BACK SPASM Explanation A back spasm occurs when the muscles of the back involuntarily contract due to injury in the musculature of the back or inflammation in the structural spine region within the discs of the vertebrae, the ligaments that attach the vertebrae, or the tendinous attachments that hold the back musculature in place. While back spasms primarily occur in the lower back, complaints of upper back spasms can be quite common as well. A back spasm can be viewed as the body s defensive mechanism, of sorts, to keep the back immobilized in order to prevent further injury. Causes Excessive activity as well as traumatic incidents can lead to injuries that, in turn, can lead to back spasms. These injuries can result from a variety of events and activities, from something as simple as a consistent, repeated movement of the spine, such as that which occurs when swinging a golf club, to more drastic incidents, such as that of a forceful blow to the back or a sudden, unnatural twisting of the spine. Inflammation and injury of the vertebrae, spinal discs, spinal ligaments, or spinal muscles as a result of such activities and incidents can often lead to back spasms. Other causes of back spasm can include sudden, radical changes in physical activity and training, prolonged sitting or standing, and repeatedly poor posture. Symptoms The central symptoms of back spasm include a severe pain as a result of leg or arm movement or spinal rotation, as well as the sensation of immobility of the spine. These symptoms are often recurring, and can be described as intermittent flaring and then subsiding, only to flare again shortly after. Back spasm has been noted to dissipate when situated in a resting position, such as lying down, but can return with subsequent movement. 1
Diagnosis Your health care professional will need to acquire a detailed history of the injury, such as a recent traumatic incident that may have incited the sudden onset of back spasm symptoms or possible new training practices or aspects that may have resulted in spinal inflammation. Your health care professional will assess the injured area, palpating (feeling) the area for any notable abnormalities or strain. He or she may also move and manipulate the limbs as well as the spine in order to assess and determine which positions and pressures induce symptoms, and you may be asked to perform various motions and movements in order to further assess. Certain cases may require x-rays, bone scans, MRI, or CAT scans in order to determine the presence of internal injury or the lack thereof. Treatment If back injury is the conclusive cause of the back spasm, the injury should first be treated by applying cold to the injury site, such as with an ice pack. Apply the ice for 15-20 minutes, up to 3 sessions per day. Your health care professional may prescribe muscle relaxants to be taken as directed, or suggest the use of non-steroidal anti-inflammatory drugs, such as Ibuprofen. There are also recommended exercises you can perform during the early treatment of back spasm. Lasting Effects Depending upon the severity of the initial causative injury, paired with the amount of inflammation and rehabilitation, back spasm symptoms may either dissipate entirely, or continue to persist, therefore requiring further attention to rehabilitation. With minor injuries and inflammation, symptoms may only last a short number of days; while with more severe cases, it may take several weeks for symptoms to completely disappear. Healing Time and Return to Play Full participation in sports or physically involved and challenging activities, especially those in relation to the initial cause of the injury, should be avoided until you are entirely symptom-free. This means that the you should be pain-free when performing basic skills, movements, and function of the sport or activity in question before participating. Participating too soon can lead to further injury and more severe symptoms. With less severe cases, full participation may be possible after only a few days; however, with greater initial injury, it may be several weeks before you re able to fully participate. Prevention Consistent exercises designed to strengthen the muscles of the back as well as enhance the flexibility of the spine and lower extremities can be effective in the possible prevention of injury. Frequently changing position, especially positions relative to a past injury or a back spasm, can help with prevention, as well as periodic stretching. 2
Rehab Recommendations Back spasm rehabilitation consists of three central elements. 1. Recovery from the initial pain, injury, or inflammation. 2. Strengthening the back and abdominal muscles. 3. Improving flexibility of the back and lower extremities. The body first reacts to back spasm with protective responses, such as pain, to alert and prevent further injury to the spine and spinal structures. In addition to the 3 elements listed above, the patient must also be sure to avoid causative activities, such as the initial incident, if possible, that could further inflame or aggravate the problem. Patient should not participate in sports or strenuous activities until free of symptoms. A health care professional may advise and suggest specific exercises to aid in rehabilitation and strength the muscles of the back. The following exercises can be used to stretch and strengthen the muscles of the back: SUPINE KNEE TUCK STRETCH 1. Lie back into the supine position on a comfortable surface with your knees bent upward and hands placed behind the knees. (Starting position) 2. Relax and inhale as you prepare to stretch, then slowly pull the knees toward your chest as you exhale and slowly breathe out. 3. Hold stretch for 3-5 seconds as you exhale. 4. Return to the starting position by relaxing and allowing the knees to come away from your chest as you inhale and prepare for the next rep. ELEVATED HAMSTRING STRETCH 1. From a stand position, elevate one leg up on a chair or bench. 2. Begin stretch by bending the trunk as you exhale and reach down toward the elevated foot. Be sure to keep the knee straight. 3. Hold statically for 5-10 seconds, and then inhale as you slowly come up out of the stretch. 4. Repeat stretch on the opposite leg. HEAD TO KNEES HAMSTRING STRETCH 1. Sit on the floor with both legs fully extended and feet together. 2. Begin stretch by leaning forward as you exhale and flex your trunk and drop your head to your knees as far as your hamstrings and lower back will comfortably allow. Try to keep your knees straight. 3. Hold statically for several seconds. 4. Slowly come up out of the stretch as you inhale and lift your torso back up. 5. Repeat for desired number of reps. 3
SUPINE HIP TWISTER STRETCH 1. Lie back into the supine position on a comfortable surface with both arms extended out to your sides and both legs extended with feet together. 2. Begin by lifting one knee up bent 90 degrees to where your thigh is perpendicular to the floor. 3. Proceed into the stretch by dropping and lowering the knee across your body as far as your back and hip will comfortably allow. 4. Come out of the stretch by slowly bringing the knee back up to the perpendicular position. PELVIC PRESS 1. Lie back into the supine position on a comfortable surface with your knees bent upward, feet together and flat on the floor. Hands can be placed either down by your sides or up on your midsection. (Starting position) 2. Relax and inhale as you prepare for the first rep, then begin Pelvic Press motion by contracting your abdominal and press your lumbar into the floor as you exhale and push all the air out of your lungs. 3. Hold that position statically for 3-5 seconds as you exhale. 4. Return to the starting position by relaxing your abdominal as you inhale and prepare for the next rep. PRONE BIRD DOG 1. Begin by lying face down (prone) on a flat, comfortable surface, like an exercise mat or carpeted floor, with your arms extended out above the head. (Starting position) 2. As you prepare to perform your first rep, relax and inhale. 3. Proceed into the upward phase as you exhale and simultaneously lift one arm straight upward, while lifting the opposite leg upward, contracting your lower back and glutes (buttocks). 4. Inhale as you return to the starting position by slowly lowering everything back to the surface. 5. Repeat step 3, except lift the opposite arm and leg for the next repetition. BACK EXTENSION Easy 1. Begin by lying face down (prone) on a flat, comfortable surface, like an exercise mat or carpeted floor, with your arms next to your sides. 2. As you prepare to perform your first rep, relax and inhale. 3. Proceed into the upward phase as you exhale, then simultaneously arch your back and lift your chest up. 4. Inhale as you return to the starting position by slowly lowering your head and chest back to the surface, then prepare for the next rep. 4
SUPINE HIP EXTENSION 1. Begin by lying back on a firm, comfortable surface with your knees up and your heels close together on the floor, spread 6 12 inches apart, and arms by your side. Inhale as you prepare for first rep. 2. Begin the upward phase by lifting your hips and lower back as high as you can, while balancing your bodyweight on your heels. Imagine digging your heels into the floor. Exhale during this phase. 3. Once at the top, hold for a 1 count (1 second). 4. Then simply reverse the motion by slowly lowering your hips under control (don t just let it drop) as you inhale back to the starting position. BALL BACK EXTENSION 1. Lie face down on a stability ball, ensuring that the feet are keeping the upper torso stable throughout movement. 2. Once stable, either cross your arms across the chest or clasp your hands behind the head. 3. As you prepare to perform your first rep, inhale and bring the torso down toward the floor while maintaining good balance. 4. Proceed into the upward phase as you exhale, and then arch (hyperextend) your back while contracting the glutes (buttocks). 5. Inhale as you return to the starting position by slowly lowering the torso back to the surface as you prepare for the next rep. In addition to these movements, you should maintain a basic level of fitness through aerobic exercises, such as walking, cycling, swimming, or jogging, to the extent that the body allows (as is comfortable, without pain), for around 15-20 minutes a day. The exercises above will aid in rehabilitation of the back and lower extremities, as well as, help prevent future injury or recurrence of back spasm. Once back spasm symptoms dissipate, you can seek assistance in developing a training program to enhance resistance and flexibility in order to protect against further back injuries that may lead to back spasm. 5