What are the 6 most common reasons for back spasms and who should you see first?

What are the 6 most common reasons for back spasms and who should you see first?

A back spasm can leave you feeling helpless and in pain.

If you have experienced back spasms, it can be from a number of causes including

Improper lifting – Twisting in combination with lifting can cause the lower back joints to sprain and the muscles and fascia surrounding it to strain.   It is important when lifting to bend at the knees instead of the lower back, and avoid twisting when lifting which can place undue stress on the lower back joints and the muscles that surround it.  It can also affect the upper back muscles as well between your shoulder blades.  Back spasms can be felt in the lower back, yet the problem may actually be a strain in the upper back.   Most people in pain cannot tell the difference.

Preexisting lower back and core dysfunction – If you have had previous lower back problems or upper back problems, it is likely that you will have future problems in those areas.  When the original problem occurred, did it self resolve or did you go for help?  What type of help did you get?  Was the help medication, exercises, manipulation, a combination of all of these?   Were they treating the area of pain or the mechanism that caused it?  If lower back spasms continue to occur more frequently as you age, it is likely that the reason behind why you hurt has never been fully understood, resulting in back spasms that often happen during many activities without notice.  Most people will tend to avoid those aggravating activities, however, until the problem is truly understood and resolved, other activities that you do may cause the back to spasm as well.  The truth is, you cannot avoid everything

To understand how the lower back works, you may consider reading the book Cheating Mother Nature, what you need to know to beat chronic pain. This unique book explains body mechanics in an easy to understand way that most consumer can begin to understand why they hurt and whom they should see.   Most often, back spasms are the symptom, rather than the problem.

Tight legs = If have tight legs, tight hamstrings, tight quads and tight calves and gluteal muscles, this is a well known risk factor for lower back and upper back spasms.   Traditional suggestions such as stretching may work temporarily, however, it is important to understand why you are tight. The tightness is actually the fascia, which is like an exoskeleton that surrounds the muscles and is responsible for how we move. Is may be from genetics, a growth spurt that happened when you were young or maybe stretching is making you tighter.  Tight legs will distort the pelvis and can cause back spasms with certain activities such as bending.

Shoulder problems – Most people with shoulder problems that were not caused by trauma may not have had the cause of the shoulder problems properly diagnosed.   Non traumatic shoulder dysfunction is a result of posture .  Most often, these postures begin in the feet, affect the pelvis and the way you walk and can result in shoulder impingements, back spasms in both the lower and upper back and even tears of the supraspinatus muscle which is common with those of us whose shoulders roll forward.  Over time, the shoulder capsules, the protective tissues surrounding the joint under the muscles will alter their shape and tighten up the neck and the mid back area.  Sometimes, this can cause spasms or cramping and in time, can result in frozen shoulder syndrome.

Body asymmetries that are inherited. – We inherit our body styles, and the way we walk is often a blueprint of how our parents walked as well.   Body style and asymmetry can result in spasms of the back and neck.  Problems with body style and the way we walk are present from the age of about 6 on. Before that, we are toddlers and are flat footed, we may assume that normal means tight, or inflexible or my normal tightness or my sciatica.   Asymmetries of the lower back can result in poor core stability and result in back spasms, neck tightness and constant stiff necks.  It can also result in knee pain.

A herniated disc or a disc bulge – Most people who have had an MRI for back spasms are having a disc herniation or bulge ruled out.  While, it is known that many of us have these problems without symptoms, an MRI is the most reliable way to determine if you back spasms may be due to a disc herniation.  If this happens to you, don’t panic, since most people recover from this within a few weeks or months.  Since these types of problems are related to how we move, it is important to note that if you have other risk factors as mentioned above for back spasms, you are at higher than normal risk for a disc herniation.

Who should you see first for back spasms.

More people are now visiting the chiropractor first for back spasms.   While the traditional approach of drugs and interventions are still recommended by physicians, a year ago, the Annals of Internal Medicine recommended a number of approaches that had two things in common; movement and no medication (a likely response to the Opioid epidemic) as the best first approach.

Chiropractors have had the best record with back spasms because their methods are holistic (they look at you, not just at the painful part) and use a number of treatments that are movement based including Spinal and Extremity manipulation, myofascial release, instrument assisted soft tissue treatment, active evaluation and treatment using treat – test – treat protocols (which personalizes the care to your unique needs).  Some may use other treatments such as cold laser which can help reduce pain, while others may also recommend acupuncture for pain control which is effective.  If your problem does not respond after a short term of treatment, they may order advanced diagnostics  and may refer you to a specialist however, a very small percentage of the patients with back spasms require this type of intervention which increases risk of side effects or surgical injury.

Seeing the right person first can determine your cost and the effectiveness and safety of your experience having back spasms relieved or eliminated. As per Consumer Reports Magazine, chiropractors due to their management and treatment styles should be the first person you see when experiencing back spasms.  Rarely, does an emergency room visit correct or properly address a mechanical back problem that results in back spasms, and it can be an expensive way to learn that.

Many patients visit their primary doctor first with back spasms.  A recent  Jama study suggested that primary care in combination with chiropractic management of back spasm was superior to the management by the primary doctor alone.  This was based on a large sample study in the Veterans Administration.