Difference between a Back Strain and a Back Sprain

Back sprains and back strains are often used interchangeably to describe muscle and ligment related back issues. But while both may have the same symptoms and treatment, they are different in some ways. This article discusses the differences between a back strain and sprain.

Back Strain versus Back Sprain

A back strain refers to a torn muscle or tendon. This happens when the muscle is over-stretched, causing it to tear.  A back sprain, in comparison, is an injury in the ligament, a fibrous tissue that connects muscles to bones. Ultrasound imaging should be able to determine if the injury caused a tear in the muscles or ligaments.

What Are the Causes of Back Strains and Back Sprains?

A back strain occurs when the muscles that move the spine are overused or overloaded, maybe due to some repetitive, prolonged movement. When the muscle is stretched beyond limit, back pain occurs.  It can also be caused by improper lifting, hence twisting the tendon that leads to a strain.

A back sprain may be caused by sudden movements, a fall, or perhaps an accident that injures the ligament. With movements so abrupt, the muscle is unable to react to keep the spine in its normal range of movement, thereby causing ligaments to tear or stretch. Curving of the lower back excessively especially in sports like weightlifting and football, being obese, or having innately weak back can also cause either strain or sprain.


Back strains cause stiffness and pain in the back. There can also be pain in the buttocks area. With either strain or sprain, it becomes very difficult to bend forward, stand straight, and walk.  If there is numbness in the legs or some problems with bowel movement, it is important to seek immediate medical help as these can be signs of nerve damage.

Depending on the extent of the injury, back sprains can be minor, moderate, or severe. Severe sprains can cause swelling and bruising.  It also becomes almost impossible to move as pain tends to worsen with movement. Other symptoms include muscle cramps or spasms, which are sudden uncontrollable contractions in the muscles.

Treatment for Back Strains and Sprains

Strains and sprains are treated similarly. The first step is pain and spasm reduction. Apply cold compress on the area as soon as possible. You can do this several times in the first and second day for about 20 minutes. To further reduce pain and swelling, taking over-the-counter anti-inflammatory drug is recommended. After about two days of cold compress, you can apply hot pad to relax the muscles and increase the flow of blood. You may also give warm bath to the patient. It is important for the patient has to take rest. One to two days of bed rest is prescribed.  After the first 48 hours, the patient can resume normal activities. Prolonged immobility can actually delay recovery.  Most people suffering strain or sprain should recover in two weeks time. Additional treatment should be given if symptoms continue for over two weeks.

Healing Time

However, although a strain and a sprain may be treated similarly, the former may take longer to heal simply because a ligament takes longer time to heal than the muscle. If the patient goes back immediately to exercising, the injury can recur. Most back sprains resolve in a period of six to eight weeks, but it may take a few months for a severe back sprain to completely recover.