Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might help.
NSAIDs are often the go-to drugs for back pain relief. They can be purchased over the counter (or, in higher doses, by prescription) and include ibuprofen (Advil) and naproxen (Aleve). NSAIDs help reduce pain, swelling, and inflammation in muscles and around damaged spinal discs or arthritic joints.
Management and Treatment
This may involve rest, and the use of ice packs and compression (pressure), especially for the first 24 to 48 hours after the injury. An over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen (Motrin®), may be recommended to help reduce pain and swelling.
Anti-inflammatory medicines such as ibuprofen, naproxen, or acetaminophen (Tylenol) also help reduce pain and swelling. As the pain decreases, you can use heat on the muscle. Stretching and light exercises to bring blood to the injured area can also be useful.
A back specialist can typically diagnose a mild strain or sprain by reviewing your symptoms and learning how your injury occurred. Depending on the severity of the pulled back muscle, they may recommend additional treatments, such as: Prescription medications for pain or inflammation. Muscle relaxant drugs.
The best prescription muscle relaxants are baclofen, carisoprodol, methocarbamol, tizanidine, dantrolene, cyclobenzaprine, orphenadrine, chlorzoxazone, and metaxalone. Naproxen (Aleve) is one of the strongest OTC medications for muscle pain, cramps, and spasms.
Speak to a pharmacist about the best treatment for you. They might suggest tablets, or a cream or gel you rub on the skin. At first, try painkillers like paracetamol to ease the pain and ibuprofen gel, mousse or spray to bring down swelling. If needed, you can take ibuprofen tablets, capsules or syrup that you swallow.
In most cases, a pulled back muscle will heal within two weeks of the injury. You should notice the symptoms getting a little better each day. However, if your back symptoms get worse or if the pain lasts longer than two weeks, you may need to see a physical therapist.
Gentle stretching to the area can be beneficial, but the key is to keep it gentle. Avoid any prolonged sitting, bending, heavy lifting, twisting, or driving - all of which can make the pain worse. Giving the area of pain a rest, at least for the next 24 hours, will most likely be beneficial.
Do not do activities that involve heavy lifting or twisting of your back for the first 6 weeks after the pain begins. Do not exercise in the days right after the pain begins. After 2 to 3 weeks, slowly begin to exercise again. A physical therapist can teach you which exercises are right for you.
"Not surprisingly, the pressure is lowest when you're lying down." But there is more pressure on the discs when you're sitting than when you're standing. "In fact, if I come into the exam room and a patient is standing, rather than sitting, my suspicion that the person has a disc herniation goes up a lot," he says.
Muscle relaxants are effective for short‐term symptomatic relief in patients with acute and chronic low back pain. However, the incidence of drowsiness, dizziness and other side effects is high.
Rest, ice, compression and elevation can help relieve pain and inflammation during the first few days of your recovery. After the first few days, you can start moving it again. Crutches. If your injury is in your lower body, you might need to use crutches to keep weight off the muscle when you walk.
Strains in lower back muscles can be treated with light, low-impact exercise to maintain range of motion and build muscle strength. Walking, cycling and swimming are also effective ways to stay active while recovering from lower back muscle strain.
After an acute injury, ice should be used to minimize swelling for the first two to three days. After this period, heat can be used to increase blood flow and assist the natural healing process. Applying heat too early may cause additional swelling by increasing blood flow to the injury.
Narcotic Pain Medications
If you experience severe pain, your health provider might prescribe a narcotic pain medication such as codeine and morphine. Narcotics relieve pain by acting as a numbing anesthetic to the central nervous system.
Ice. Apply ice to the injury for 20 minutes each hour you're awake. Ice can help reduce inflammation. Never apply ice directly to bare skin; instead, wrap the ice pack in a towel first.
“Naproxen [Aleve] and ibuprofen are better for inflammation and muscle strains. A bonus of Naproxen is you can take it twice a day versus every 4 to 6 hours like with acetaminophen. This can be more convenient for many people.”
Traditionally succinylcholine has been the most commonly used muscle relaxant for this purpose because of its fast onset and short duration; unfortunately, it can have serious side effects.