How can stiff and tight muscles cause back pain?

Hinge Health member’s question: 

"How do tight muscles cause back pain, and what can I do to feel better?” 

Hinge Health physical therapist Paige Nelson’s answer:

Stiff or tight muscles can limit your body’s ability to move freely and efficiently. That can sometimes translate to back pain. 

While some muscle tension in your back is normal and even necessary for stability and function, too much tightness can be uncomfortable. Let’s take a closer look at how tight muscles contribute to back pain and what you can do to address it.

How do tight muscles contribute to back pain? 

When muscles in your back and surrounding areas become tight, it’s often because they’re compensating for imbalances, stress, lack of movement, or repetitive strain. For example, your lower back muscles might overwork to pick up the slack for underused glutes, while prolonged sitting or stress can cause tension to build up in your neck and upper back.

This excessive tightness also puts strain on nearby joints, nerves, and tissues, creating a ripple effect of discomfort. Over time, this tension can make everyday movements harder, interfere with sleep, and even prevent your back from recovering after physical activity or minor injuries.

How can I treat muscle stiffness and back pain?

Here are several common strategies I recommend to address muscle tightness and reduce back pain. 

• Stretching and strengthening. Stretching can help muscles return to a more relaxed state and improve mobility, while strengthening ensures that muscles are balanced and able to support your movements. For example, activating underused muscles like your glutes can reduce strain on your lower back.

• Heat therapy. Applying heat to stiff areas promotes blood flow and muscle relaxation, which can ease discomfort and improve mobility.

• Stay hydrated. Proper hydration supports muscle function and can prevent excessive tightness.

• Gentle movement. Low-impact activities, such as walking, yoga, or swimming, help loosen tight muscles and improve circulation without overloading your back.

• Manage stress. I know that managing stress is much easier said than done. But high stress can contribute to muscle tightness. Simple techniques like deep breathing, meditation, or progressive muscle relaxation can go a long way in reducing tension and calming your body.

• Listen to your body. If muscle stiffness limits your ability to perform daily tasks or persists for more than a few days, it may be time to adjust your routines or talk to a physical therapist.

Should I see a doctor for a stiff or tight back?

If muscle tightness disrupts your sleep, lasts longer than a few days, or causes significant functional limitations, it’s important to address the issue. Tight muscles may not always be the sole cause of back pain, but they are often overlooked as a contributing factor. 

A physical therapist can create a personalized plan to address muscle imbalances, improve mobility, and reduce back pain. They can also teach you techniques to prevent future issues.

My main takeaway 

By understanding what causes muscle-related back pain, you can take action to feel better and move more freely. Here are a few resources I commonly recommend for tight, stiff back muscles: 

• The Best Exercises for Back Flexibility, According to Physical Therapists

• The Exercises and Stretches for Low Back Pain That Physical Therapists Swear By

• 6 Upper Back Stretches That Physical Therapists Swear By

• 12 Back Strengthening Exercises Physical Therapists Swear By

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. Shiri, R., Coggon, D., & Falah-Hassani, K. (2017). Exercise for the Prevention of Low Back Pain: Systematic Review and Meta-Analysis of Controlled Trials. American Journal of Epidemiology, 187(5), 1093–1101. doi:10.1093/aje/kwx337

2. Magawa, N., et al. (2023). The Impact of Stretching Intensities on Neural and Autonomic Responses: Implications for Relaxation. Sensors, 23(15), 6890. doi:10.3390/s23156890