-back-strains-and-sprains/management-and-treatment
  7. ↑ https://www.uofmhealth.org/health-library/hw47901
  8. ↑ https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Treating-Sports-Injuries-with-Ice-and-Heat.aspx
  9. ↑ https://www.spine-health.com/treatment/heat-therapy-cold-therapy/ice-packs-back-pain-relief
  1. ↑ https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ice-packs-vs-warm-compresses-for-pain
  2. ↑ https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut3391
  3. ↑ https://www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Treating-Sports-Injuries-with-Ice-and-Heat.aspx
  4. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446809/
  5. ↑ https://www.health.harvard.edu/pain/best-bets-for-back-pain
  6. ↑ https://www.health.harvard.edu/pain/where-to-turn-for-pain-relief-acetaminophen-or-nsaids
  7. ↑ https://www.aafp.org/afp/2013/0601/p766.html
  8. ↑ https://www.getreliefresponsibly.com/use-pain-medicine-safely/adult-nsaid-dosage-chart
  9. ↑ https://familydoctor.org/pain-relievers-understanding-your-otc-options/
  10. ↑ https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-prescription-acetaminophen-products-be-limited-325-mg-dosage-unit
  11. ↑ https://www.aafp.org/afp/2013/0601/p766.html
  12. ↑ https://medlineplus.gov/ency/article/002123.htm
  13. ↑ https://www.peacehealth.org/medical-topics/id/hn-2879002
  14. ↑ https://health.clevelandclinic.org/does-magnesium-help-you-sleep/
  15. ↑ https://www.drugs.com/mtm/magnesium-citrate.html#interactions
  16. ↑ https://www.aafp.org/afp/2009/0715/p157.html
  17. ↑ https://www.spine-health.com/blog/bed-rest-not-always-best-bet-beating-back-pain
  18. ↑ https://my.clevelandclinic.org/health/articles/4290-low-back-pain-coping
  19. ↑ https://www.spineuniverse.com/wellness/ergonomics/sitting-disease-its-impact-your-spine
  20. ↑ https://www.spine-health.com/blog/poor-posture-causing-your-back-pain
  21. ↑ https://medlineplus.gov/ency/article/002119.htm
  22. ↑ https://www.nhs.uk/conditions/back-pain/treatment/
  23. ↑ https://www.spine-health.com/wellness/exercise/specific-hamstring-stretches-back-pain-relief
  24. ↑ https://pubmed.ncbi.nlm.nih.gov/25736957/
  25. ↑ https://www.polarisspine.com/blog/8-exercise-mistakes-that-exacerbate-back-pain
  26. ↑ https://medlineplus.gov/ency/article/002119.htm
  27. ↑ https://www.spine-health.com/conditions/sports-and-spine-injuries/running-and-lower-back-pain
  28. ↑ https://medlineplus.gov/ency/article/002119.htm
  29. ↑ https://www.spine-health.com/wellness/exercise/stretching-back-pain-relief
  30. ↑ https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/back-pain/sls-20076265
  31. ↑ https://www.henryford.com/blog/2017/02/back-pain-core-exercises
  32. ↑ https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
  33. ↑ https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906
  34. ↑ https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain
  35. ↑ https://motusheals.com/physical-therapy-faq/
  36. ↑ https://my.clevelandclinic.org/health/treatments/12058-pain-relievers
  37. ↑ https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/back-pain/art-20044526
  38. ↑ https://www.spine-health.com/wellness/sleep/choosing-best-mattress-lower-back-pain
  39. ↑ https://familydoctor.org/condition/low-back-pain/
  40. ↑ https://www.hss.edu/conditions_muscle-strain.asp
  41. ↑ https://medlineplus.gov/ency/article/002119.htm
  42. ↑ https://familydoctor.org/pain-relievers-understanding-your-otc-options/

About This Article

Luba Lee, FNP-BC, MS
Medically reviewed by:
Luba Lee, FNP-BC, MS
Board-Certified Family Nurse Practitioner
This article was medically reviewed by Luba Lee, FNP-BC, MS. Luba Lee, FNP-BC is a Board-Certified Family Nurse Practitioner (FNP) and educator in Tennessee with over a decade of clinical experience. Luba has certifications in Pediatric Advanced Life Support (PALS), Emergency Medicine, Advanced Cardiac Life Support (ACLS), Team Building, and Critical Care Nursing. She received her Master of Science in Nursing (MSN) from the University of Tennessee in 2006. This article has been viewed 12,737 times.
3 votes - 100%
Co-authors: 6
Updated: March 7, 2023
Views: 12,737
Categories: Strain Injuries (Pulled Muscles)

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

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