How to treat a pulled muscle and when to see a doctor for muscle strains

• To treat a pulled muscle, you will first have to determine the severity of the muscle strain.
• For mild or moderate strains, at-home treatment methods like RICE — rest, ice, compression, and elevation — should take a few weeks to heal your pulled muscle.
• For severe strains, or persistent muscle pain, surgery or physical therapy may be necessary.
• This article was medically reviewed by Eric Freeman, DO, a pain management specialist at Redefine Healthcare Orthopedic Pain & Spine Center.
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A pulled muscle — also known as a muscle strain — occurs when a muscle stretches too much, which causes the muscle fibers or tendons to tear.

Pulled muscles commonly occur in the lower back or hamstring. And while they can occur from overexertion during sports, even routine activities like a poorly placed step can cause a muscle strain.

Here's what you need to know to diagnose and treat your muscle strain.

Muscle strain symptoms

Muscle strains can be serious or mild in nature. "It totally depends on the severity of the trauma of tissue," says Clint Soppe, MD, orthopedic surgeon and sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles.

Doctors often assign strains a grade:

• Grade I is mild. While this level of sprain will hurt, you should still have somewhat normal strength.
• Grade II is moderate. For this level of sprain, you may notice swelling and bruising, as well as experiencing a loss of strength in the strained area or limb.
• Grade III is severe. The pain will be very harsh and you'll see visible signs of the injury, such as bruising or swelling.

How to treat a pulled muscle

You can use a variety of at-home treatments for your muscle strain. Soppe recommends the RICE treatment method:

• Rest: Give the strained muscle a break for at least one full day. If it's in your leg, for instance, you should avoid walking. In general, stay away from any activities that lead to more pain for the injured muscle.
• Ice: Apply ice to the muscle to help reduce swelling. The day of the injury, you'll want to do this frequently — aim for 10 to 15 minutes per hour. On subsequent days, you can relax the frequency to every 3 to 4 hours. But do not place ice directly on the skin — instead, wrap a tea towel or other type of cloth around the ice.
• Compression: Wrapping an elastic bandage around the area can also help cut down on swelling. Make sure the bandage does not restrict blood flow. If it feels numb, it's too tight.
• Elevation: Raise the injured area up — ideally over your heart. For example, while sitting or reclined, you can stack pillows to rest a muscle strain in your leg above your heart.

Overall, RICE may be most effective at reducing symptoms, rather than healing on a cellular level — according to Soppe, that will only happen naturally, with time. "RICE helps decrease symptoms while the body is healing so we can carry on with our lives during the healing phase," he says.

Over-the-counter painkillers can also be effective at managing pain and reducing inflammation. "Tylenol and anti-inflammatories such as ibuprofen can be very helpful in terms of alleviating pain and allowing us to be more mobile while we're in the early stage of healing," Soppe says.

But don't overdo it: Non-steroidal anti-inflammatories (or NSAIDs) like Advil can cause gastrointestinal side effects if taken on an ongoing basis, while excessive Tylenol can lead to potential liver dysfunction.

RICE and over-the-counter pain medication "are by far and away the most valuable of initial treatments for these strains," says Soppe. If your muscle strain is more severe or these treatment methods don't work, you may also want to consider physical therapy, wearing braces or splints, or surgery.

When to see a doctor for your muscle strain

A pulled muscle — even a mild or moderate one — can take a while to heal. For some muscles it might take a couple of weeks, and for others, it can last months.

Muscle strains in the legs, such as the quadriceps, hamstring, or calves, may be particularly persistent. But typically, they should start to feel better over a few weeks, says Soppe.

"The majority of strains heal just by the body's own innate capabilities," he says. "The ones that linger tend to be more severe — like a tendon-type injury," Soppe says.

More severe (usually grade III) muscle strains may require surgical treatment. "If it involves the tendons or tendon attachments, it'll need surgery," Soppe says. The tendon is the tissue that connects muscle to bone — if it's torn, surgery can help with reattachment.

If you feel or hear a severe pop sensation when the strain occurs, that's a sign that you should see a doctor, says Soppe. Reach out to a doctor if you have significant pain or do not see progress in improvement after a few weeks, he says.

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