About 80 percent
of Americans will have back pain at some point in their lives. Sometimes this can show up as a back spasm, an involuntary tensing or contraction of a muscle in the back.
“Essentially, the feeling of spasm is caused by the muscle contracting as a result of some kind of signal that’s triggering it,” says Dr. Jeremy S. Smith
, an orthopaedic spine surgeon at Hoag Orthopedic Institute in Orange, California.
This condition ranges from occasional spasms to ongoing, chronic spasms. Some people have only mild discomfort with a back spasm, while others experience severe pain.
In general, back spasms can be treated without surgery and go away after a few days. But if there’s an underlying problem with the spine, this condition may require more intensive treatment.
Causes of back spasms
Dr. Robert Wagner
, a physical medicine and rehabilitation physician with the National Spine and Pain Centers in McLean, Virginia, says multiple things can cause back spasms, but they generally fall into two categories. The first involves damage to the muscle itself or the tendons and ligaments associated with the muscle.
“It’s kind of like when a hamstring is overused and you get a cramp in the muscle,” Wagner says. “The same type of scenario can occur in the low back.”
This can be caused by overuse or fatigue, such as while lifting something heavy. Repetitive motions, especially ones you are not used to, can also cause back spasms. So can holding a position, like being bent forward, for a long time.
Smith says the most common cause of back spasms is lifting something heavy the wrong way. Spasms can also happen from twisting suddenly and repeatedly, such as while shoveling or playing golf, football, or another sport.
Some people may also be more likely to injure the back muscles. “In general, someone who was weak core muscle strength has more susceptibility to low back spasms,” says Smith.
Back muscles can also spasm in response to an injury to the spine. “When that occurs,” says Wagner, “the muscles go into spasm to protect the spine by keeping you from moving.”
These injuries include:
Sprain of a joint in the spine, also known as a facet joint. Wagner says this is similar to spraining the knuckle in your finger. This can happen when making a quick, sudden movement, or when holding an awkward back position for too long.
Tear in an intervertebral disc. These discs provide cushioning between the bones of the spine (vertebrae). A tear can happen due to age-related degeneration of the disc, or a fall or other trauma.
Herniated disc. If a disc tear is severe enough, the soft inner part of the disc can push out through the tear. This is also known as a slipped disc.
In these cases, “the muscle is not the problem,” says Wagner, “but the muscle ends up being a symptom because there is an underlying structural problem that has occurred.”
When to seek medical help
“Most back spasms will resolve in one to three days,” says Wagner. “But if you have trauma—such as a fall or automobile accident—and you have immediate pain and spasm, then you want to see a primary care or urgent care physician sooner to make sure that you didn’t injure the spine.”
Older people, especially those with osteoporosis, should seek help after a fall severe enough to cause back spasms. “Osteoporosis predisposes you to a higher probability of fracture when falling,” says Wagner. “You can actually get a compression fracture in the spine from the fall.”
For anyone who has a history of osteoporosis and has a back spasm after a fall, it is recommended that you get an X-ray to rule out a stress fracture or compression fracture. If multiple areas are affected, a bone density test may also be recommended to evaluate the fall and determine the next status of treatment recommended.
Smith says you should also seek medical care if you have any weakness, numbness or tingling in the legs. This may indicate that something is pressing on the spinal cord or a spinal nerve.
“All of these things might indicate that there’s something a little bit more involved than a simple back spasm,” Smith says.
Treatment for back spasms
Treatment for back spasms involves:
Ice therapy. Wagner says ice reduces inflammation and swelling in a muscle that has been strained or injured, which helps the muscle relax. “In a way, ice paralyzes the muscle to force it to not spasm,” he says. Ice or cold packs should not be applied directly to the skin, but instead over a protective barrier like a hand towel. Ice should be used 10 minutes on with a towel per patient tolerance, and always an hour off between usages to help prevent frostbite or skin irritation.
Heat therapy. Ice is more beneficial on the first day or two after injuring the muscle, says Wagner. After that, heat can be applied to a tight muscle to help you stretch it out. He suggests using a heating pad for only 15 to 20 minutes at a time, with at least that amount of time in between sessions.
Non-steroidal anti-inflammatory medications (NSAIDs). Aspirin, ibuprofen (Advil, Motrin) and other over-the-counter drugs can reduce inflammation in an injured muscle. This can help the muscle to relax.
Prescription medications. For severe back spasms, or for a chronic back problem, your doctor may recommend a muscle relaxant to help calm the muscle or a dose of steroids to bring down the inflammation.
Rest, but not too much. Smith recommends a “mild amount” of rest and returning to your previous level of activity as soon as possible.
Physical therapy. This can help you strengthen your back and core muscles, as well as teach you how to improve your posture.
Chiropractic adjustments. Chiropractic care is helpful in the treatment of muscle spasms, as these muscles are attached to a vertebra which may have become misaligned. Early detection of a misaligned spinal region my help accelerate the recovery process.
“Someone who has continued muscle spasms beyond a few days and is unresponsive to NSAIDs, a muscle relaxant or heat and ice therapy really needs to seek medical attention,” says Wagner, “because there can be an underlying injury to the spine that is making the muscle go into spasm.”
This might require additional testing, such as an X-ray or MRI scan to see if there is any damage to the bones or soft tissues of the spine.
Preventing back spasms
Smith says there are several things you can do to reduce your risk of back spasms, especially if you are prone to having them. This includes:
Exercise regularly. Smith says an exercise program that focuses on core muscle strengthening and trunk stabilization is a good place to start. He recommends yoga or Pilates to many of his patients. But the key thing is to find something that you will do regularly and with good form.
Maintain a healthy weight. If you are overweight or obese, your spine has to carry a heavier load, which can put stress on the spine itself and also on the back muscles.
Cigarette smoking has been linked to higher rates of back pain
. Quitting may also make it easier for you to exercise regularly.
Practice good posture. Even if you haven’t experienced back spasms, Smith says you should look at your posture throughout the day. Are you sitting or standing upright? Is your head balanced over your shoulders, even while using a smartphone or other electronic device?
Move more often. Every 30 minutes or so, get up and move around. “Something as simple as that may alter the outcome and susceptibility to these injuries,” says Smith.
Back spasms without an underlying spine problem are generally easily treated. If you do develop back spasms and have any concerns, see a doctor. They can help you identify the cause and provide you with a treatment plan to get you moving again.
Updated: June 5, 2021