The Complete Guide to Back Injury Recovery

Introduction

An estimated 80 percent of people will experience a back problem at some point in their lives. This guide is designed to help you identify the most common types of back injuries, select the best treatment options, and learn prevention techniques so you can try to avoid back injuries in the first place. Of course, it’s always a good idea to seek medical attention after sustaining any type of injury, so talk to your doctor about the best treatment options for your situation.

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Chapter 1

Back Anatomy

It's important to know that back muscles are not the only ones that contribute to back pain and injury. Weakness or imbalance in the chest, hamstrings, abdominal, and gluteus muscles also play an important role in back health. 

 

THE SPINAL COLUMN

The 33 vertebrae that join together to make up the spine are divided into three primary sections that can potentially be injured:

  • Cervical spine: 7 vertebrae in the neck that support and move the head
  • Thoracic spine: 12 vertebrae in the middle of the back that hold the ribs
  • Lumbar spine: 5 vertebrae in the lower back that bear body weight

The remaining bones make up the sacral spine and coccyx and connect to the hips and pelvis. Unlike the 24 bones listed above, these are fused together and not moveable.

Each vertebra has a slightly different shape depending on where it is located in the spinal column, but they all have a body that bears weight, space for the spinal cord to pass through, and structures that enable attachment to the muscles that make up the back. 

BACK MUSCLES

Back muscles are classified into three major groups:

  • Superficial muscles that move the shoulders
    • Trapezius: lift and rotate the scapula
    • Latissimus dorsi: lift and rotate the arms
    • Levator scapulae: lift the scapula
    • Rhomboids: retract and rotate the scapula
  • Intermediate muscles that move the trunk
    • Serratus posterior superior: elevate the upper ribs
    • Serratus posterior inferior: depress the lower ribs
  • Intrinsic muscles that move the spinal column
    • Superficial: two splenius that move the head and neck
    • Intermediate: three erector spinae that flex the spine
    • Deep: three transversospinales that stabilize the spine

When it comes to back injuries, the muscles that can come into play include:

  • Extensors: back and gluteal muscles that enable lifting and standing
  • Flexors: abdominal and iliopsoas muscles that enable bending forward
  • Obliques or rotators: side muscles that enable rotation in the trunk

All of these muscles work together to support and move the spinal column. When any of them are weak, or if there is an imbalance of muscle strength, it can increase the risk of a back injury. Muscles in the back can also be pulled or strained, resulting in a potentially painful injury.

CONNECTIVE TISSUES

Ligaments are fibrous bands that connect the bones of the spine to each other. They also protect the intervertebral discs and help stabilize the spine by preventing too much movement of the bones. There are five major ligaments in the back, some of which run the full length of the spinal column and some of which connect the individual bones to one another. When a ligament is stretched or torn, the result is a back sprain injury.

Tendons are also fibrous bands of tissue, but they connect muscles to bone. When a tendon is stretched or torn, the result is a back strain injury.

Back Anatomy

Chapter 2

Types of Back Injuries

Back injuries can be caused by trauma, disease, or genetic conditions, but the most common type—and the most preventable—is known as a mechanical injury. This means that the injury is caused by placing stress on the spinal joints, discs, vertebrae, muscles, ligaments, or tendons. This stress can be the result of factors such as poor posture, incorrect lifting technique, overuse, or rapid twisting during athletic activity. The three most common types of mechanical injuries are strains, sprains, and pulled muscles. 

BACK STRAINS

The most prevalent type of back injury is a strain, which occurs when the muscles and/or tendons are stretched or torn. Some of the symptoms of a strained back include:

  • Soreness or tenderness in your back
  • Pain that radiates to your legs, buttocks, or thighs
  • Back pain that occurs suddenly
  • Pain that increases when standing, walking, or twisting
  • Muscle spasms in the back 

Back strain is one of the most common injuries of any type and the primary cause of lower back pain.

Unless there is a complete tear of a muscle or tendon, most back strain injuries heal on their own. The recovery time from a back strain depends on the severity of the injury and the treatment approach, and can range from one to ten weeks.

PULLED BACK MUSCLES

A pulled back muscle is essentially the same as a strain or muscle tear, and the terms can all be used interchangeably. When a muscle is damaged, some or all of the muscle fibers and the attached tendons get overstretched (or pulled) and start to tear. Whether you call it back strain, a pulled back muscle, or a torn muscle, the symptoms, causes, and treatment options are all the same.

BACK SPRAINS

A sprain in the body occurs when a ligament (the tissue that connects bone to bone) becomes stretched or torn. The symptoms of a back sprain are very similar to a strain and might also include:

  • Severe pain when the injury occurs
  • A popping sensation when the injury occurs
  • Tenderness, swelling, and bruising
  • Loss of function

A medical professional can distinguish between a strain and a sprain by performing certain tests. For example, pain that is associated with passive motion is most often linked to a sprain because muscle contraction is not required for the movement.

A back sprain can occur in any of the three areas of the back. Neck sprains may occur when the ligaments that connect the seven bones in the neck become overstretched or torn. Upper back sprains are uncommon and are typically caused by other conditions such as osteoporosis or traumatic injury. Lumbar back sprains, which are the most common, may happen when one or more ligaments in the sacroiliac region of the spine becomes overstretched.

The most common causes of back sprain are contact sports, sudden movements while walking or running, prior injury, and obesity. Recovery time can range from two to four weeks for a mild sprain to up to ten weeks for a more severe injury. 

Chapter 3

Back Injury Treatment

Because often times the body is able to heal itself, the treatment approach may be similar for most back strains, sprains, and pulled muscles. Exceptions include more severe injuries that require surgical intervention and chronic conditions in which the body does not heal. If you are concerned about either of these possibilities, consult a medical professional to address your back pain. 

Recovery time for a back injury can range from one to ten weeks, depending on a range of factors such as:

  • Severity of the injury
  • Physical fitness and muscle conditioning
  • Treatment approach
  • Overall health

The good news is the vast majority of people recover from back sprains and strains within one month. However, if you want to stay injury-free, it’s important to try to take preventive measures and avoid the behaviors that contributed to your injury in the first place.

BED REST

Although it might be tempting to stay completely immobile until the pain subsides, bed rest is recommended only for the first few days. The sooner you can safely move around, the better your recovery may be. Resting for too long may contribute to muscle stiffness, which can ultimately cause more discomfort. Too much rest after a back injury may also lead to loss of muscle strength, which could contribute to a longer recovery time and increase your risk of reinjury.

RICE THERAPY

The combination of rest, ice, compression, and elevation is a classic approach to most types of injuries that cause inflammation, including a sprain or strain. While too much bed rest can be detrimental, it is important to give your body a break while healing. Don’t expect to maintain your normal level of activity, and be sure to get enough good quality sleep, as this is when your body does most of its healing.

Applying ice or using other cold therapy methods like cryotherapy systems may help reduce pain and inflammation. When cold comes into contact with the skin and penetrates deeper into the other tissues, the nerve endings are temporarily slowed or deadened, which helps reduce the sensation of pain. Cold also slows cellular metabolism, which helps prevent excess inflammation and allows tissues to heal faster.

Compression helps prevent excess fluid, or edema, from building up around the injury. This helps contribute to a faster healing process and also enables better range of motion. Compression can be applied statically using bandages or braces or actively with a cold and compression system. Active compression is may be more effective because in addition to pumping away excess fluid, it also supports the flow of freshly oxygenated blood and nutrients to the injury site to promote healing.

Elevation is not always convenient with a back injury, but it is relatively easy for neck and upper back strains and sprains. For lower back pain, some people try inversion therapy to relieve stress on the muscles and joints while also reducing blood flow to the area at the same time.

HEAT THERAPY

Therapeutic heat can be applied with hot pads or by soaking in a warm bath. Heat should be applied only after the initial inflammation has subsided, typically after three or more days. Applying heat too soon may contribute to swelling because it increases blood flow by dilating the blood vessels. Applying heat after the inflammation has died down may help loosen stiff muscles and relieve pain and soreness.

MASSAGE

When recovering from a back sprain or strain, it’s not uncommon to feel some stiffness in the muscles, especially if you have experienced spasming. Massage may help relieve tension and reduce stiffness, which may help improve range of motion. This is important for recovery because it may allow you to perform the strengthening and stretching exercises that support a healthy back.

PHYSICAL THERAPY

Your doctor might recommend working with a physical therapist while recovering from a back sprain or strain. A physical therapist will show you exercises that you can perform both in the clinic and at home to help strengthen and stretch the muscles that support the spine. They can also show you proper posture, lifting techniques, and athletic form to help you avoid future injuries. Some physical therapists also use medical devices to help relieve pain and reduce inflammation. These might include cold and compression systems, contrast therapy devices, ultrasound, or transcutaneous electrical nerve stimulation (TENS).

MEDICATION

Over-the-counter pain medications such as aspirin, acetaminophen or ibuprofen may be taken to relieve minor discomfort. You may also try applying topical solutions that help dull the pain and relieve sore muscles. For more severe pain, your doctor might prescribe a prescription pain reliever or muscle relaxant to prevent painful spasms. If inflammation is severe, your doctor might also recommend a corticosteroid injection at the injury site.

Chapter 4

Preventing Back Injuries

The best approach to any type of injury is to try to prevent it in the first place. You can’t always avoid a back injury—sometimes a cough or sneeze in the wrong position is enough to pull a muscle. While you might not be able to control other factors like inherited diseases and traumatic injuries, you can take steps to help prevent the most common causes of back injury. Use these tips to help avoid unnecessary back injuries.

STRENGTHEN AND STRETCH

Back strains and sprains happen when too much stress is placed on a muscle, tendon, or ligament. Strengthening the muscles that support the spine and keeping the connective tissues supple and flexible may help you avoid injury. Core and abdominal exercises can help stabilize the spine. If you suffer from chronic back pain, consider low-impact activities such as walking, swimming, and cycling to help maintain muscle mass and keep your body moving.

USE PROPER TECHNIQUES

Avoid lifting or get help with moving objects that are too heavy. When you do lift, don’t bend at the waist to do it. Bend your knees, and stand up from a squatting position to avoid putting too much pressure on your back. Incorrect posture may lead to back injury by repeatedly putting stress on the joints, muscles, and connective tissues, so think about your position while you sit or stand, and make adjustments as necessary. When playing sports, try to learn proper techniques, and practice them so your body uses muscle memory to get in the correct positions.

MAINTAIN A HEALTHY WEIGHT

Excess weight contributes to stress on the spine, especially in the lower back. Try to take steps to maintain a healthy weight to help alleviate and prevent back pain.

WARM UP BEFORE ACTIVITY

Moving too quickly or extending your range of motion when your muscles are tight can lead to a strain. Take the time to warm up the muscles and gently stretch before engaging in activities that require you to move your spine. This includes both athletic activity and household chores like gardening.

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