A pulled muscle (also referred to as a muscle strain) causes most episodes of back pain.  When injured the muscles can become inflamed and spasm, causing low back pain and significant stiffness

A pulled back muscle can create a surprising amount of pain. However, not much can be done for a strained back muscle except for rest, applying hot and cold therapy and taking pain relievers.

Ice massage and ice application is generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application such as ice massage therapy provides the most pain relief.

Moist heat, such as a warm bath or whirlpool, is thought to aid the healing process by increasing circulation and relaxing muscle spasms.