If you’ve ever woken up clutching your back in agony, you’ve maybe experienced a bout of acute low back pain, or — in layman’s terms — you “threw out your back” or “tweaked your back.” Almost everyone experiences this kind of back pain at some point, says Justin Melson, PT, DPT, a physical therapist at Hinge Health. “It’s the most common type of injury we see,” he adds. 

If this sudden back pain has only happened to you a couple of times, you may wonder what caused it and how long it will take to get better. If you tend to throw out your back somewhat often, you may worry that it will continue, and as a result, you may shy away from activities you usually enjoy.

The truth is that occasional bouts of lower back pain are often just part of life, much like you’ll occasionally get a cold or headache. But knowing how to handle these thrown out back episodes can make a big difference in your recovery. As one Hinge Health member recently shared with us, “I tweaked my back recently, but the recovery has been so much faster thanks to the exercises I’ve done daily.”

Here, learn what happens to your body when you throw out your back, why movement is medicine when it comes to treatment, and what tips and exercises Hinge Health physical therapists recommend so you can start feeling better.

What Does ‘Throwing Out’ Your Back Mean?

People often say they’ve “thrown out” their back when they have sudden-onset pain that is associated with a physical activity like lifting, shoveling, or bending. The actual term is acute lower back pain, says Dr. Melson. It’s often due to a strain in one or more of the muscles in your lower back. 

“This is more common with combined movements, such as when you combine bending with twisting,” he says. These injuries are more common, not because the movements are bad for you, but because many people simply are not ready to handle the task. Bending while twisting is not something most people do every day, so doing it would be like a brand new runner starting with a 10-mile run. This person is more likely to get injured than someone who is a trained runner — not because running is bad for them, but because their body is not ready to handle the load of the activity yet.

This means you may be more likely to notice thrown out back symptoms after that first golf round of the season or after spending a day moving boxes, toting luggage, or shoveling snow if your body isn’t prepared for those movements. “Your joints or muscles can get a little irritated because they’re moving in a way that they’re not used to,” explains Dr. Melson. “As a result, your back can tense up and tighten, contributing to back pain.”

Did I Throw Out My Back Because I Lifted Something Heavy? 

Probably not. A common misconception about acute lower back pain is that it happens when you lift something heavy. 

The good news is that you can train your body and your pain system to be more resilient to a variety of movements with simple exercise therapy. (More on this below.) 

Symptoms of Throwing Out Your Back

Acute low back pain can feel differently for different people, stresses Dr. Melson. Thrown out back symptoms can be sharp and stabbing, leaving you going “ow ow ow!” Or it can feel like more of a dull ache. Sometimes it even feels like a charley horse (a pulled or cramped muscle).

This kind of back pain generally seems to feel better if you recline or lie down, notes Dr. Melson. It may feel worse when you bend or lift, or when you sit, stand, or walk. This, however, does not mean that rest is best. 

Rest Is Not Best

Despite the fact that movement and activity may make your symptoms feel a little worse after a back injury, it’s very important to stay active, stresses Dr. Melson, since you don’t want muscles to further stiffen up. This will actually worsen your pain and delay recovery. 

That’s why Hinge Health physical therapists like to say movement is medicine. Even if it causes a bit of an uptick in your pain, nudging into your pain with some gentle movement and activity calms your pain system down and makes you feel better sooner. As one Hinge Health member recently told us, “I tweaked my back while moving some furniture yesterday. I completed my exercises this morning and feel much better. Whenever I have back discomfort, the exercises provide relief for the pain.”

How to Treat a Thrown Out Back

Acute low back pain can be painful, but it usually resolves on its own pretty quickly, says Dr. Melson. Symptoms often ease over a few days and feel mostly better within a couple of weeks. Still, throwing out your back can make it hard to do your usual activities, and it can be frustrating to feel like you need to wait it out. But there’s a lot you can do to aid the healing process and get back to your normal routines faster. 

Stay active. “It’s natural to worry that you’ll hurt your back even more if you walk around,” says Dr. Melson, especially if movement causes some discomfort at first. “But it’s actually one of the best things you can do for your back. It encourages blood flow to the affected area and it prevents muscles from stiffening up.” 

That doesn’t mean that you should ignore or “fight through” unacceptable levels of pain. Rather, try to find ways to make activity more comfortable, advises Dr. Melson. Maybe you go for your usual walks but make them a little shorter if your back is bothering you. Yoga or tai chi are usually good choices because you can modify exercises to find your movement sweet spot — where you’re challenging your body but not causing pain that is unacceptable for you. A 2019 review published in the journal Medicine, for example, found that tai chi, either alone or with physical therapy, helped decrease low back pain.

Adjust your usual routine as needed. Movement is very important to healing, but you may need to scale back on your usual routine, too. If you have very severe pain, you may need more rest between activities than usual for a couple days. Try lying on your back with a pillow under your knees and your head and shoulders elevated and see if that’s comfortable. Just remember that too much rest doesn’t help you heal. “Research shows that people with low back pain recover faster when they remain active,” stresses Dr. Melson.

Use heat therapy. You can apply heat (like a hot pack) to your lower back for 15 to 20 minutes several times a day to help with pain. If you find ice helps relieve pain, too, then you can alternate hot and cold, says Dr. Melson. 

Make some work modifications. Some tweaks to your work environment can help you feel more comfortable as your thrown out back heals. If you’re sitting, you can roll up a towel and place it between your low back and the back of your seat to help support the area and relax those muscles. More importantly, try to change positions frequently. It’s best not to sit or stand for prolonged periods without taking a “movement snack.” This can cause your muscles to stiffen up. Instead, take mini movement breaks periodically through the day — ideally, every 10 to 15 minutes, suggests Dr. Melson. 

Take pain medication as needed. Over-the-counter pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for back pain. They may help relieve symptoms enough so that you can keep up with work and activities. It’s important to make sure that you are safely able to take these medications, based on your medical history.

Try physical therapy. A physical therapist can show you stretching and strengthening exercises to help treat pain and prevent pain from returning. Importantly, they can help address any movement fears or concerns you have, so you can resume your usual activities. “People may feel scared to bend, lift, or twist, and instinctively avoid them because they don’t want to feel pain,” explains Dr. Melson. “But these activities are safe, even when you’ve thrown out your back. We work to improve patients’ confidence, so that they can return to them.”

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.