Muscle spasms in the back can completely debilitate an individual leaving the person in pain and unable to move. Once serious injuries are ruled out (fracture, disc injury, neurological injuries), the focus can be on relieving the muscle spasm through the application of heat, rest, isometric muscle exercises, and gradual stretching exercises.
The key to recovery from back muscle spasms is to allow the body time to begin the healing process through needed rest and the application of heat. Isometric muscle exercises can also be utilized early to alleviate the muscle spasms.
Isometric Contraction to Help Reduce Spasm
An isometric muscle contraction is one in which the muscle contracts without any movement of the adjacent joints. It is an ideal contraction for early rehabilitation because the patient can perform an isometric contraction without moving.
Another benefit of utilizing isometric contractions in early rehabilitation is that the contractions can be performed to the tolerance of the patient. A patient can perform the contraction at an intensity that is comfortable for the patient (i.e., 50% of maximum intensity, 60% of maximum intensity).
The pain from muscle spasms may be lessened through performing isolated isometric contractions of the back muscles. This is based on the physiological principle that after a muscle contraction is held, the muscle will then relax. If the muscle in spasm can be isolated and isometrically contracted, it is possible to get the muscle to relax.
Isometric contractions should be held for a maximum of 10 seconds at an intensity that the patient can tolerate but one that does not cause an increase in pain. The 10 second contraction can be repeated 10 times each hour as tolerated.
Low Back Isometric Contraction
A comfortable position for patients with back spasms is lying on the back with hips and knees flexed and feet and lower legs supported on pillows. This position takes strain off the lower spine and back. This is a good position to begin isometric muscle strengthening.
Without moving, the individual pushes his/her lower back against the bed. Because the back is already lying against the bed, there is no movement of the lower back. The individual begins with a 50% contraction intensity (held for 10 seconds) and gradually increases the intensity of the contraction to his/her own tolerance being careful not to increase pain.
As the spasm diminishes over time, the individual can gradually increase the intensity of the contraction to a maximum contraction.. Again, the goal is still to repeat these contractions 10 times every hour. Once the individual can perform these contractions at a maximum level, he/she can then proceed to more advanced exercises to continue to strengthen the core muscles.
Beginning Back Stretching Program
A gradual stretching program also needs to be initiated once the spasms begin to subside. The stretching should not begin until movement is possible without the back muscles going into spasm.
A good beginning stretch is called the “cat” stretch. The individual assumes a position on his/her hands and knees with his/her back beginning in a neutral (flat) position. The individual gradually pushes his/her back towards the ceiling until the back is in an arched position. This position is held for 15-20 seconds or as tolerated and then repeated twice.
The sit and reach is another good beginning stretch. The individual sits on the floor with both legs stretched out in front. The individual then slowly leans forward and stretches as far as possible. The stretch should be to the point of tightness, but not pain. This position is held for 15-20 seconds and then repeated twice.
A strengthening and flexibility program should be continued every day to reduce the possibility of muscle spasms. Daily exercises should become part of a healthy routine to develop a strong back.