Pulled Lower Back Muscle (Lumbar Strain): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
A lumbar strain is an overstretch or small tear of the muscles or ligaments in your lower back, usually from lifting, twisting, or an awkward movement. It causes sudden, achy, sometimes spasming pain that's worse with movement. It's rarely serious and most people recover within a few weeks by staying gently active. Physical therapy helps you heal faster and lowers the chance it returns.
What is a lumbar strain?
A lumbar strain (often called a "pulled back muscle") is an injury to the soft tissues — muscles and ligaments — that support your lower spine. It does not involve nerve or disc damage, which is why it tends to heal well.
Symptoms
The classic pattern is pain that comes on quickly after a specific movement: a dull ache or sharp catch across the lower back, muscle tightness or spasm, and stiffness that's worse first thing in the morning or after sitting. Pain usually stays in the back rather than traveling far down the leg.
What causes it / risk factors
Lifting something heavy or awkwardly, a sudden twist, repetitive bending, a fall, or even a hard sneeze can do it. Deconditioned muscles, long sitting, and a recent spike in physical activity raise the risk.
How it's diagnosed
Lumbar strain is diagnosed from your history and a hands-on exam. Imaging is usually unnecessary because scans don't show muscle strains well and aren't needed for typical cases.
Physical therapy treatment
What a PT does. Your therapist confirms there's no nerve involvement, eases the spasm, restores comfortable movement, and rebuilds strength so the area tolerates daily demands. Exercises & progression (overview). Early gentle movement and walking, then graded core and hip strengthening and safe lifting mechanics. Staying active beats bed rest for recovery. Recovery timeline. Most strains improve markedly within 2–6 weeks.
Treatment options compared
Active recovery and PT are first-line. Short-term pain relief and heat can keep you moving. Imaging, injections, and surgery aren't appropriate for a simple strain.
Red flags
Seek care for leg weakness, numbness in the groin, loss of bladder/bowel control, fever, or pain after a major injury — these point to something beyond a strain.
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Frequently asked questions
Often 2–6 weeks, with the worst usually easing in the first week or two.
Sources (5)
- MedlinePlus: Low back pain - acute. — NIH/MedlinePlus
- AAOS OrthoInfo: Low back pain. — AAOS OrthoInfo
- Qaseem A, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017. — PubMed
- Hayden JA, et al. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021. — Cochrane
- Hartvigsen J, et al. What low back pain is and why we need to pay attention. Lancet. 2018. — Lancet
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.