Lower Back muscle Spasms: causes, symptoms and treatments. TeMed.com

1. Back MuscleSpasms (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 andRisk 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 camel’s back. TeMed.com

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. TeMed.com

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. TeMed.com

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. TeMed.com

6. Prevention Once the back spasm episode has passed, and you’ve 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 don’t 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. It’s 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. TeMed.com