A back spasm is the involuntary contraction or tensing of the muscles in the lower back. The condition ranges from infrequent and mild discomfort to severe pain.  Although ‘back attacks’ seem to occur out of the blue, the movement that triggers the incident is generally preceded by a series of small strains to the structures of the spine that develops slowly over time. Once injured, inflammation sets in. This, in turn, sensitizes the nerves, causing the muscles to contract and spasm.

FIRST AID

• For the first 48-72 hours after your spasm, apply a cold pack to the area to reduce any inflammation.  Protect the skin from any risk of ice burn with a thin towel before applying the pack.  Apply for 20 minutes and use every 1-2 hours as needed.
• After 72 hours, apply moist heat.  A wet towel or warm shower will help.  It’s is important to improve circulation to the injured muscle in order for it to recover and function well.
• Muscle relaxants are prescription medications e.g. valium that do not directly target the muscles but have an overall relaxing effect on your body and prescribed if there is acute pain and only on a short-term basis.
• A nonsteroidal anti-inflammatory medication can help reduce inflammation and pain e.g. ibuprofen and aspirin.
• Try to relax the muscles that are in spasm with controlled breaths.  The muscles are contracting in order to protect another area of your body that is at risk of injury e.g. a weaker muscle, joint or disc.  Because the muscle is in spasm, it is becoming progressively shorter and consequently more painful.   As you try to relax, extend the muscle with gentle bending opposite to the contraction of the muscle.  Take slow inward and outward breaths to calm yourself, even though you are uncomfortable.  Don’t try to overstretch. Only allow very slight increments.  By increasing the length of the muscle, you will decrease the amount of pain from the muscle which also reduces injury to the area that the muscle is trying to protect.   Alternate periods of stretching with rest.
• For a severe muscle spasm, you may find movement is too painful and you need to rest in order to reduce stress on your lower back.  Lay on your back with your upper body supported at a slight incline and a pillow under your knees, or sitting at an incline in a reclining chair with your legs supported and knees slightly bent.
• To the best of your ability, try to get up and move as much as possible.  This could mean a day of mainly rest, followed by a day that includes several short walks round the home, 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 may lead to more pain.
• Gentle massaging may help soothe the pain and allow the muscle to slowly release.
• Make sure that you are drinking enough fluids as dehydration and loss of electrolytes may affect the length and success of your recovery.
• Elevating your legs takes pressure off the spine and may also help relieve pain.

LONGER-TERM SELF-HELP

• Losing a few pounds if you’re overweight will help relieve the stress on your spine and joints.
• Standing up straight and wearing low-heeled shoes will help provide stability and strength in your lower back.
• Avoid spending too much time in bed or sitting.
• Incorporate stretching exercises into your daily routine. Muscle fibers benefit from gentle stretching. Consider taking Pilates or yoga classes.