Man with muscle tightness and lower back pain being treated by physiotherapist on a chair

What is Muscle Tightness?

Muscle tightness is a symptom with many underlying causes. People can often report ‘feeling tight’ with or without a pathological reason. Biomechanically, muscle tightness is often attributed to muscle overuse. It can also occur over long periods of inactivity or from maladaptive movement patterns. 

Prolonged muscle activity can also lead to chronic muscle tension and can result in pain throughout the region. In order for muscles to contract, they require neural innervation and signals from our central nervous system. Proper functioning of muscles also requires an ability to turn off muscle activity. Occasionally, the ability to ‘switch off’ is impaired, either due to muscle overuse, physiological changes, psychosocial factors, or in the unfortunate event of cerebrovascular events such as stroke.

 In the context of the lower back, pain may result from a combination of biopsychosocial factors.  It is often triggered by an acute event, where musculature around the lumbar spine region may tighten and even spasm as a response to help protect the spine, or gradually over time when there is inactivity (causing reduce blood flow to the area) or repeated movement (i.e. overuse). Clients may describe feeling ‘stiff’ or ‘tight’ through their lower back and often experience associated pain that can radiate into the buttocks, or in more severe cases, produce neural symptoms that refer down the leg.

 In both acute and gradual onset, central sensitization can occur, which can increase an individual’s risk of developing chronic low back pain.


Common symptoms / signs:

  •         Pain
  •         Rigidity
  •         Reduced range of motion
  •         Neural symptoms, such as numbness, pin and needles or tingling
  •         Muscle weakness
  •         Limited or inability to do daily tasks


How is Muscle Tightness treated?

Movement and education!

As with any condition, it is crucial to educate individuals with muscle tightness-related low back pain on their condition, what they should or should not do, and what to expect in their recovery process. Most importantly, they should be encouraged to continue moving to help restore muscle function.

Doing exercises is the most effective way (physiologically AND financially) to address muscle tightness that may be causing low back pain. Exercises will involve movement retraining, mobility exercises and strengthening of intrinsic stabilizers (i.e. transverse abdominus). For acute muscle spasms, soft tissue massage and heat therapy may be helpful to temporarily relieve pain and enable enough movement for an individual to begin gentle exercises.


  •         Cat-cows
  •         Pelvic tilting in crook-lie
  •         Windshield wipers
  •         McKenzie stretch
  •         Pigeon stretch
  •         Lying hamstring stretch

Core strengthening:

  •         Bird-dog
  •         Pilates Toe-taps
  •         Bear hold +/- shoulder taps
  •         Dead bug


Foam rolling is also recommended as a self-management strategy that individuals can use at home to relieve muscle tightness. Individuals with low back pain should also be encouraged to continue gentle aerobic exercise, such as walking, especially during the acute injury period.


For individuals with long-standing low back muscle tightness and symptoms of pain centralization, a multidisciplinary approach is shown to be highly effective, especially if they are presenting with a complex biopsychosocial background. If treatments and exercises are showing minimal improvement, it would be worth a deeper investigation into the role of biopsychosocial factors using appropriate outcome measures, such as the Fear-Avoidance Belief Questionnaire (FABQ) and the Modified Somatic Perceptions Questionnaire (MSPQ).


Risk factors of Muscle Tightness

  •         Increased age
  •         Stress, depression and anxiety
  •         Sedentary lifestyle
  •         Nature of occupation
  •         Comorbidities (see below)


Other causes related to Muscle Tightness

Because muscle tightness is a common symptom, there are many underlying causes and conditions that may be related:

  •         Overuse injuries, such as tendinopathy
  •         Poor posture
  •         Spondylolisthesis
  •         Disc disorders
  •         arthritis
  •         Polymyalgia rheumatica
  •         Fibromyalgia
  •         Dystonia
  •         Amyotrophic lateral sclerosis – progressive neurodegenerative disease that can cause a loss of voluntary muscle control
  •         Chronic fatigue syndrome
  •         Lupus
  •         Parkinson’s disease
  •         Claudication (more relevant to lower limbs)



Stanton, T. R., Moseley, G. L., Wong, A. Y., & Kawchuk, G. N. (2017). Feeling stiffness in the back: a protective perceptual inference in chronic back pain. Scientific reports, 7(1), 1-12.



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