Low Back Muscle Spasm

What Is Low Back Muscle Spasm?

One presentation of low back pain is muscle spasm. This can accompany a low back strain or many other lumbar spine diagnoses. Low back muscle spasm presents as sudden, severe pain in part of the low back with decreased ability to move it for a time. For example, you are in a bent position and you cannot straighten up. That muscle is hard/tight to the touch compared to the other back muscles. It may appear swollen; for example, the right side of your low back looks bigger than the left. This can be present for a few minutes-hours and can come repeatedly over a number of days to several months, depending on your activities, movements and postures.

How To Treat Low Back Muscle Spasm:

It usually requires you to change positions, and the severity decreases if you find a relieving position such as lying on your side or getting onto hands and knees. Any new injury needs to be treated with ice for at least 2-3 days to minimize swelling and inflammation. Muscle spasm can be decreased with the use of heat to relax the muscle. If there is not significant swelling or internal inflammation, you can use heat to treat the pain associated with muscle spasms.

Medical Treatments for Low Back Muscle Spasm:

For this diagnosis, you will likely be prescribed muscle relaxers, anti-inflammatory medicine and/or pain relievers. Certain movements, positions or activities may need to be limited to prevent the spasm from returning (for example walking less, decreasing housework, or not playing your sport for a time). Other treatment options are Physical Therapy, chiropractic care, massage, and acupuncture.

How To Prevent Low Back Muscle Spasm:

If you prevent all other forms of low back pain, you will prevent low back muscle spasms. This means:

1. Practice good postures.

2. Practice good ergonomics and body mechanics.

3. Exercise regularly for your overall spine health.

4. Avoid a sedentary lifestyle because all tissues, including your spine, thrive on movement.

5. Do back extension exercises (moving spine in backward direction).

Back Health Survey: Am I At Risk For Low Back Pain?

1. How frequently do you perform moderate-high intensity exercise?
     a. 5-7x/week
     b. 2-4x/week
     c. 1x/1-2 weeks
     d. rarely

2. How many hours/day do you sit on most days of the week?
    a. <4 hours/day
    b. 4-6 hours/day
    c. 7-10 hours/day
    d. >10 hours/day

3. How often do you perform back strengthening exercise or core strengthening?
    a. >3x/week
    b. 1-2x/week
    c. occasionally
    d. what do you mean by back or core strengthening exercise?

4. What is your usual sitting posture?
    a. upright, with extra lumbar support (lumbar roll, rolled towel, etc)
    b. upright, without lumbar support (decent chair but no additional lumbar roll or cushion)
    c. mildly slumped
    d. severely slumped or rounded

5. What is your present weight status?
    a. ideal body weight
    b. mildly overweight
    c. moderately overweight
    d. severely overweight

6. How many episodes of major low back pain have you had in your lifetime (enough to limit your usual functional activities)?
    a. no major episodes
    b. 1 major episode or injury
    c. 2-3 episodes
    d. >3 episodes

7. How far down did your low back pain symptoms radiate?
    a. no major low back pain in my past
    b. low back only
    c. low back and buttock(s)
    d. down to thigh (not below knee)
    e. down below the knee

8. How did your low back pain resolve?
    a. no major low back pain in my past
    b. completely resolved
    c. partially resolved
    d. never resolved

9. How often do you practice proper body mechanics during daily activities (such as squatting instead of bending, avoiding twisting, and good lifting techniques)?
    a. All the time; with both difficult and easy tasks
    b. Most of the time, especially difficult tasks
    c. Sometimes
    d. Rarely

10. How much heavy lifting do you regularly perform?
     a. occasionally-rarely. Always with good technique
     b. frequently. Always with good technique
     c. occasionally-rarely. Without considering technique
     d. frequently. Without considering technique

11. How often do you participate in high risk sports/activities (such as skiing, skydiving, skateboarding, 4-wheeling, etc)?
      a. rarely and not likely to in the future
      b. once every few years
      c. multiple times per year
      d. very frequently

12. How often do you perform standing forward bending exercises (such as touching the toes)?
      a. never. not since elementary school calisthenics
      b. occasionally, when I need to stretch my back
      c. frequently, during my usual workouts
      d. daily or multiple times daily


Score: Count your score by assigning points to each letter answer.
Legend
a: 0 points
b: 1 point
c: 2 points
d: 3 points
e: 4 points


Results:
>30 points: Get to know your Physical Therapist and spine surgeon. You will be seeing us a lot.
20-30 points: Moderate risk unless you make major changes immediately.
13-20 points: Mild-moderate risk. Consider ways to improve!
6-12 points: Mild risk. But beware and don't become complacent in these areas.
0-6 points: You have a healthy back and are at low risk as long as you continue good habits!

Tune in next time for more discussion about these questions/answers!

Post your answer in the comments section. There will be three prizes awarded!
 

What is a good stretch for my low back?

A lot of my low back patients tell me that they have tried to stretch their backs out by bending forward to touch their toes. Unfortunately, this is not a good stretch for most of them. So how should you stretch out your back if it feels tight or stiff?

Here is a simple exercise that you can do this weekend at home, either on your bed, on the couch or on the floor. Lie on your tummy (face-down), and prop up onto your forearms. Hold this position for a few minutes as you watch AFV, play Angry Birds or read the paper. This is a position that children stay in sometimes when they watch TV or play video games, but it actually is a very healthy position for adults as well! Think about the position that your low back is in throughout most of your day. How often, if ever, do you stretch your spine in the backwards direction? The forward position (flexion) of your spine occurs whenever you sit or bend forward, so it is likely the majority of your day. Therefore it does not need to be stretched in that direction.

So try your new backwards (extension) stretch for at least 3-5 minutes, at least 1-2x/day, and you likely will get better results than other back stretches.



Ref: McKenzie, Robin. Treat Your Own Back, 9th edition. Orthopedic Physical Therapy Product: 2011.

How to avoid BACK PAIN with reaching/bending

My patients with back pain typically fall into two categories: trauma vs non-trauma. Traumatic injuries can come from a major accident or an easy task done incorrectly (bending down to pick up shoes from the floor and then patient is unable to stand back up). Non-traumatic back pain frequently comes from repetitive poor postures and bad bending/reaching habits.

Based on my posts "How many times per day do you reach to the floor," the number is likely more than 30 times and may be even higher than 50 for those of you with small children. So how can you modify these RTF's (reach-to-floors) so as to decrease your risk for back pain, back spasm, back strain or worse?

First, check your back position each time you reach down to the ground or a low surface. You can squat (with your back straight) or use the golfer's grab (kick 1 leg back behind you). You can sit on a stool or chair. You can kneel. You can get on your hands and knees. You can sit on the floor. Be creative; there are many ways to reach down without straining your back. It simply takes the effort to think twice before you bend.

Next, modify where you place the objects that you use the most to be at an easy-to-reach height. For example, store your dish soap in a decorative container on the counter instead of under the sink. What objects do you have in your lower cabinets, cupboards, drawers and shelves? They should be the ones you use rarely. Anything you use multiple times/day should be easily accessible with minimal reaching required. This is especially true for those of you with back problems (which limit your ability to bend) and knee problems (which limit your ability to squat).

Finally, always give yourself the mechanical advantage. Use your big muscles to do the work they were made for (thigh, buttocks muscles). They are easily able to do the work of lifting so your back does not have to.

Wrong Way To Feed The Dog (Video)

Why should you take better care of your body?

1. It is the only body God gave you.
2. Your body will thank you when you are older.
3. Taking care of it now will make your life easier down the road.
4. It's just like your favorite car: take care of it, and it will run longer.
5. You will feel great and look great!
6. To set a good example for your children and those who look up to you.
7. To decrease your aches and pains and prevent them from coming back.
8. To reach your maximum physical potential! You don't know how much your body is capable of (running a marathon, losing 50 pounds, returning to your favorite sport)!
9. To improve your sleep, decrease your stress, and boost your energy levels.
10. To keep you out of the doctor's office and doing the activities you love.
11. Because you want to know your grandchildren and great-grandchildren.
12. No one else will or can do it for you.
13. To save you money! Unhealthy living ends up being terribly expensive over a lifetime.


"Since we have these promises, dear friends, let us purify ourselves from everything that contaminates body and spirit, perfecting holiness out of reverence for God." -2 Corinthians 7:1 (NIV)

The difference between Chiropractors and Physical Therapists

Let's imagine you have back pain, and you need some help. Who do you call? The good news is that you have options: primary care doctor, spine specialist, physical therapist, chiropractor or even alternative medicine (such as accupuncture).

So what is the difference between the treatment you get from a chiropractor and a physical therapist?

Chiropractors specialize in manipulating (popping) various joints and segments of the spine and pelvis. They usually take x-rays to determine the areas that are not properly aligned. Then they develop a treatment plan, which includes manipulations to many different joints of your back. Depending on the chiropractor, you may also get electric stimulation, heat, ice, and decompression (a form of traction). More rarely, you may get some exercises. Most health insurances cover chiropractic care, but you will likely have co-pays. And anything your insurance does not cover (certain procedures), you pay out of pocket. Many chiropractors recommend that you continue treatment for weeks-months and then come back periodically for spine adjustments.

Physical Therapists specialize in decreasing pain and restoring normal physical function through exercise, education, hands-on techniques (which may include tissue or joint mobilization and joint manipulations), posture/body mechanics training, functional activities, modalities (such as electric stimulation, heat, ice, decompression/traction, ultrasound), gait training (improving walking patterns), balance training, stretching and/or strengthening. All health insurance covers Physical Therapy, but you will likely have co-pays. To see a PT, you simply need a doctor's prescription (if you want your health insurance to pay for it). PT's aim to find out the cause of your pain/symptoms, to treat them and to teach you how to prevent them again in the future. The goal is to make you independent in managing your own symptoms so that you no longer need PT. Depending on your injury/surgery, you may need PT for 1-2 visits or up to several months.



References:
American Physical Therapy Association (www.apta.org)
American Chiropractic Association (www.acatoday.org)

The danger of your first episode of Low Back Pain

Did you know that one of the biggest risk factors for low back pain is prior low back pain? It sounds obvious, but this has huge implications for you. It means that preventing a first episode of low back pain decreases your chance of having future episodes. Therefore, you are less likely to have chronic low back problems in your future.

Each of you is in one of these categories:
Group 1. No prior low back pain
Group 2. Prior low back pain

Here is my advice for both groups.

Group 1. Prevent an initial back injury and a first episode of low back pain through good posture, body mechanics/ergonomics, lifting correctly, avoiding bending/twisting and regular exercise. This is urgent for you because if you hurt your back once, you will very likely hurt it again. So prevent it now, before it is too late.

Group 2. See a Physical Therapist if you have frequent episodes of low back pain. Prevent future episodes through good posture, body mechanics/ergonomics, lifting correctly, avoiding bending/twisting and regular exercise. It is harder for you to prevent future back pain than group 1 because you have already injured your spine in the past. But Physical Therapy treatment can be very effective to teach you how to manage and prevent symptoms.



Ref: McKenzie Institute International. Part A. Mechanical Diagnosis and Therapy of the Lumbar Spine.

How many times per day do you reach to the floor? Part 2

15. Reach into bottom drawer of the refrigerator for an apple.

16. Reach down into lower kitchen cabinet for a tupperware to take leftovers to work.

17. Pick up your keys, which you dropped on the floor.

18. Throw your bags into the trunk of your car or your back seat.

19. Reach down to the floor of your car for the water bottle that fell.

20. Pick up your bag/briefcase out of the trunk or back seat.

21. Pick up the quarter you found on the sidewalk.

22. Place your bag/briefcase down on the floor while you take off your coat.

23. Pick up the paper from your desk that blew off.

24. Get a book out of the bottom drawer/shelf.

25. Reach down to get the water bottle you just bought from the vending machine.

26. Plug in the cord from your laptop into the outlet.

27. At lunch, pick up the napkin that fell off your table.

28. Tie your shoelaces.

RTF's (reach-to-floors) continue increasing, and it's only 2 pm!

To be continued.

How many times per day do you reach to the floor?

How many times per day do you reach down to the floor to pick up a light object? Consider how you do this reaching because it is quite frequent. And if you bend/twist your back every time, you are at high risk for back pain. So let's consider a typical weekday and count up the necessary RTF's (reach-to-floor's).

1. Pick up the pillow on the floor that fell off during the night.
2. Reach under the bathroom sink for a towel.
3. Reach under the bathroom sink for another roll of toilet paper.
4. Reach down to wash your toes.
5. Reach down to dry your toes.
6. Reach into bottom drawer of your dresser.
7. Pick up your shoes from the floor.
8. Tie your shoes.
9. Pick up your cell phone that dropped out of your pocket.
10. Reach under the bathroom sink for your after-shave or makeup.
11. Pick up your socks that you threw on the floor.
12. Pick up your briefcase or computer bag.
13. Pick up Snoopy's water bowl.
14. Replace Snoopy's water bowl.

As you can see, the RTF's add up, with 14 by 7AM! To be continued.

Health/Fitness Review: Gold's Gym

My review of Gold's Gym (Village at Sandhill in Columbia, SC)

The facility is a good size, with 3 main workout areas. The largest one has around 15 treadmills, 15 elliptical machines, 8 stationary bikes, 3 stair climbers, 1 upper body bike and a lot of machine weights. 

The second area has around 8 treadmills, 8 elliptical machines, machine weights, small dumbbells (2-15 lbs), exercise balls, medicine balls and mats.

The third area has all the free weights plus some machine weights. Very few women exercise in that area of the gym. Next to the free weights area is a basketball court.

There is a 3-lane pool, which is a comfortable temperature for swimming laps or doing water aerobics. When the water classes are in session, there is only 1 lane for lap swimming.

There is 1 large room for classes, including Zumba, body pump, aerobics, yoga, etc. The Zumba class (at least in the evenings) is always jam-packed! Classes are offered various times of the day and appear to be sufficient for the demand.

Another workout space is the cinema room, which plays movies and stays very dark. So bring your flashlight so you can see the buttons to start the treadmills. This room includes around 5 treadmills, 5 ellipticals and 5 recumbent bikes.

There is a small spinning room, which I have not yet used. It does not appear to get over-filled though.

For the more athletic type, there are 2 raquetball courts, which stay booked every evening and frequently at lunchtimes also. They can be booked ahead, if you call first! Good luck beating the veterans to the calendar!

The non-exercise areas include tanning, water massage table, whirlpool, steam room, sauna room, locker rooms, and the huge Kids Care room. I have been 100% pleased with the childcare providers there! The childcare hours are reasonable.

The staff are friendly and helpful. And there is a large staff of personal trainers available for an added cost.

The location of the gym is good, with easy access from Two Notch Rd, Clemson Rd or North Springs Rd. It is located in the Village at Sandhill mall, which makes it close to shopping and eating venues.

So...do I recommend Gold's Gym? Yes! The membership price is comparable to the other gyms and if you pay up-front for 1-2 year memberships you get quite a good rate. The price may even be lower than other gyms, depending on which specials you catch.

Is there a down side? Yes. The gym is very full in the early evening hours, making it difficult to find your cardio machine of choice. But that is expected, and you can always vary your workout by using a different machine until a treadmill opens up.

10 most convenient ways to exercise

1. Go for a walk in your neighborhood. Take your dogs. Take your kids. Walk to the park instead of driving. Walk 10 blocks instead of taking the subway or taxi. Look for an excuse to get out of the house!

2. Walk around the block on your lunch break. If you have an hour for lunch, use 30 minutes for exercise! If you have a desk job, be intentional about moving around during lunchtime and other breaks.

3. Ride a stationary bike while watching TV. If you have little time or ability to exercise outside of the home, consider buying a stationary bike, which is cheaper than a 6-month gym membership.

4. Take the stairs (every time)! Make it your routine, whether 1 flight or 5.


5. Go window shopping. Walk around town or the mall. And next time you are tempted to shop online, spend the time actually going to the store.

6. Go to the gym on your way to or from work. Be sure to choose one that is on your route. Or take advantage of the gym at work. If you are on a time budget, just work out for 30 minutes.

7. Play chase with your children or pets. This is an easy way to get your heart rate up quickly. And your babies will love you for it.

8. Do housework or yardwork. Try to work for 30-60 straight minutes. And use good body mechanics by squatting frequently.


9. Do jumping jacks, push-ups and crunches at home. Or use an exercise DVD. This is an ideal option for young moms during naptime!

10. Stand up while using your laptop or phone. Standing burns more calories than sitting. And it is a better position for your back!

Top 7 reasons why sitting causes back pain

1. Most people sit with slouched posture, which puts your low back in a rounded or flexed position for hours each day. Our backs were not made to stay in one position all the time. This can cause future problems in the spine such as arthrits, herniated disks, and sciatica.

2. People who sit at work typically sit for too long without changing positions. If your job involves sitting all day, standing up, stretching or walking around briefly every 30-60 minutes will help.

3. Very few people sit with lumbar support, which helps to align the low back. Good posture starts with the pelvis. Tilt your pelvis forward so that less of your buttocks are supported on the chair. That way the bottom of your pelvis is supporting your trunk and you increase the arch in your low back. Once you have that position, use a lumbar roll/pillow to maintain it.

4. A slumped low back leads to a rounded mid back with shoulders rounded forward and the neck to be excessively forward. This can lead to progressive neck problems and even shoulder pain (especially with lifting overhead).

5. Aside from sitting at work, we tend to have a sedentary lifestyle, with many leisure activities done also in the sitting position. With present technology, we can do almost everything from the convenience of our homes. While it is convenient to buy clothes and even stamps at home, it is taking a toll on our backs. Having a sedentary lifestyle leads to obesity, which carries multiple health risks.

6. We do very few activities with our spines extended backward, which is an important position to achieve regularly for optimal back health. If you do not regularly lean backward (increasing the arch in your low back), then start doing so several times daily. It can be done sitting or standing. Another way to arch backward is to lie on your tummy and prop up on your forearms.

7. Slumped sitting posture puts the back muscles (and other back tissues) in a lengthened or stretched position while also causing the muscles and tissues on the front of the hip, abdomen and chest to be in a shortened position. This imbalance can cause further posture problems, weakness and instability with greater risk for back pain and injury.