Nothing brings you to your knees (or into the bed) faster than lower back spasms. You will get through this and we can help with these stretches for lower back spasms
First things first, low back spasms can be down right traumatic. There are few words to describe the pain that is experienced during a low back spasm.
Many of us have had an incident where our back will seem to lock up.
I have personally experienced a back spasm where I went to lift a log and sent my low back screaming, I told my wife that this must be what birthing a child must be like. She promptly put that notion to rest saying, “imagine what you are feeling, then multiply it by 10, and imagine it lasting for 10 hours.” One day I’ll learn to not compare anything to childbirth...
Regardless of my wife’s uncanny ability to endure pain and push humans into the world (4 times!), the pain was real. I was stuck in a continuous loop where the more I moved, the more it hurt. The good news is that there is light at the end of this tunnel of pain.
Vaughn et. al 2022 describes acute muscle spasms of the back as sustained involuntary contractions of a muscle of muscle group that cannot relax and have been present for 6 weeks or less. He goes on to say that during a lifetime 84% of adults will experience muscle spasms.
The good news is that most people (90%) will recover in about a month.
Although so many people have had to deal with this pain, most people don’t know how to get over the lingering effects. That is where we, or another physiotherapist, comes in!
There are times where the pain from a low back spasm can get to the point where you may need to seek medical attention. When the pain is so severe that you cannot move, and that lasts for greater than an hour. It may be time to seek emergency care.
A trip to the emergency room for a debilitating low back spasm will usually end with a steroid injection to bring down the inflammation and calm the muscles down. This is a last resort due to the expensive nature of going to the ER and invasiveness of a steroid injection.
A majority of the time you can ride it out, but for those few severe cases, it's important to know that you have an option.
Yes! Stretching for low back spasms is an effective way to reduce symptoms.
In the acute phase it's difficult to do pretty much anything. Many people will experience lingering symptoms following back spasms that can include muscle soreness, stiffness, and generalized pain. These symptoms can be improved with gentle movements and stretching.
Stretching can start the process of recovery and reduce the lingering pain. When the body experiences a traumatic event such as a back spasm it will be very apprehensive towards movement.
If the spasm occurred when we were bending over to pick something up, then that movement will be avoided at all cost. This is one of those times where our brain is trying to preserve the body due to the negative feedback that it received when the spasm occurred.
Stretching can be a way to reintroduce movement in a way that won't trigger the back and start the process of letting your brain and body know that bending is a safe move. It is unrealistic that we can avoid bending over. So, it is better to maintain a mind set of progression rather than stagnation.
Walking for low back spasms can be helpful. However, when a back spasm hits, you won’t be able to do much of anything until the muscles begin to calm down.
Evidence shows that low, moderate, and even high intensity aerobic activity is effective to reduce low back pain. I often encourage my patients to walk as much as tolerated when treating low back pain.
The increased heart rate and activation of the low back and hip muscles have a positive impact on pain. Not only does aerobic activity blunt the pain response, it uses the muscles of the low back to move.
The activation of the muscles that the back uses to walk can lead to better function and help the pain go away faster. Incorporating our hip muscles as well is important as low back and hip pain can go hand in hand. When starting an aerobic program with a goal of improving resiliency for the low back, it is important to start small.
Pay attention to your pain and how it responds to walking. For some people, the pain may come on immediately, which may mean that you aren’t quite ready for walking as a form of exercise. Other people can only last 5 to 10 minutes.
Go until the pain gets too high then back off. Try to find the time that you can tolerate and repeat it over several bouts. The goal is to get comfortable before adding to the time.
When adding time, try to do it in 5 minute increments. This typically is long enough to increase the load, but short enough to not over do it. In short, walking is good for low back spasms, but be sure to approach it patiently and progress slowly.
Lower trunk rotations and knees to chest are a good place to start. Loosening the muscles around the lower back can help reduce the pain following a low back spasm. During a cycle of spasms the muscles can become stiff and rigid and have poor oxygen supply.
Stretching can help the muscles relax and get them to return to their normal length.
The knees to chest exercise below mimics bending over while not loading the lumbar spine. It has the lower body flex which causes a stretch to the low back. This in turn will help loosen those tight low back muscles.
The lower trunk rotations below work similarly by stretching the muscle fibers of the low back as well as start the process of normalizing the mechanics of the lumbar vertebrae. Remember, the goal with these stretches is to restore movement back to what it was before the incident.
The knees to chest stretch is a great place to start when you are experiencing the low back pain from spasms. The stretch puts you in an unloaded position, so you can start to bend the spine without all of the pressure that comes from standing. This stretch is done while laying on your back. Start by bending one knee and then lifting your knee towards your chest. You can use your arms to help draw the leg closer to the body and further enhance the stretch. Start on one side, then move to the other. Try to do both legs up towards the chest while holding them. This helps to stretch the lower back and put the spine in a position that shouldn’t cause much discomfort.
The lumbar rotation stretch is another gentle approach to help sooth the pain associated with low back spasm. The set up starts while laying on your back. This can be done on the floor if you like a harder surface or in bed. Start by bending the knees to about 90 degrees. From there let the knees fall to one side staying within a pain free range. Then allow the knees to fall to the opposite side. Repeat the movement for several repetitions, trying to allow the legs to fall further to each side.
Lower back spasms where you can’t move can do a number on a person’s psyche. It can lead to psychological distress and a development of “fear avoidance” behavior.
Much like the term implies, fear avoidance is where you avoid a particular position or movement because you fear what it might do to you. We have to continue moving our backs through a variety of positions and ranges of motion.
If you threw your back out while picking something up, you are going to have a hard time convincing yourself that the next time you pick something up that it won't happen again.
This concept is where the “therapy” part of physical therapy kicks in. Using principles of cognitive behavior therapy of exposure to a fearful stimulus is a powerful tool in the recovery process. As we have stated in nearly all of the blogs, your back is strong, stable, and adapted to movement.
I am not saying to go deadlift 300 lbs right after an episode of a back spasm. What I am saying is that you can regress a movement to the point where you can tolerate it. Not only does this prime the tissues for progression of load, but it primes your brain to allow your body to accept those stresses once again.
In conclusion, there is a high likelihood that you will experience low back spasms at some point in your life.
The pain is very real, but remember that there is a very high probability of clearing up.
Also keep in mind that movement is not your enemy, you just need to find the one’s that work for you. The exercises outlined in this article are generally a safe place to start. Make sure that you give your body time to adapt to load as you progress.
Revision Health Services offers telehealth for Florida residents as well as massage and physical therapy locally in Jacksonville, Nocatee, and St. Johns, Florida. To find out if our services could be the best fit for you, reach out and let's chat!
Until next time, stay healthy, keep moving, and take care of yourself.
Vaughan, S. A., Torres, K., & Kaye, R. (2022). RESUME-1: a Phase III study of tolperisone in the treatment of painful, acute muscle spasms of the back. Pain management, 12(1), 25–33. https://doi.org/10.2217/pmt-2021-0041