Back and muscle pain: causes, relief and when to get checked
Most sudden back pain comes from a strained muscle or ligament and improves within a few weeks. Stay gently active, use ice and then heat, and take an over-the-counter pain reliever. Get checked if the pain follows a fall, spreads below the knee, or isn't better after a few weeks.
Acute back pain usually lasts a few days to a few weeks, according to the NIH's National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
MedlinePlus says many people feel better within a week, and the pain should be gone after another 4 to 6 weeks.
Bed rest is not recommended; easing back into normal activity after the first couple of days helps recovery.
Imaging is usually not needed in the first 4 to 6 weeks unless certain warning signs are present.
Lifting with your legs, keeping loads close and avoiding twisting help prevent back strain.
What usually causes back and muscle pain?
MedlinePlus explains that most sudden low back pain comes from an injury to the muscles or ligaments that support the back. A strain, a small tear or a muscle spasm can follow lifting, a sudden movement, sitting too long or a minor accident. Strains elsewhere, such as the hamstring, work the same way.
Lifting and twisting: moving furniture, carrying kids, yard work or shoveling snow in an Illinois winter
Long sitting: desk work, gaming or a long drive with poor posture
Disk problems: a bulging or herniated disk can press on a nerve and cause sciatica
Weak bones: compression fractures, often linked to osteoporosis in older adults
Causes outside the spine: a kidney infection or kidney stone can feel like back pain
NIAMS lists risk factors that make back pain more likely: low fitness and weak back and belly muscles, weight gain, an inactive lifestyle, jobs with heavy lifting or long hours at a desk, poor sleep, stress, and age over 45.
Strain, disk or something else? How to tell
Where it hurts and what came with it are strong clues. This table is based on MedlinePlus and NIAMS.
Common causes of back pain and their clues
Cause
Where it hurts
Clues
Muscle strain or spasm
Low back, one or both sides
Started after lifting, twisting or a long sit; tight, sore muscles
Herniated disk or sciatica
Low back, buttock and down one leg
Shooting or burning pain, tingling, may travel below the knee
Compression fracture
Middle or low back
Older adult, osteoporosis, pain after a minor fall or lift
Kidney infection or stone
Side of the back, below the ribs
Burning when you pee, blood in the urine, fever
Muscle strain elsewhere
Hamstring, shoulder or neck
Pain, spasm and swelling in the muscle after effort
Pain that goes below the knee, or comes with numbness, tingling or weakness in a leg, should be examined rather than waited out.
These steps follow MedlinePlus advice for acute low back pain.
Ease off for a few daysCut back on normal activity at first, but avoid bed rest. Lying down all day slows recovery.
Ice, then heatUse ice for the first 48 to 72 hours, then switch to heat.
Take a pain relieverIbuprofen or acetaminophen can help. Follow the package directions.
Sleep in a friendly positionLie curled on your side with a pillow between your knees, or on your back with a pillow under your knees.
Get moving againAfter a couple of days, slowly return to your usual activities. Avoid heavy lifting and twisting for about 6 weeks.
Add light exerciseAfter 2 to 3 weeks, try walking, a stationary bike or swimming. Starting hard exercises too early can make pain worse.
How long to wait
Many people feel better within a week. Contact a provider if the pain lasts longer than 4 weeks, feels different or worse than past episodes, or comes with any of the signs in the next section.
When to visit urgent care for back pain
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Usually fine at home
Soreness after lifting or yard work
Pain that eases when you move around
Pain that is a little better each day
No numbness, tingling or leg weakness
Come in to urgent care
Back pain after a fall or injury
Pain or tingling that travels below the knee
Burning when you pee or blood in the urine
Fever with back pain
Pain that is worse lying down or wakes you at night
Severe pain that keeps you from getting comfortable
Pain that lasts more than 4 weeks
A history of cancer, steroid use or unexplained weight loss
Walk in or book a visit online. If you were hurt on the job, tell your employer and let us know at check-in. Our workers' compensation care page explains how work injury visits work. Signs of a nerve or spine emergency are listed at the bottom of this page.
What happens at our Westmont, IL clinic
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Urgent Care Center of Westmont, also known as Immediate Care Center of Westmont, sees back and muscle pain at two Westmont, IL clinics, open 7 days a week. Our team is led by board-certified physicians.
Questions. Where it hurts, how it started, what makes it better or worse, and whether pain or tingling travels down a leg.
Exam. Your clinician checks how you move, where it is tender, and the strength, reflexes and feeling in your legs.
Tests only when they help. A urine test can check for a kidney infection. X-rays may be taken after a fall or injury, and are available only at our main clinic at 29 N Cass Ave.
A treatment plan. You get a home-care plan, and your clinician may recommend prescription medicine when appropriate.
Follow-up. If pain lasts or needs more care, we explain options such as physical therapy or a specialist visit.
MedlinePlus notes that X-rays and scans usually aren't needed at the first visit or during the first 4 to 6 weeks unless certain symptoms are present. That is why your clinician may skip imaging for a simple strain. Learn more about a general urgent care visit.
Back pain at work, in older adults and in kids
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At work
The CDC's National Institute for Occupational Safety and Health (NIOSH) explains that work-related muscle and back disorders come from forceful or repeated lifting, pushing, pulling and carrying, awkward postures, vibration and cold work areas. Assistive lifting devices and better job design help prevent them. After a work injury, a return-to-work exam can confirm you are ready for your duties.
Older adults
Back pain is more common after 45. In older adults with thin bones, even a minor fall or lift can cause a compression fracture, so new back pain after a fall deserves an exam.
Children and teens
Back pain is less common in kids. Pain that lasts more than a few days, wakes them at night, or follows a sports injury should be checked.
How to prevent back pain
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MedlinePlus offers these tips to protect your back:
Lift the right way: get help with heavy items, keep the load close, bend at the knees, lift with your legs and don't twist.
Push snow instead of lifting it when you can, and take small scoops.
Exercise to strengthen your back and belly muscles and improve flexibility.
Keep a healthy weight and stay active.
Use a supportive chair, a footstool, and a small pillow or rolled towel behind your low back.
Take a walking break every hour on long drives.
Avoid standing for long periods and wearing high heels.
Worry when back pain comes with loss of bladder or bowel control, numbness in the groin, new leg weakness, a high fever, or follows a major fall or accident. Those need emergency care. See a clinician soon for pain after a smaller fall, pain below the knee, burning urination, or pain lasting more than 4 weeks.
Should I go to urgent care for back pain?
Yes, if the pain follows a fall or injury, travels below the knee, wakes you at night, comes with fever or urinary symptoms, or isn't improving after a few weeks. Urgent care can examine your back, test your urine, take an X-ray at our Cass Ave clinic when needed, and recommend treatment.
Do I need an X-ray for back pain?
Usually not for a simple strain. MedlinePlus says tests are usually not ordered at the first visit or during the first 4 to 6 weeks unless certain symptoms are present. An X-ray may help after a fall or injury, or in an older adult who may have a fracture. Your clinician decides after the exam.
Is it better to rest or move with back pain?
Move. Cut back for the first few days, but avoid bed rest. MedlinePlus advises slowly returning to your usual activities after a couple of days and adding light exercise like walking after 2 to 3 weeks. Avoid heavy lifting and twisting for about 6 weeks while your back heals.
Should I use ice or heat for back pain?
Use ice first, then heat. MedlinePlus advises ice for the first 48 to 72 hours after back pain starts, then switching to heat. Wrap ice in a cloth so it doesn't touch your skin. Heat can relax tight muscles once the first few days have passed.
How long does a pulled back muscle take to heal?
Most pulled back muscles feel better within about a week, and MedlinePlus says the pain should be gone after another 4 to 6 weeks. NIAMS describes acute back pain as lasting a few days to a few weeks. Pain that lasts longer than 4 weeks, or keeps coming back, should be checked.
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