5 Common Causes of Tight Back Muscles – and How to Treat Them

There are many potential causes of tight back muscles, ranging from serious nerve issues to simple overuse in sports.

Overuse of Muscles

Anecdotal research suggests that strenuous exercise like running long distances can lead to stiffness and tightness in the back (2). Strength-training activities like lifting weights, especially movements that involve pulling or lifting, can also commonly cause tightness in the back. However, research indicates that the activation of muscles in the back during lifting activities varies between individuals, depending on biomechanics and technique, meaning that how exercise impacts the body varies from person to person (3). Push-ups, a common exercise performed for upper-body strength, have also been shown to cause tightness in the lower back (4).

Arthritis

Arthritis is a class of degenerative diseases involving chronic inflammation of joints, eventually leading to significant structural damage and local pain. Types of arthritis include osteoarthritis, degenerative arthritis, and rheumatoid arthritis, which occurs as a result of an issue with the auto-immune system (5). Inflammation as a result of spinal arthritis commonly leads to stiffness and pain in the muscles of the back (6).

Acute Injury

Severe trauma from a blow to the back sustained during an incident like a car accident or sports injury can also cause tightness in the back muscles. This is especially true when the damage sustained is enough to cause a strain or sprain in the muscle, since these injuries cause inflammation and swelling that often lead to or come with muscle tightness (7).

Fibromyalgia

Fibromyalgia is a condition involving widespread pain at several points of sensitivity and stiffness or tightness in related muscles, including the back. It can also cause fatigue and issues with sleep (8). There’s still a great deal of uncertainty around the cause and exact nature of fibromyalgia. Some studies have associated fibromyalgia with altered neurological activity, leading many doctors to classify it as a neurological disorder (9).

Muscle Sheath Contractions

The thoracolumbar fascia (TLF) is the scientific name for a sheath of muscle that encapsulates the spine, providing it with flexibility and additional support. Research indicates that excessive contractions of the TLF could cause stiffness and pain in the back, a condition known as “frozen lumbars” (10).

There are plenty of other factors that can contribute to tightness in the back. Studies have also shown, for example, that dehydration can lead to excess damage of the muscles during strenuous exercise (11).

Almost every medical condition thought to cause tight back muscles, from blunt force trauma to fibromyalgia, can be diagnosed with a physical exam conducted by a medical professional. More serious conditions causing tight back muscles that involve neurological issues may need to be identified during specialized scans or examinations.

For conditions related to the spinal cord and TLF, doctors may order an immunohistochemical analysis of spinal fluid. This tests the fluid for the presence of certain proteins that may be connected with excessive tightness in the sheath, as well as levels of myofibroblasts, small connective tissue cells that increase contractile force to help close wounds on the skin (12).

Certain kinds of arthritis that cause muscle tightness can also be detected by the presence of nodules and rashes on the skin.

Depending on the nature and cause of tight back muscles, several different treatment methods can be effective for tense back muscles.

Physical Therapy

Depending on the severity of your muscle tightness, a simple routine of gentle stretching may be enough to improve your symptoms. More serious muscle tightness may require a program of physical therapy designed by a certified Doctor of Physical therapy to relieve tight back muscles focuses on motions that stretch and lengthen muscle tissue, increasing blood flow (13).

Non-steroidal Anti-inflammatory Drugs (NSAIDs) 

For more serious and chronic pain, doctors may prescribe NSAID medications including naproxen as well as prescription options. NSAIDs are usually taken in oral or topical form. It’s important to keep in mind that NSAIDs can strain the kidneys, liver, stomach, or heart (14).

Heat Therapy

Studies indicate that sustained heat treatment can help improve symptoms of delayed-onset muscle soreness (DOMS), including tightness and stiffness in the muscles. Prolonged exposure to heat for several hours immediately after exercise appears to be the most effective way to treat tight back muscles as a result of DOMS, because it increases flexibility and blood flow to the muscle tissues.

Muscle Relaxants

For serious, chronic pain from tight back muscles, doctors may prescribe muscle relaxants. There are several types of muscle relaxants useful for tight back muscle relief – popular medications include cyclobenzaprine (Flexeril), carisoprodol (Soma), and baclofen. However, muscle relaxants shouldn't be a long-term solution for tightness and stiffness in back muscles. They’re most often used for acute pain and tightness caused from an accident or injury and typically aren’t prescribed for longer than a month or two.

There are few side effects of physical therapy other than some discomfort and pain experienced while performing stretches and other therapy movements.

Side Effects of NSAIDs

If you have a pre-existing condition that negatively affects the function of your kidneys or liver, you may want to avoid NSAIDs or use them only under careful medical supervision. More minor symptoms of NSAIDs include indigestion, nausea and heartburn.

Side Effects of Muscle Relaxants

Muscle relaxants have well-documented side effects that are typically considered a bit more severe than NSAIDs, including fatigue, nausea and dry mouth. Certain types of muscle relaxants are also well-known for their dependency risks, especially carisoprodol (15).

Side Effects of Heat Therapy

Like physical therapy, heating treatment with an electric pad or warm water carries relatively little risk. Because heat therapy increases circulation to the muscles, there is some risk of greater inflammation with sustained exposure to heat. For muscle tightness that involves inflammation and swelling, cold treatment may be more effective than heat therapy (16).

Tightness in back muscles is an extremely common ailment. It can be difficult to diagnose and treat the issue given how many different conditions can cause the symptoms.

The best way to deal with tight back muscles is to be conservative with treatment methods, beginning with physical therapy or gentle stretching of trigger points. If tightness persists, you can try medication like NSAIDs and muscle relaxants or heat therapy. Always talk to your physician before starting any new treatment program. With enough experimentation, you can find a treatment method and volume that works best for your particular muscle tightness problems.