The Ultimate Guide to Back Spasms

Back spasms are like a charley horse in your back. Here's why they happen...and what you can do about them.

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Count yourself lucky if you’ve never groaned about a back spasm. A common complaint in the doctor’s office, back spasms can accompany run of the mill back or neck pain or result from a traumatic event, such as a fall or auto accident.

Back spasmsBack spasms are like a charley horse for your back.

What is a Back Spasm?

A back spasm is a painful involuntary and sustained contraction of one or more muscles of the spine. “Runners may get a feeling of having a charley horse in their calf muscle. That’s what a back spasm feels like, but in a different part of the body,” says Saad Chaudhary, MD, spine surgeon at the Mount Sinai Hospital in New York City.

A spinal muscle spasm could represent something serious, such as a microtear around a spinal disk that can generate enough inflammation to cause muscles to tense. In most cases, however, a muscle spasm in the back is a symptom of a mild muscle injury, such as a sprain, Dr. Choudhary says.

“It’s hard to decipher the [pathology] of a muscle spasm. But one of the theories of back muscle spasms is that if there has been a noxious stimulus that disrupts the muscles, they act together in a bracing fashion to protect the spine,” Dr. Chaudhary says.

Here’s the backstory on five muscle spasms that can cause back and neck pain.

Muscle Spasms of the Cervical Spine

 If you feel a muscle spasm in your neck, it’s likely a contraction of the trapezius muscle, the large cape-shape muscle group that runs down the neck to the midback. A back spasm in the cervical spine could also signal a contraction of the sternocleidomastoid, located at the base of the skull on either side of the head.
 

When these cervical muscles spasm, the pain tends to be localized to the point of muscle irritation. “But if the spasm is a symptom of an underlying inflammation or nerve irritation, it may radiate downward,” Dr. Chaudhary says.

Muscle Spasms of the Thoracic Spine

The trapezius runs all the way from your neck to the last vertebra of your thoracic spine (mid-back). That means a spasm may not only affect the neck, but the middle of your back as well. Spasms in the midback area can also result from a contraction of the rhomboid muscle, which connects the shoulder blades to the rib cage and spine. Generally, because there’s less movement in the midback, muscles in this protected area of the spine are less likely to spasm, compared to the cervical and lumbar region, Dr. Chaudhary says.           

 

Back spasms anatomyCertain muscles in the back are more prone to spasm than others.

Muscle Spasms of the Lumbar Spine

A spasm in the lower back is likely a contraction of the erector spinae muscles, a large group of stabilizing muscles that run on either side of the spine, or the latissimus dorsi, Dr. Chaudhary says. Commonly referred to as “lats,” they’re one of the largest muscle groups in the body, covering the middle and lower back.
 

Relieving Muscle Spasms

Treatment for muscle spasms depends on the how you were injured. “Taking a full history is important,” Dr. Chaudhary says. “Did you just lean over and pick up a box or sleep in an uncomfortable position?” That sort of pain is less concerning than if your back spasms started after you were involved in a high-speed auto accident or a fall from a significant height.

Back spasms that occur after such “red flag” events will require an immediate full neurologic and muscular examination and advanced imaging, such as MRI. “We want to make sure we’re not missing any significant underlying instability or injuries of the spine that would require extensive treatment,” Dr. Chaudhary says.

Other “red flags” include osteoporosis (loss of bone mass) or ankylosing spondylitis, a form of arthritis that primarily affects the spine. Osteoporosis may cause an underlying compression fracture. Ankylosing spondylitis can cause parts of the spine to fuse. Both underlying conditions can cause muscle spasms, Dr. Chaudhary says. A personal history of cancer may also cause your doctor to dig deeper.

Conservative treatment is likely all that may be needed to relieve muscle spasms of the spine, such as:

  • Wearing a soft collar initially for a cervical spasm
  • Applying heat or ice
  • Anti-inflammatory medication
  • Light activity, such as walking while avoiding bending, twisting and lifting
  • Physical therapy
  • Manipulation to improve range of motion of spinal muscles

“If you’re not getting better within four to six weeks of conservative treatment, then we would order an MRI of the area,” Dr. Chaudhary says. “But the majority of patients with back spasms get relief with conservative treatment.”

Back spasms core strengthStrengthen your core to prevent muscle spasms in your back.

        

Still, preventing back spasms is an even better idea. “There’s a globally accepted phenomena of being ‘heart healthy’ with regard to cardiovascular health. I tell my patients that we need to be ‘spine healthy’ as well by keeping the abdominal muscles, lumbar extensors and the erector spinae muscles fit with stretching and core exercises regularly,” Dr. Chaudhary says. “Warming up, stretching and doing yoga and Pilates exercise will go a long way to minimize muscle spasms and injuries.”

 

Updated on: 05/20/20
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Richard D. Guyer, MD
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