Initially, treatment for back sprains and strains may involve rest and refraining from activity. This can help reduce inflammation and calm symptoms. However, prolonged bed rest – more than one or two days – should be avoided. Instead, patients should engage in light activity, which can speed up healing and recovery. Patients should immediately stop any activity that aggravates the muscles. An individual's physician can suggest appropriate exercises, which may include stretching, swimming or walking.

In addition, treatment often involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs). In many cases, these drugs can be purchased by the patient in over-the-counter formulations. In cases of more significant pain, prescription medications may be necessary. Patients should consult their physician before using any medication, as even over-the-counter medications present health risks and side effects when taken in certain dosages.

Patients can also apply cold (cryotherapy) and heat (thermotherapy) to reduce back pain associated with sprains or strains. Cold treatment should be used first before moving on to hot treatment. This technique can soothe sore and inflamed muscles. Upon injuring the back, ice should be applied several times a day for up to 20 minutes at a time. Ice should not be applied to the back directly – there should always be at least a thin barrier between the ice and the skin. Cold compresses may also be used. Cold treatment should be used as long as spasms persist.

Once acute pain has subsided – or after two or three days – heat from a heating pad or heat lamp should be used to loosen tight muscles. Again, applications should last no longer than 20 minutes. Patients may also benefit from hot compresses or baths (hydrotherapy). Although not scientifically proven to resolve back pain, these treatments do appear to reduce pain and inflammation and increase mobility for some patients.

Following a back sprain or strain, patients generally are advised to avoid heavy lifting or twisting of the back for about six weeks. The vast majority of back sprains and strains heal within four weeks, with most improving within a few days. However, in other cases, back pain can become a potentially chronic problem requiring  further treatment. Treatments recommended by a physician may include:

• Professional therapies such as physical therapy or manipulation therapy.
  
  
• Instruction in posture and ergonomics.
  
  
• Modalities (physical agents) such as electrical therapy or ultrasound therapy.
  
  
• Complementary and alternative treatments such as acupuncture, acupressure, yoga or biofeedback. “Dry needling” of the muscles can also help to decrease muscle spasms.