Causes and treatment of lower back spasms
A lower back spasm usually feels like a muscle is firmly contracting or moving. However, it might also feel like a dull ache that moves, a sharp pain in a specific location, or any combination of these painful sensations. Some people also find that pain from lower back spasm radiates to other areas of the body, such as the hips or legs.
In this article, we look at the causes of lower back spasm as well as prevention, diagnosis, first aid for symptoms, and treatment.
Common causes of lower back spasm are poor posture, arthritis, strains, and nerve damage.
Lower back spasm usually occurs due to injuries or inflammation.
In some people, the cause may be something relatively minor, such as a mild strain. In other people, a serious underlying condition may be responsible, such as a herniated or ruptured spinal disc.
Some of the most common causes of lower back spasm include the following:
Poor posture, especially when sitting at a desk or in a car, can strain the back muscles. This can cause painful spasms. Some people may adapt their posture to deal with the spasms, potentially making the pain worse.
Not getting enough exercise
According to the Centers for Disease Control and Prevention (CDC), only around 20 percent of U.S. adults are spending enough time exercising.
It is common for people to pass much of the day sitting down or hunched over a computer screen. Over time, this can weaken the muscles in the back and other areas of the body. The lower back may attempt to compensate for this weakness, which can cause painful muscle spasms.
Sitting for long periods can also cause muscle spasms because of muscle weakness and inflammation.
Muscle overuse and post-exercise pain
The overuse of any muscle can trigger muscle spasms for a few days. Some people also experience post-exercise pain known as delayed onset muscle soreness (DOMS). This is especially common when a person tries a new exercise.
Strains and sprains
A sprain is an injury to a ligament, while a strain is a tear in a tendon or muscle. Both can cause muscle spasms and pain in the lower back. Overstretching the area or falling over are common causes of sprains and strains.
Sometimes muscle overuse can also cause a strain or sprain. These injuries often heal on their own, but they can be very painful for several weeks.
Conditions or injuries that damage either the nerves in the back or the nerves that carry signals to the back can cause spasms and pain.
One of the most common forms of nerve damage is radiculopathy. This disorder results from inflammation, compression, or injury to a nerve root in the spine. Radiculopathy can cause tingling and pain. Some people may also experience a sensation that feels like a muscle spasm, even though it is not.
Sciatica is one of the most common forms of radiculopathy. It results from the compression of the nerve roots that make up the sciatic nerve. It usually causes pain that travels down a person's buttocks and into the leg, but the pain may also radiate into the lower back.
Diabetes, spinal cord injuries, and some other conditions may also cause nerve problems that can sometimes feel like a lower back spasm.
There is a disc cushioning each vertebra in the spine. Damage or injury to these discs can cause intense back pain.
One of the most common types of injury to vertebral discs is known as a herniated disc. This is when a disc is compressed and bulges out of the spinal column. Sometimes a herniated disc can rupture, causing even more pain. This can feel like a muscle spasm.
A ruptured or herniated disc can make it difficult for a person to exercise or move. Over time, this can cause muscle weakness that leads to back spasms.
Stress and anxiety
Anxiety and stress may cause lower back spasms.
Some people respond to stress by unconsciously tensing their muscles or by producing more adrenaline. Stress and anxiety can also decrease a person's motivation, which can lead to physical inactivity. All of these factors contribute to the likelihood of muscle spasms.
Sometimes, people may even experience psychological distress as physical pain, which is a process known as somatization. The pain is real, but it does not result from any physical condition or injury.
A crack or stress fracture in one of the bones of the spine can cause spondylolisthesis. This condition can cause part of a person's spine to move out of position.
The resulting lack of alignment can cause back pain that feels like muscle spasms. The muscles may also spasm in an attempt to compensate as the shifting spine will lead to weakness.
Spondylolisthesis is a common cause of lower back pain in young athletes.
Problems with the skeleton
Twisting of the spine, which occurs in scoliosis, may cause muscle spasms in the lower back. Over time, this spinal deformity may also cause a person to adopt a less active lifestyle. This can lead to muscle weakness that makes the spasms worse.
Spinal stenosis causes the spinal cord to narrow over time. This puts pressure on the nerves of the spine, potentially causing pain that feels like muscle spasms. Some people respond to this pain with poor posture or a less active lifestyle, which can worsen the spasms.
Arthritis can cause lower back pain that feels like a muscle spasm but in reality is a problem with the joints of the spine. As with other painful conditions, some people with arthritis may become less active, which can cause muscle weakness and spasms.
Fibromyalgia is a poorly understood chronic condition that causes pain and tenderness in multiple areas of the body. Many people with fibromyalgia experience muscle spasms.
Diagnosing the cause of lower back pain and spasms can be challenging. For some people, those with fibromyalgia, for example, the diagnosis may need to be one of exclusion, which means ruling out other conditions to determine the cause.
A doctor will take a full medical history and ask for details about the spasms. A physical examination or imaging scans of the lower back and spine may also be necessary. If there are other symptoms, the doctor might explore whether or not they relate to the muscle spasms.
A doctor may recommended physical therapy as a treatment for lower back spasms.
Treatment depends on the cause of the symptoms. While exercise and stretching may improve many causes of lower back spasm, this might not be sufficient for chronic conditions. Depending on the diagnosis, a doctor may recommend:
- pain medication
- physical therapy
- surgery to repair damaged discs
- spinal decompression surgery
- antidepressants or other drugs to manage stress, or to cope with the impact of the physical pain on mental health
Home management and first aid
If the pain is intense, does not improve with home management, or keeps coming back, it is necessary to see a doctor. However, some strategies that may help with lower back spasm in the meantime include:
- applying hot and cold packs alternately to the area — 20 minutes on and 20 minutes off for each pack
- massaging the area gently to loosen tense muscles
- stretching, walking, and other gentle exercises that do not strain the back
- taking over-the-counter pain medications, particularly nonsteroidal anti-inflammatory drugs such as ibuprofen
- using relaxation techniques, such as meditation and deep breathing
It is not always possible to prevent lower back spasm, but good self-care can reduce the risk of chronic back problems.
People should follow the CDC recommendation and ensure they get 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic exercise each week. It is also advisable to do muscle-strengthening exercises on at least 2 days of the week.
Stress management, including meditation or deep breathing, can prevent unconscious tensing. People who spend extended periods sitting should stretch regularly and take hourly breaks. Practicing good posture can reduce the pain that comes with sitting for extended periods.
Back spasms often disappear on their own. They may come back, or they might never appear again. It depends on the cause.
People with chronic conditions such as arthritis typically find that their symptoms get worse with time. However, if they are willing to try different medications and other strategies, it is possible for their symptoms to improve.
Lower back spasm can be painful and frustrating. It may cause some people to stop exercising or to become less active, which will exacerbate the problem.
The best way to deal with back spasms is to stay active and experiment with home treatment options. If the pain does not go away, then it is best to see a doctor.