The first step when treating a back spasm is to get immediate relief by relaxing the muscle. Some effective treatments can include, muscle relaxants, cold therapy, heat therapy, walking, and anti-inflammatory medication. After the pain from the back spasm resolves, physical therapy can help prevent future spasms.
Muscle spasms in your back can be so painful that they may have you headed for the emergency room. If you experience a back muscle spasm, make sure to stop and listen to your body. Either your back is telling you not to do that activity ever again, or it’s warning you that there’s a more serious underlying issue in your spine.
See Pulled Back Muscle and Lower Back Strain
Watch: Lower Back Strain Video
Causes of muscle spasm
The first step to getting to the bottom of what your back is telling you and to feeling better is to determine the cause of your back muscle spasm.
Watch Video: What Is Your Back Muscle Spasm Telling You?
In general, most lower back muscles spasms occur because of the following reasons:
- The muscles are trying to protect themselves from muscle strain
A back spasm can occur after any type of strain or injury to the soft tissues—the muscles, tendons or ligaments—in the spine. Following the general treatment guidelines below and the recommendations from your doctor or physical therapist will go a long way in relieving your pain, and your back muscles should calm down in a week or so.
- The muscles can spasm in response to an underlying anatomical problem
If your back spasm does not get better in 1 to 2 weeks, or it comes and goes over time in the same area of your back, you may have an underlying anatomical problem in your spine. Examples of underlying issues that could cause your back to spasm include:
- Facet joint osteoarthritis
- Degenerative disc disease
- Spinal stenosis
- Pain from a herniated disc
In these cases, the pain is coming from the anatomical problem, and the muscle instinctively reacts to the pain and inflammation by going into a spasm. If this is the case for you, then you will want to seek medical attention in order to treat not just the acute pain but also to address the underlying cause of your symptoms.
See Should I See a Doctor for Back Pain?
First aid for a painful back muscle spasm
When your back goes into spasm, the first step is to get some immediate relief from the intense pain. The initial goal of treating the muscle spasm is to get the muscle to relax, thus relieving the pain. Some effective treatments include:
These are prescription medications that do not directly target the muscles; rather, they have an overall relaxing affect on your body. They are typically only prescribed if there is intense, acute pain, and only on a short-term basis. Some examples of muscle relaxants medications include Valium and Flexeril.
See Muscle Relaxants
Applying ice wrapped in a protective sheath or towel, or a cold pack, to the painful part of your back is another way to help relieve an acute flare up of pain. As a general guideline, cold therapy will help reduce local inflammation, which in turn contributes to relieving pain. You can use a commercial ice pack or make one yourself. For example, you can put some ice or frozen vegetables into a baggie, add some water to smooth out the lumps, double bag to prevent leaking, cover it in a towel to protect your skin from ice burn, and apply it to the painful area of your back.
A nonsteroidal anti-inflammatory medication (NSAID) can help reduce inflammation and pain. Examples of over-the-counter NSAIDs include ibuprofen (e.g. Advil, Motrin), naproxen (e.g. Aleve), and aspirin. Some people find that acetaminophen (e.g. Tylenol), which addresses pain but not the inflammation, is effective.
See Types of NSAIDs
Walk as much as possible
To whatever extent possible, try to get up and move as much as possible. For example, this could mean a day of mainly rest, followed by a day that includes several short walks around the house, followed by a day with a short walk every hour or half hour, or longer walks as tolerated. Prolonged inactivity will stiffen your muscles and will likely lead to more pain. In general, walking is gentle on your back and promotes blood flow, which in turn helps speeds the healing process.
Heating pads and heat therapy
Applying a heating pad to the affected area can bring soothing pain relief. Some people find heat is best, some prefer ice, and some find it most helpful to alternate the two therapies. You try a see what works best for you, and talk to your physical therapist or doctor for suggestions about what might work best in your specific situation.
See Benefits of Heat Therapy for Lower Back Pain
If your spasm has occurred as a result of an overuse injury or muscle strain, these measures will get you through the relatively small amount of time it will take for the muscle to heal and go back to normal.
On the other hand, if your spasm is occurring in response to an underlying spine or disc dysfunction, these treatments will help treat the pain, but the underlying cause of the problem will still need to be addressed.
Whatever the cause of your back muscle spasm, after the acute pain has resolved you will want to consider physical therapy, as usually a controlled, progressive exercise program that is tailored to fit your needs will give you the best chance of avoiding a future flareup of pain.