How to Tell if Back Pain Is Caused by Nerve Compression or Muscle Strain

Back pain is one of the most common health concerns, but not all back pain is the same. Two of the most frequent causes—nerve compression and muscle strain—can feel similar yet require different treatment approaches. Understanding the difference can help you decide when to rest at home and when to seek specialized care.

What Is Muscle Strain?

A muscle strain occurs when the muscle fibers in the back are overstretched or torn. This often happens after lifting something heavy, twisting awkwardly, or overexerting yourself.

Common signs of muscle strain:

• Dull, aching pain
• Pain that improves with rest
• Stiffness, especially after activity
• Sensitivity to touch in the affected area
• Pain localized to one spot

What Is Nerve Compression?

Nerve compression (also known as a “pinched nerve”) occurs when something—such as a herniated disc, bone spur, or spinal narrowing—presses on a spinal nerve.

Common signs of nerve compression:

• Sharp, burning, or electric-like pain
• Pain that radiates into the legs (sciatica)
• Numbness or tingling
• Muscle weakness
• Pain that worsens with sitting, coughing, or bending

Key Differences

• Location: Muscle strain usually stays in one area; nerve pain often travels.
• Sensation: Muscle pain is dull and achy; nerve pain is sharp or tingling.
• Function: Nerve compression can cause weakness or numbness—muscle strain rarely does.

When to See a Specialist

Seek evaluation if your pain:

• Lasts longer than a week
• Radiates into your arm or leg
• Causes weakness or numbness
• Interferes with daily movement

A spine specialist can perform an exam and imaging to find the exact cause and create a personalized treatment plan.