Muscle Pain (Back Pain and Back Spasms)

Many patients who experience back pain assume that their problem is related to the discs or joints in their back. In reality, back pain is often related to back muscles that have seized up in muscle spasms, or due to continued tightness in the muscles. Back pain related to muscle pain is usually of an acute nature, as patients will typically only experience short term pain that subsides as the muscles heal themselves. In some cases, though, muscle tightness may continue as a chronic problem related to a number of emotional or physical factors. Let's take a look at what some of these most common factors are, and how we may be able to treat them so that the muscle tension breaks up and does not return.

What causes muscle spasms and how do we treat them? A muscle spasm is an intense, continued occurrence of muscle tightness that occurs in response to an injury, to prevent the injury from becoming more severe. Muscles may go into spasm when the muscles themselves become damaged, or when the structures or nerves that they connect to become injured. A muscle spasm may occur as an immediate reflexive response due to an injury, or in response to inflammation of the muscle or associated structures that the muscles are connected to. The muscle inflammation may occur when a muscle is overstretched or torn. This is one type of sprain and strain injury that doctors describe as the cause of what is usually acute pain. Strain typically describes a muscle that has become overstretched or overloaded. Sprains describe overstretching or partial tears of the ligaments in these same areas of the back. Back spasms caused by muscle strain doesn't sound like a serious injury, but it may result in incapacitating pain. Because of the severity of the pain levels, back spasms account for the majority of the back pain related visits to the emergency room in the U.S.

Muscle strains may also be referred to as pulled muscles. When strains or tears occur in the low back muscles, inflammation may develop around these injured muscles. These muscles may react to the inflammation by going into a continued state of contraction - known as a muscle spasm. These spasms may lead to severe pain and difficulty moving. Some types of activities that may lead to these conditions and symptoms include falls, sudden movements, lifting while twisting, lifting with a bent back, and lifting heavy objects. The pain may be described as axial low back pain when the symptoms are confined to the lower back where the injury has occurred. The pain/condition may be described as referred pain or radiculopathy when the pain radiated away from the site of the injury and to the buttocks, hips, or leg. The area of the injury may be sensitive or sore to the touch, feel worse while working it out, and better while resting.

Many patients should feel lucky to have this type of back injury and not others related to the nerves, joints, ligaments, or discs. Connective tissues such as the ligaments and discs are poorly supplied with blood vessels, while structures such as the muscles and bones are highly vascular. Structures that are more generously supplies with blood vessels have a greater capacity to heal themselves faster. As the blood vessels bring vital nutrients to the tissues that are in need of repair, the inflammation subsides and the patient experiences relief. For this reason, muscle strains usually heal on their own in a matter of days to a few weeks.

Within a small window of time, patients will usually be advised to rest their injured muscles, along with conservative treatments such as icing and anti-inflammatory medications. Rest is not usually advised for long periods of time in order to avoid muscular deconditioning (weakening of the muscles). After a period of more than two weeks of significantly limited mobility, the back muscles may begin to atrophy. This atrophy of the muscles may have the effect of destabilizing the parts of the spine that those muscles had the job of supporting.

In general, people who have an active lifestyle are athletic, and who practice good body mechanics as they work and play are less likely to suffer from back spasms. A person's lifestyle of regular exercise and stretching makes it less likely that they will become overstretched or torn in other situations, such as at work. A complete exercise program, which should especially be practiced by people with a back history, should include a combination of stretching, strengthening, and aerobic conditioning.

Back spasms may occur in response to injuries caused my muscle or injuries. For this reason, both strain and sprain injuries are treated in a similar way. For these injuries, they may be treated with:
  • Pain medication: to disrupt pain signals from reaching the brain.
  • Anti-inflammatory medication: to reduce the inflammation that triggers the spasm.
  • Muscle relaxants: which have an overall sedative effect throughout the body, including a global sedative effect on all the muscles.
  • Massage: Massage therapy may loosen the muscles and increase circulation to the affected muscles in need of healing.
  • Chiropractic: Chiropractic manipulation may be performed to fix the imbalances in the body that are contributing to the inflammation of the affected structures in the back.