Lower back spasm

1
Back Muscle Spasms (Cramps)
A spasm is a spontaneous, abnormal contraction of
a muscle. When it occurs in the back near the
spinal cord or the nerve roots, it can be very
painful. The muscles in the low back work in
concert with the abdominal musculature. Without
them, extension and lateral movement of the
spinal column would be impossible. Back muscles
also add stability by keeping the spine erect and
maintaining balance. That balance can be
compromised when the muscles are in spasm as a
secondary response to even a slightly injured
lumbar joint or disc.
2
Causes and Risk factors

• Spasms happen often when a muscle is swollen and
  tender (inflamed) or strained. Any great force
  can tear the muscles and tendons of the lower
  back. This occurs commonly in sports like weight
  lifting, football, basketball, baseball or golf
  that require pushing or pulling or sudden
  twisting of the back.
• The risk of back spasm goes up if you have
• A pelvis that tips forward more than normal
• Any back weakness such as arthritis,
  spondylolysis, spondylolisthesis, disk rupture,
  spinal stenosis, or a tumor
• Lordosis
• Tight hamstrings, the tendons that run down the
  back of the legs
• Weak or inflexible muscles along the spine
• Weak stomach muscles

Conditions, such as degenerative disc disease or
herniated disc, may cause a back muscle spasm. A
disc may herniate or bulge and compress a nearby
spinal nerve root causing irritation and
inflammation. The body attempts to immobilize the
affected area to stop pain by tightening the
surrounding musculature and as a result, painful
muscle spasms occur. Muscles can become too tight
due to lack of exercise, too much exercise,
structural imbalances, dehydration and
electrolyte loss, or any combination thereof. In
contrast, some muscle groups are too weak. When
muscular imbalances become chronic aberrant
forces are transmitted to the spine.
Consequently, one movement outside of the norm
can trigger an injury to a spinal joint,
ligament, or disc resulting in spasm and back
pain. Because these structures are already
primed, the event that triggers the spasm is
nothing more than the proverbial straw that broke
the camels back.
3
Diagnostic

• A doctor may take the patient's medical history
  and do a physical examination.
• The exam may show tenderness at a specific point
  or a general spasm and tenderness in the back
  that gets worse with any movement, especially
  bending forward.
• Point tenderness on the spine with more pain when
  the spine is extended should be checked for
  fracture.

4
Treatment
Activity and walking as tolerated combined with
the nonsteroidal anti-inflammatory drugs (NSAIDS)
are also frequently prescribed. Some of these
drugs are now available over-the-counter.
Patients with bleeding problems or a history of
stomach ulcers should not take these medications
without them being recommended by their
physician. Acetaminophen (Tylenol) is a
reasonable and safe alternative for those who do
not have chronic liver disease. Muscle relaxants
can also be used, but they are no more effective
than NSAIDS and can cause sedation. Spinal
manipulation may be helpful in some cases, but
consult your physician first. Narcotic
analgesics, such as Percodan and Demerol, are
very rarely needed and usually not prescribed for
more than a few days at a time.
5
Treatment
If pain fails to resolve Patients who have
persistent back pain beyond 1-2 weeks should
consult with their physician. Physical therapy
and in some cases counseling on how to cope with
the pain can be helpful. Continuing to exercise
and trying to be as functional as possible at
home and work may also be helpful. Spinal manipu-
lation is not thought to be helpful. Massage can
help in the short term. For acupuncture, the
evidence is conflicting as to whether there is
benefit. If your physician becomes concerned that
your lumbar spasms are caused by a disc
compressing nerves, he may refer to a pain or
orthopedic specialist. A pain specialist can
inject cortisone into the area around the spinal
cord where the nerve is being compressed. In
severe cases that do not resolve or which worsen
include leg weakness or bowel/bladder control
problems, urgent consultation with an orthopedic
surgeon so that he can perform a procedure to
remove the part of the disc compressing the
nerve. Cortisone and other steroid drugs are
occasionally used for a short period to reduce
pain and inflammation. They can be quite effec-
tive in relieving the symptoms of acute back
pain, but they can also cause serious side
effects and are not useful as a long-term
approach. When pain is more severe, more potent
painkillers may be prescribed, again for a brief
periods.
6
Prevention
Once the back spasm episode has passed, and
youve allowed enough time for the inflammation
to subside, start focusing on what you can do to
prevent it from happening again. Start
stretching Incorporate stretching exercises into
your daily routine. Muscle fibers benefit from
gentle stretching and so will you. Consider
taking Pilates or yoga classes always stretch
before physical exercise. Get in shape If you
dont engage in regular physical activity, now is
the time to start. Exercise confers benefits too
numerous to mention and too important to ignore.
Join a gym. Start playing a sport. The key to any
exercise routine is that it be done
consistently. Strength training Always an
important part of any exercise regimen, strength
training not only builds muscle, it can reduce
muscular imbalances. Remember muscles work in
opposition to each other, so be sure to balance
out your back strengthening routine with
abdominal work. Make avoiding another episode of
muscle spasm in the back a priority. Its never
too late to start increasing your strength and
flex- ibility. Choose activities that you enjoy
and commit to doing them on a regular basis.