Back contusion: causes, exercises, treatments

Maybe you slipped on an icy sidewalk and landed on your back. Or you took a direct hit during a pickup basketball game. Now your back feels sore, swollen, and bruised — and you’re wondering: Should I rest completely? Or, is it okay to keep moving?

Chances are, you have a back contusion — the medical term for a bruised back muscle. These injuries are common. “We see them often in physical therapy, especially after falls or sports injuries,” says Rodrigo Quevedo, PT, DPT, a physical therapist at Hinge Health.

While back contusions can be painful, they often heal with gentle movement — not prolonged bed rest. “People are often hesitant to move after a back contusion,” says Dr. Quevedo. “But physical activity is a crucial part of recovery. Targeted exercises and gentle movement help your body heal and prevent muscle stiffness.”

Here’s what to know about a back contusion — including symptoms, recovery time, and when you should check in with a provider for an in-person evaluation. Plus, get exercises recommended by Hinge Health physical therapists that can help you move comfortably again.

When seeking medical care immediately makes sense

In some cases, a back contusion can lead to tingling or numbness in your legs or even weakness that radiates into one or both legs. If you feel these symptoms, it’s important to get medical attention right away. If the injury was more than mild, you may need additional evaluation, including imaging to rule out fractures.

What is a back contusion?

A back contusion (sometimes called a lumbar contusion or lower back bruise) occurs when a direct force impacts soft tissue in your back. Lower back contusions are most common, often occurring from falls where you land on your butt.

“A contusion is simply the medical term for a bruise,” says Dr. Quevedo. “Whenever your muscles or soft tissue sustain an impact, bleeding can occur underneath the skin. That’s what causes the discoloration, along with pain and swelling.”

There are different types of back contusions, depending on where the impact occurs. “While a standard back contusion affects the muscle and soft tissue, a spinal contusion involves injury to the bone (vertebrae),” explains Dr. Quevedo.

Symptoms of back contusion

Sometimes, symptoms of a back contusion are so subtle you may not even notice them. “There may just be light yellow discoloration, and some mild pain,” says Dr. Quevedo. But other times, symptoms may be more pronounced. 

Here’s what you may notice:  

• Localized back pain that worsens with movement or pressure

• Discoloration 

• Swelling and tenderness 

• Muscle stiffness

• Reduced range of motion

• A dull ache or sharper pain with certain movements

• Pain that significantly improves in 1-2 weeks

Causes of back contusion

Back contusions usually happen after a direct impact to the back that affects underlying muscle fibers, connective tissue, and small blood vessels. The most common causes include:  

• Slipping. Losing your footing on a slick surface or missing a step can cause you to land on your back or butt, resulting in a bruise to the muscles and soft tissues.

• Sports collisions. Contact sports can sometimes involve direct blows to the back. “Usually this involves a direct hit to the back muscle,” says Dr. Quevedo. Activities like football, hockey, or martial arts carry a higher risk.

• Home accidents. Everyday tasks around the house can sometimes lead to unexpected falls. “This is probably one of the most common causes of low back contusions after sports,” says Dr. Quevedo. “Oftentimes, patients come in with a bad bruise on their back because they were on a ladder changing a lightbulb or painting, and they slipped and fell.”

• Vehicle accidents. Car crashes or bicycle accidents can cause a direct impact to the back, leading to bruising of the muscles and surrounding soft tissues.

• Workplace incidents. Back contusions can happen on the job if you slip, bump into equipment, or are struck by a falling object. Jobs that involve physical labor or working around machinery may carry a higher risk.

How movement can help heal a back contusion

After a back contusion, your instinct may be to stay still. While short-term rest (24-48 hours) can help calm acute soreness, too much inactivity can actually slow recovery. And for this condition, it’s very safe to move even with the pain.

“Gentle movement promotes blood flow and helps prevent stiffness,” says Dr. Quevedo. “If you completely stop moving, muscles can tighten and weaken.” 

The key is finding your movement sweet spot, or enough activity to support healing without aggravating pain too much. Keep in mind that your sweet spot may shift from day to day, and that’s okay. Some days your back may feel looser, while for others it may feel more stiff or sore. Adjust your activity level accordingly.

“The goal is to do something every day,” says Dr. Quevedo. “It doesn’t have to be intense. It just has to keep you moving.” As pain and swelling improve, you can gradually increase your activity duration or intensity, so you can get back to your usual routine.

Many of these exercises can help increase blood flow to the bruised muscle in your back. Diaphragmatic breathing helps calm your nervous system, which can make it easier to relax tense muscles and manage pain. Gentle movements like open book rotations, cat-cow, and seated pelvic tilts help stretch and mobilize the muscles along your spine. Bridges and child’s pose strengthen and increase flexibility in other muscles that support your back, including your glutes and hips. Try doing all of these as you heal from a back contusion, or stick to the ones that feel best for you. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for back contusion

Any back injury can be unsettling, but remember your body is resilient. Most back contusions heal with simple at-home treatments, including exercise therapy, modifying activities, applying cold and heat therapy, and time. Consider these treatments recommended by Hinge Health physical therapists: 

• Try physical therapy and targeted exercises. Targeted exercises, like the ones above, can help ease tension along your spine and improve mobility and range of motion as you heal. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Light movement helps maintain circulation and prevent stiffness. “Movement helps relieve muscle spasms and prevents loss of muscle strength,” explains Dr. Quevedo. While you should avoid strenuous exercise or sports if you’re in pain, it’s usually fine to continue everyday activities and light activities like walking. If a certain movement increases your pain too much, dial it back or switch to another task.

• Pace your activities. Modify activities that trigger pain. Until pain subsides, you’ll need to modify heavy lifting, carrying and pushing. “If you usually carry a whole laundry basket, for example, empty it out and just lift half,” says Dr. Quevedo. Listen to your body, and if it tells you a certain activity is too much, scale back until you feel better then gradually try to work back up. Some temporary increase in pain is expected and a normal part of the healing process.

• Apply ice or heat. Try icing your bruise shortly after it occurs to reduce swelling and inflammation. It also temporarily numbs nerve endings which can ease pain. After about five to seven days, Dr. Quevedo suggests switching to heat, which can increase blood flow to the area and relax tight muscles. Consider alternating between the two, or choosing the method that brings you the most relief.  

• Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pain from a back contusion. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.

• Consider lifestyle modifications. Factors like sleep, stress, nutrition, and certain activities can all play a role in how you feel. In fact, many people are surprised to learn that pain isn’t just about what’s happening physically — your daily habits and overall well-being can have a real impact, too. Staying curious about how your routines affect your muscles and joints can help you identify where small changes might help reduce pain. For example, you might notice your pain is less noticeable on low-stress days.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain from a back contusion. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How to prevent a back contusion

While back contusions are often hard to prevent, the best way to reduce your risk of a back contusion is to focus on balance and coordination training, because both of these help prevent falls. “The more active you are, the better prepared your body is to handle an impact if one happens,” says Dr. Quevedo. 

Consider these approaches:

• Strengthen your back and core muscles. “The stronger your back and core muscles, the more resilient your back will be,” says Dr. Quevedo. This doesn't mean strong muscles can't get bruised — they can still be injured if you fall. But building strength in these areas improves your balance and coordination. This helps you stay steady on your feet, preventing preventable falls in the first place. Aim to include strengthening and stretching exercises for both areas at least twice a week.

• Practice good balance and coordination. Both can reduce your risk of falls — one of the most common causes of back contusions. Simple exercises like heel-to-toe walking, single-leg stands, and squats can help improve balance and control.

• Reduce fall risk at home. About two-thirds of all falls happen indoors, and many others occur outdoors on sidewalks, streets, or parking lots. To reduce risk of falls at home, keep walkways well-lit and clear clutter from floors, such as cords and loose rugs. If a task requires climbing a tall ladder — like cleaning gutters or washing high windows — consider hiring a professional. “Ladders are a huge cause of falls,” says Dr. Quevedo.

• Wear supportive footwear. Shoes with good traction and support can help prevent slips and falls, especially on uneven or slick surfaces.

When to see a doctor

Most back contusions improve with simple treatments, like the ones above. However, if your pain is severe, worsening, causing difficulty with daily activities, is more than a mild injury, or if you have any concerns, consult a healthcare provider. 

You should also seek medical care right away if you notice:

• Inability or difficulty with standing or walking

• Numbness, tingling, or weakness in your legs

• Loss of bowel or bladder control

• Severe or rapidly increasing swelling

• Pain that doesn't improve after 1-2 weeks

• Signs of infection, such as increased warmth, redness, or fever

PT tip: Movement modifications are temporary, not permanent

Recovering from a back contusion takes time, and it’s normal to adjust your activities as your body heals. “Patience and movement are essential with back contusions,” says Dr. Quevedo. “They can take time to settle, but most people gradually see improvements with gentle activity.”

You might worry that modifying your routine means you’ll never get back to normal. But these adjustments are temporary tools to help your body recover. “As your pain improves and your strength returns, you’ll be able to ease back into your usual activities,” says Dr. Quevedo.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. El Sayed, M., & Callahan, A. L. (2023, August 8). Mechanical back strain. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK542314/

2. Jiang, J., Zhou, Q., Zhang, C., & Cong, K. (2025). Activities of daily living mediate the association between balance and falls in middle aged and older adults. Scientific Reports, 15(1). doi:10.1038/s41598-025-14608-6

3. Chou, R. (2021, September 20). Patient education: Low back pain in adults (beyond the basics). Www.uptodate.com. https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics

4. Mulcahey, M. (2019, September). Muscle Contusion (Bruise) - OrthoInfo - AAOS. Www.orthoinfo.org. https://orthoinfo.aaos.org/en/diseases--conditions/muscle-contusion-bruise/

5. Kim, G. S., Park, M. K., Lee, J. J., Kim, L., Lee, J. Y., & Kim, N. (2025). Situational and environmental risk factors associated with home falls among community-dwelling older adults: Visualization of disparities between actual and perceived risks. Geriatric Nursing, 62, 221–228. doi:10.1016/j.gerinurse.2025.02.006