Back Spasms

Back Spasms

Back spasms are areas of tightness, knots, cramps, or twitching along the muscles that run next to the spine.  They are often caused by muscular imbalances, dehydration, nutritional deficiencies, over exercise, stress, anxiety, and many other causes.

Ice

Ice is useful for acute injuries and/or when there is inflammation.  Apply ice to affected area when the injury is less than two weeks old.  Also, if the part of the back is warm, red, swollen, painful, or any combination of those characteristics.  Ice should not be used when there is poor circulation in the area, if the spasms are chronic- over two or three weeks old, or if the back or ones whole body feels cold.  Here are some links to learn more about using ice.

https://my.clevelandclinic.org/health/diseases/15466-muscle-spasms/management-and-treatment

https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold#cold-therapy

Heat

Heat should be used for chronic injuries or recurrent injuries.  Apply heat to the affected area when the injury is over two to three weeks old.  And, if the part of the back is cold, pale, tight, painful, or any combination of those characteristics.  Heat should not be used if the injury occurred recently, if there is swelling, flushing, or if the back or ones whole body feels hot.  Here are some links to learn more about using heat.

https://www.everydayhealth.com/pain-management/using-cold-and-heat.aspx

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ice-packs-vs-warm-compresses-for-pain

Massage

Massage is good for back spasms because spasms are caused by the fact that the muscle has a lack of blood and oxygen.  Lack of oxygen in the muscles causes an increase of lactic acid.  Lactic acid in the muscles causes a deep heavy ache in the muscles after activity.  The spasm increases the amount of lactic acid in the muscle.  The increase of lactic acid in the muscle causes tighter spasms.  This is called, the pain-spasm-pain cycle.

Massage releases the lactic acid bound up in the muscles which allows the re-introduction of blood and oxygen into the muscles.  This also allows the removal of lactic acid and other waste products that are built up in the spastic muscle.

Trigger Point Therapy

Trigger points are similar to muscle spasms but have other characteristics.  A trigger point will cause severe pain with certain movements that use the affected muscle.  A trigger point will also “spray” a pain pattern to an area some distance away from the trigger point.  There are images on the internet that show these patterns.

A picture of some common lower back trigger point patterns can be seen here:

https://www.pinterest.com/pin/139048707221023516/?lp=true

There are various treatment methods that can relieve trigger points.

Active Release Technique is a method that uses direct pressure on the trigger point while the affected muscle is contracted.  The patient then moves the muscle through its full range of motion to a fully stretched position while the doctor maintains contact and pressure to the trigger point area.  The process is continued until the trigger point has more or less dissipated and the patient is dismissed from the clinic for the day.  The process continues until the trigger point is gone- it takes a number of visits.

Here is a link to learn more about Active Release Technique:

http://www.activerelease.com/ART-for-Patients.asp

Another useful treatment for trigger points and other spasms is Post-Isometric Relaxation.  This method is one in which the doctor moves the affected muscle to the end of its range of motion.  The patient then contracts the muscle with a slight force against the the doctor’s hands which are stabilizing the joints covered by the affected muscle.  The patient continues this slight contraction for about ten seconds.  Then, the patient is instructed to exhale and relax the affected muscle while the doctor continues to apply gentle pressure to the joints and the relaxation should allow a lengthening of the affected muscle.  After a few cycles of the technique, the trigger point or spasms should dissipate for the session and the patient is dismissed from the clinic for the day.  The process continues until the trigger point or spasm is gone- this also takes a number of visits.

Here is a link to learn more about Post-Isometric Relaxation Technique:

https://www.dynamicchiropractic.com/mpacms/dc/article.php?id=41025

Stretching

There are many websites, videos, and instructional manuals for learning how to stretch the spinal muscles.  Stretching is an excellent way to help lengthen spastic muscles over time.  This process is slow and laborious.  But, as the saying goes, “slow and steady wins the race.”

Chiropractic Treatment

Chiropractic treatment consists of a doctor taking a joint to its normal range of motion and applying a slight thrust to the joint slightly beyond its normal range of motion.  Usually, a “popping” or “cracking” sound will be heard which is the sound of gas escaping through the joint.  This is similar to the mechanism of the sound of a can of soda being opened or a cork releasing from a bottle.

When the thrust is applied to the “locked up” joint.  The chiropractic adjustment creates a stretch on the muscle spindles surrounding the joint which elicits a reflex.  This allows the spastic muscle to relax to some extent.  There is a process involved and the patient must return a number of times until the muscle spasm is gone.

Here are a few links to learn more.  They come from PubMed so the language is a bit advanced:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149032/

https://www.ncbi.nlm.nih.gov/pubmed/17905321

https://www.ncbi.nlm.nih.gov/pubmed/20538226

https://www.ncbi.nlm.nih.gov/pubmed/23499141

Drugs

There are drugs that are prescribed for muscle spasms.  Some of them, like Skelaxin or Robaxin/methocarbamol, relieve muscle spasms, but scientists do not know why they work.  Others, like Valium, work by reducing anxiety by increasing GABA in the nervous system.  GABA is an inhibitory neurotransmitter, which means it “slows you down,” so to speak.  Flexeril/cyclobenzaprine works by inhibiting the actions of the brain stem instead of working at the level of the spinal cord to induce muscle relaxation.

These drugs, while considered usually safe, are not to be used for more than a month or two.  They are not indicated for long term use.  Valium especially has a strong addictive property compared to the other drugs mentioned.  These drugs should not be taken while a person is drinking alcohol, taking anti-depressant drugs, taking opioid drugs, or driving or operating heavy machinery.  These drugs can cause drowsiness and liver damage.

The amount of time it takes for these drugs to take effect varies as well.  The average amount of time for Valium to reach its peak concentration in the body is 60 to 90 minutes.  Skelaxin takes about 3 hours to reach peak concentration in the body.

Here are the links showing more information about these drugs:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/017821s051lbl.pdf

http://www.endo.com/File%20Library/Products/Prescribing%20Information/Robaxin_prescribing_information.html

https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf

http://labeling.pfizer.com/ShowLabeling.aspx?id=689

https://www.addictioncenter.com/benzodiazepines/valium/

Acupuncture

Acupuncture is an ancient treatment which most likely originated in China over 2,500 years ago.  It was most likely used up to 10,000 years ago as a way to drain blood, perform surgery, or drain abscesses.  But, the introduction of metal needles around 800 B.C. was a new, innovative, and safer way to perform the treatment.

Over the past 2500 years there have been numerous works and treatises detailing the diagnosis and treatment of musculoskeletal problems using acupuncture and other treatment methods.  One of the early works, The Spiritual Pivot (靈樞經Líng Shū Jīng) lists what are termed as The Tendinomuscular Channels.  These are like the acupuncture channels one can find in a text book or poster but they deal with the muscles and tendons themselves.

Acupuncture to what are termed A Shi (阿是: Ā Shì) points were popularized by the physician Sun Si-Miao (A.D. 581-682).  The term means “Ah, yes” or “Ouch, there it is.”  These are points on the body that do not fit into the usual Acupuncture Channel Theory but are still useful and “active.”  These A Shi points usually refer to trigger points or spasms in the muscles.  Needling into these areas has always been a part of acupuncture.  So-called “Dry Needling” is still acupuncture.

Here are some links that give more information about how acupuncture relieves back spasms:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458928/

https://www.ncbi.nlm.nih.gov/pubmed/28158152

https://www.ncbi.nlm.nih.gov/pubmed/26406203

https://www.ncbi.nlm.nih.gov/pubmed/25801100

https://www.ncbi.nlm.nih.gov/pubmed/28690077

https://www.ncbi.nlm.nih.gov/pubmed/23593553

Conclusion

At our office, we use many different drug-free treatment strategies to help people to get rid of their back spasms and other musculoskeletal problems.  Dr. Waltemate can assign stretches and ice and heat to perform at home.  He performs trigger point therapy.  Dr. Waltemate has his doctorate in chiropractic and has treated thousands of patients over the past seventeen years.  Acupuncture is Dr. Waltemate’s primary choice for back spasms and he has studied under many masters from both East and West.

If you are suffering from back spasms.  Don’t hesitate to call our office at (314) 569-0057 or e-mail Dr. Waltemate at eric_waltemate@stlouisacupuncture.net

Seven Ways to Relieve Back Spasms

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