Lower Back Spasms: Causes, Diagnosis, and Treatment
Muscle spasms, often the result of injury, can make for a very tense back. Spasms can occur in any of the body’s muscles, including, of course, the trunk, hips and/or core — those areas where good muscle control and flexibility really matter to the health of your spine.
While many times spasms stem from the muscles themselves, they can also be a result of a more structural problem such as disc herniation. When this is the case, the muscles are trying to stabilize the affected area and to prevent you from moving in such a way as to cause further damage. In his book, Heal Your Aching Back, Dr. Jeffrey Katz, associate professor at Harvard Medical School and co-director of the Brigham Spine Center, says this automatic tightening is a reflex that you can’t consciously control. Sometimes, he says, you don’t even realize it’s occurring until later — when you feel the related pain.Katz adds that another source of muscle spasm in the neck can be emotional stress.
Maybe you can’t control the spasming while it’s happening, but afterward, the contraction can be so strong, it may significantly slow down progress you might otherwise make in the treatment room. Or it may simply interrupt your life with too much pain. Either way, what do you do? Read on to find out what the experts recommend — from medication to holistic care.
Stretching Is the Best Medicine for a Back Muscle Spasm
Ultimately, the best thing you can do for a back muscle spasm is stretch, says Dr. Loren Fishmen, a physical medicine, and rehabilitation specialist in New York. (Fishman is also a yoga instructor.) Though generally not serious, they often baffle doctors and family members, he says. This is because even though they likely produce little movement or support, muscles in spasm are hard at work; as such, they require oxygen and nutrient delivery as well as waste disposal. But contraction clamps down on blood vessels through which these substances pass, limiting the exchanges that can occur. Instead, acid builds up in your muscle which can hurt — and makes for more spasm It’s a vicious cycle until you can relax the muscle, he says.Other ways to release the muscle, according to Fishman, include hot baths, gentle massage, and hot packs. The idea, he says, is to dilate the blood vessels and speed tissue repair.
What can — or will — a conventional medical doctor do for your back muscle spasm? In 2006, a roundtable reported in the European Spine Journal consisting of 4 M.D.s who regularly treated pain explored the issue in an effort promote the best possible choices for screening, diagnosing and treating acute low back pain caused by spasm in the paraspinal muscles. (The paraspinal muscles are the long muscles located at the back of your trunk.)
The docs talked about such things as when to order films and other diagnostic tests — and which tests to order — along with medication choice, non-drug treatments, the use of complementary therapies and the role your emotional and social well-being (called biopsychosocial factors) plays in the healing process.
Recommendations that emerged from the conversation included having a thorough physical exam and medical history intake, getting moving as soon after the pain starts as you can, using diagnostic imaging tests sparingly, and more. The doctors advocated patient education as well as good doctor-patient communications. They also concluded that taking a combination of muscle relaxers and NSAIDs may help reduce the spasm (and pain, of course).
Fishman adds that conventional medicine can offer treatments designed to interrupt the blood vessel constriction — muscle spasm cycle. Examples include ultrasound, an injection of an anesthetic or a visit to a physical therapist that includes electrical stimulation to fatigue the muscle, thereby enabling it to relax.