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 patient feels a sudden pain in the lower back while twisting, pushing or pulling. At first, it may be possible to continue the exercise. But after two to three hours, bleeding in the muscles stretches the torn muscle and tendons.
The spasm that results causes severe back pain that gets worse with any movement of the back. The patient usually prefers to lie still, curled up with the knees bent and the spine arched forward.
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
A doctor will 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.
As soon as possible after the injury, the patient should be treated with rest, ice and compression.
Often conservative treatment is tried first. This includes muscle relaxants, anti-inflammatory medicine, pain management (injections) or chiropractic care.
Lordosis increases stress on the muscles and ligaments that support the back. How much depends on the tilt of the pelvis. Once healing begins, most patients benefit from exercises to strengthen abdominal muscles and to stretch and strengthen back muscles to restore flexibility.
