How Long Do Back Spasms Last & What To Do For It?

The answer to the question “How long do back spasm last” depends on answer to the question “what causes back spasm?” Back spasms is a severe continuous contraction of paravertebral muscles. Paravertebral muscle is also known as back muscles. Expert suggestions reveal that if a person is suffering from back spasms, then to heal it, the person needs to remain active. However, as far as the recovery period of back spasms is concerned, it also depends on the intensity of the pain. If the pain associated with back spasm is sharp and intense then it may take a longer time to heal. However, the back spasms caused because of a strain, injury to the soft tissue, resolves within three to six weeks. During the three or six weeks the back spasms can be very painful.

How Long Do Back Spasms Last?

What Causes Back Muscle Spasm-

  • Muscle Fatigue
  • Muscle Weakness
  • Muscle Overuse
  • Manual Work
  • Heavy Weight Exercise
  • Dehydration

Mineral Deficiency- Deficiency of sodium, potassium, calcium and magnesium

  • Spinal Nerve Irritation
  • Spinal Canal Stenosis
  • Spinal Foraminal Stenosis
  • Fracture of Vertebra
  • Spinal Cord Pinch
  • Spinal Canal Stenosis
  • Spinal Tumor
  • Epidural Hematoma
  • Epidural Abscess
  • Facet Joint Diseases
  • Arthritis
  • Partial Dislocation
  • Vertebral Column Tumor

How Long Do Back Spasms Last?

Back muscle spasm caused by muscle fatigue lasts for 2 to 5 days. Rest, adequate fluid intake and treatment of pain helps to recover from muscle fatigue in 3 to 5 days and pain subsides in intensity from mild to none. Back spasm caused by muscle weaknesses remain for 2 to 4 weeks or longer. Muscle weakness caused by dehydration and mineral deficiency gets better when condition improves that may take 1 to 2 weeks. Back muscle weakness caused by long term chronic disease may take 8 to 12 weeks to recover after once the chronic disease is completely recovered.

Back muscle spasm caused by over use of back muscle gets better after 2 to 5 days of rest. The muscle overuse by manual worker or an individual lifting heavy weight may cause muscle tear. Muscle spasm associated with muscle tear often takes 6 to 8 weeks to heal. During healing period back muscle undergoes on and often in spasm.

Muscle receives signal to contract or relax through a spinal motor nerve. Spinal motor nerve branches out from spinal cord and carries signals or impulses from brain and spinal cord to paravertebral muscles. Motor nerve irritation or pinch in spinal canal or spinal foramina causes intermittent muscle spasm and if not treated may result in persistent muscle spasm. Spinal nerve irritation or pinch is caused by fracture of vertebra, foraminal stenosis and spinal stenosis. The symptom such as back muscle spasm continues until the cause of motor nerve irritation or pinch is not removed. The back muscle spasm may last for several week or month until condition is surgically treated and wound is healed. Motor nerve hyperactivity is also caused by irritation or pinch of spinal cord. Such intermittent back muscle spasm remains for several weeks until cause is removed.

What to Do For Back Spasms?

Back spasm may last for 12 to 24 hours and get better with rest. Occasionally non-opioid pain meds help to relieve spasm in 24 hours. If back pain lasts for more than 24 hours then you must consult primary care physician or specialist like orthopedic surgeon, neurosurgeon or pain specialist to rule out diseases that may need immediate medical attention and treatment. Differential diagnosis of back muscle spasm needs multiple investigation and consultation of specialist.1

Rule Out following Serious Conditions-

Back pain lasting more than 24 to 48 hours should be investigated with radiological studies to rule out following serious condition to prevent permanent damage to spinal cord or spinal nerve-

  • Foraminal stenosis
  • Spinal stenosis
  • Fracture of vertebral bones
  • Spinal tumor
  • Epidural hematoma
  • Epidural abscess.

Investigations to Diagnose Back Spasms-

Most of the cause resulting in back muscle spasm can be diagnosed following radiological studies of vertebral column and spinal cord. The following list of radiological studies are recommended for diagnosis of cause of back muscle spasm.

Treatment to Relieve Back Muscle Spasm and Treat the Cause of Spasm

The paravertebral back muscle spasm often limits day to day activities and interferes with employment. In case the back pain is severe and conservative treatment fails to relieve back muscle spasm then medications are tried. Occasionally emergency surgery may be necessary. Emergency surgery is necessary to prevent permanent nerve damage as well as prevent irreversible spinal cord injury. Therefore, it is important to understand all treatment options including surgery.

Conservative Treatment for Back Spasm-

Conservative treatment is one of the option tried prior to medications and surgery. Conservative treatment helps to treat spasm in most cases. Conservative treatment prevents patient’s exposure to side effects of medications, interventional injection therapies and surgery. The intermittent back spasm often responds to conservative treatment if cause of spasm is not irritation or pinch nerve. In most cases combinations of conservative treatments are recommended. Conservative treatment is prescribed by primary care physician or specialist. Occasionally patient is referred to chiropractor or osteopathic physician. The services rendered by a chiropractor or an osteopathic doctor helps to get rid of the back spasms by reducing pressure sensitivity of trigger points that initiated muscle spasm. Massage therapy helps to relieve back spasm by enhancing flexibility, improving the blood flow to muscles and diminishing muscle tension.2 Therapeutic massage reduces muscle stiffness and diminishes sustained muscle contraction.

Choice Of Conservative Treatment For Back Spasm Are As Follows-

Medication-

Medications are prescribed for severe pain that is not relieved by conservative treatment or patient is unable to continue conservative therapy. Typical pain medications used in the conservative treatment of lower back spasms include NSAIDs, acetaminophen, oral steroids, muscle relaxants, narcotic drugs, and anti-depressants.3 Each of the medications has limitations, strengths, and also risks. The back spasm may or may not respond to one type of medication. In most cases combination of more than one medication is used. The anti-inflammatory medication and muscle relaxants in most cases relieve the back muscle spasm or at least decreases the intensity of pain. In most cases it is lot less painful to perform massage therapy, stretching exercises, physical therapy and chiropractic treatment when patient is taking pain medications. However, it is also important to understand in few cases that conservative treatment and medication may not help to relieve paravertebral muscle spasm. In such cases other treatments are tried while patient is taking pain medications. Opioids are useful to treat severe pain for short period of time like 2 to 3 weeks. Opioid causes dependency and addiction. Opioids are avoided if pain relief is tolerable with NSAIDs and other alternative pain medications. Medications are often prescribed until back spasm is relieved and then discontinued. In few cases cause of back spasm needs to be treated by surgery. In such cases medications are continued until patient recovers from surgery and pain is tolerable.

The medicines that are used in treating back spasms are the following-

NSAIDS- Non-steroidal anti-inflammatory medications. Most often motrin, naproxen and celebrex are prescribed to treat back spasm.

Tylenol- Acetaminophen (Tylenol) is used as a pain medication. Tylenol does not work as an anti-inflammatory medication.

Opioids-These are strong medicines and are used to ease severe pain in the back caused due to back spasm. They are usually taken for only seven to fourteen days.

Muscle Relaxants– These medications help when the patient suffers from sustained or prolonged back spasm that is not responding to conservative treatment and pain medications. The common side effects of such medications are drowsiness. Muscle relaxants prescribed are Flexeril, Skelaxin, Soma and Baclofen.4

Anticonvulsants- Anticonvulsants are used in treating back spasms that is not responding to conservative treatment and have lasted for 2 to 3 weeks. Evidence suggests that these medicines are not that strong enough to help get rid of the acute pain. Anticonvulsants used as analgesics is Neurontin.

Antidepressants- Medicines like amitriptyline and duloxetine help treats depression. Tricyclic anti-depressants are prescribed for chronic pain.

Botox Injection. The botox is a neuro toxin known as botulin toxin A. The botox solution is injected in the muscle that is contracted.5 The toxin paralyses muscle and releases back spasm. The effect may last from 3 days to several weeks.

Physical Therapy

Physical therapy for back spasms includes stretching, exercises of back muscles, heat therapy and ultrasound therapy. Physical therapy is recommended when pain medications and muscle relaxants does not help to relieve spasm. Physical therapy is also advised following surgery to rebuild the atrophied muscle.

Injection Treatment For Back Spasm-

Injection treatment is also known as interventional therapy. Injection therapy involves insertion of needle and injection of medication or Steroid Injections. In this context, it is important to say that some of the medicines which work for some may not work for others. Therefore, it is important for the patient to consult a physician prior to taking medicines for back pain.

Trigger point injection– Trigger point injection procedure for treating back spasm is performed by placing tip of the needle over the most painful trigger point within the muscle. Placement of needle is often done using X-Ray or ultrasound images. Once the needle is placed within the muscles then mixture of local anesthetics and corticosteroid amounting 3 to 5 ccs is injected. Procedure is repeated 2 or 3 times at 2 weeks interval.

Corticosteroid Epidural Injection- Corticosteroid epidural injection is performed to relieve back spasm when spasm is caused by irritation or pinch of spinal nerve. Thus, patient diagnosed of spinal stenosis and foraminal stenosis are considered for epidural steroid injection. The procedure is performed using X-Ray image intensifier.

Facet Joint Injections– Facet joint disease or dislocation causes back pain and also back muscle spasm. Such pain is treated with facet joint cortisone injection or facet joint surgery. Facet joint surgery is performed to repair facet joint dislocation. Facet joint injection procedure is performed by placing needle at facet joint. The tip of the needle is placed in the joint under x-ray guidance. The medications injected is corticosteroid and local anesthetics. Volume of medication injected in neck is 2 to 4 ccs, thoracic epidural space 4 to 5 ccs and in lumbar area 8 to 10 ccs.

Surgery

Surgery is performed when paravertebral muscle spasm is caused by irritation or pinch of spinal nerve or spinal cord. The procedure is performed to relieve the pressure.

Surgery is preferred when all other treatment fails to relieve the symptoms. Foraminectomy surgery is performed to relive the pressure of spinal nerve within spinal foramina. Similarly, laminectomy and spinal fusion surgery is performed to relieve the pressure over spinal cord.

  • Foraminectomy
  • Laminectomy
  • Spinal fusion

Yoga for Relieving Back Spasms

Yoga therapy is also known as Yoga Asanas. Below mentioned are some of the yoga poses and pranayama for treating back spasms-

Tadasana (Palm Tree Pose)- Such pose stretches the muscles. Even the tiny muscles are stretched by doing this asana. Palm Tree Yoga pose relaxes the body and it creates a healing effect on the nerves.

  • Parsavkonasana (Lateral Angle Posture)- It stretches the heart, hip, and the waist muscles.
  • Makrasana (Crocodile Posture)- It stretches the muscles of the legs and back muscles. It helps to get rid of physical and mental body fatigue.
  • Yastikaana (Stick Pose)- This yoga asana can be effective in stretching and soothing the tiny body muscles and can also be useful in relieving back spasms.
  • Matsyasana- This yoga pose is good in the treatment of back and neck muscular spasm
  • Adho Mukha Savasana (The Downward-Facing Dog Pose)- It relieves the lower back muscle spasms and also provides spinal support. It is good to heal muscular cramps.
  • Balasana (Child Pose)- An effective yoga posture that relaxes the body. It is good in the treatment of muscular spasms.
    Balasana (Child Pose) for Relieving Back Spasms
  • Bhujangasana (The Cobra Pose)- The cobra pose gives gentle stretching to the back, leg muscles.
  • Wall Plank- It soothes and stretches the muscles surrounding the spine, leg, and hands.
  • Shavasana (Corpse Pose)- This yoga pose is effective in the treatment of strain, stress cramps, depression, back spasm.
  • Saithalyasana (Animal Relaxation Pose)- Good for spines that are stiff.
  • Anulom Vilom Pranayama- It is beneficial in relaxing the muscles.
  • Deep Breathing- It helps to ease out muscles and provides relief from back spasms.

References

  1. Diagnosis and treatment of low-back pain because of paraspinous muscle spasm- a physician roundtable.

    McCarberg BH1, Ruoff GE, Tenzer-Iglesias P, Weil AJ., Pain Med. 2011 Nov;12 Suppl 4-S119-27.

  2. An adjunct to manipulation in acute low-back pain associated with muscle spasm.

    GIFFEN LE., J Am Osteopath Assoc. 1952 May;51(9)-440-1.

  3. Acute back pain and spasm. A controlled multicenter trial of combined analgesic and antispasm agents.

    Basmajian JV1., Spine (Phila Pa 1976). 1989 Apr;14(4)-438-9.

  4. Randomized, double-blind trial of carisoprodol 250 mg compared with placebo and carisoprodol 350 mg for the treatment of low back spasm.

    Serfer GT1, Wheeler WJ, Sacks HJ., Curr Med Res Opin. 2010 Jan;26(1)-91-9.

  5. Botulinum toxin a injection to facial and cervical paraspinal muscles in a patient with stiff person syndrome- a case report.

    Pakeerappa PN1, Birthi P2, Salles S3., PM R. 2015 Mar;7(3)-326-8.

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