There are many possible causes for lower back spasms, including poor posture, muscle overuse, and sprains and strains. People who experience recurring or worsening spasms or pain should see a doctor for an assessment.

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 spasms radiates to other areas of the body, such as the hips or legs.

In this article, we look at the causes of lower back spasms as well as prevention, diagnosis, first aid for symptoms, and treatment.

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Lower back dysfunction is often due to a combination of factors. Injury, inflammation, and muscle weakness can all cause lower back spasms, pains, and discomfort. Many of these factors may occur simultaneously or result from one another.

In some people, the cause may be 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.

Poor posture

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 worsening the pain.

Muscle weakness

Worldwide, 25% of adults do not meet the recommended physical activity levels.

A sedentary lifestyle 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 cause muscle spasms because of muscle weakness and inflammation.

Muscle overuse and post-exercise pain

The overuse of any muscle can disrupt its working. This can lead to spasms, pain, and discomfort. 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 are common causes of sprains and strains.

Disc disorders

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 compression on a disc causes it to bulge out of the spinal column. A herniated disc can put pressure on nearby nerves.

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 to exercise or move. Over time, this can cause muscle weakness that leads to back spasms.

Arthritis

Arthritis can cause lower back pain that feels like a muscle spasm but, in reality, is a problem with the spine’s joints. As with other painful conditions, some people with arthritis may become less active, which can cause muscle weakness and spasms.

Osteoarthritis is a common cause of lower back pain and dysfunction. Osteoarthritis is the gradual degeneration of cartilage and bone in a joint. Other autoimmune forms of arthritis, such as rheumatoid arthritis, can also affect the back.

Learn more about all forms of arthritis in our dedicated hub.

Nerve damage

Conditions or injuries that damage 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.

Stress and anxiety

Stress and anxiety can also cause lower back spasms.

Some people respond to stress by unconsciously tensing their muscles or producing more adrenaline. Stress and anxiety can also decrease a person’s motivation, leading 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.

Spondylolisthesis

Spondylolisthesis leads a part of a person’s spine to move out of position. Isthmic spondylolisthesis is the rest of a bone fracture that allows for slippage. By contrast, degenerative spondylolisthesis results from a weakening of ligaments around the joints. This is common during the aging process and does not require a fracture or other direct trauma to occur.

The resulting lack of alignment can cause back pain that feels like muscle spasms. The muscles may also spasm to compensate as the shifting spine will lead to weakness.

Spondylolisthesis is a common cause of lower back pain in young athletes.

Scoliosis

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.

Scoliosis can affect a person’s posture and movements. These changes can lead to muscle imbalances in the spine, potentially causing spasms and back pain.

Spinal stenosis

Spinal stenosis causes the spinal canal 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.

People with spinal stenosis may also experience:

  • burning or aching pain in the back
  • loss of sensation in the lower extremities
  • tingling or cramping in the lower back, buttocks, and legs

Fibromyalgia

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.

Treatment depends on the cause of the symptoms. While exercise and stretching may improve many causes of lower back spasms, this might not be sufficient for chronic conditions. Depending on the diagnosis, a doctor may recommend the following:

  • pain medication
  • physical therapy
  • surgery to repair damaged discs
  • spinal decompression surgery

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 spasms in the meantime include:

  • applying hot and cold packs alternately to the area
  • 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 spasms, but good self-care can reduce the risk of chronic back problems.

People should 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 at least 2 days a 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.

Lower back spasms 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.

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.