What to Do About Back Spasms

Medically Reviewed

It can happen when you bend to pick up a dropped pen. Sudden, excruciating pain makes it difficult to straighten up. Your back is in spasm.

A back spasm may occur while performing any number of everyday activities—picking up a child, shoveling snow, putting laundry in the washer, sitting at a desk for a long time, or even sneezing. The resulting pain and stiffness may restrict your range of motion and keep you from maintaining normal posture.

Fortunately, most people who experience back spasms will recover quickly, usually without seeing a doctor. If you experience a back spasm, you’ll need to know how to manage the pain and what to do to help prevent a recurrence.

Understanding your condition

Back spasms are caused by an involuntary contraction of muscles that brings about pain because the muscles cannot relax. The pain is often described as feeling like a knot in the muscle. The most common area affected is the lower back, because it supports most of the body’s weight.

Back spasms can occur when lifting or pulling something too heavy, twisting your body the wrong way, making a sudden awkward movement, overreaching or overstretching, or sitting or standing for long periods of time, particularly if you have bad posture.

Some spasms occur because the nerve that connects to a muscle is irritated, such as when a herniated disc irritates spinal nerves.

What makes you susceptible to back spasms? Here are some factors that may increase your risk:

• Age. Years of wear and tear on the spine will make you more likely to suffer from back pain, including spasms.

• Poor physical shape. Weak back and abdominal muscles can’t properly support the spine, so back problems are more common in people who don’t get enough exercise.

• Weight. Being overweight or obese puts more stress on the back.

• Occupation. Regularly using your back muscles to lift, push, or pull while twisting your spine will cause your back to spasm. Conversely, sedentary work or hobbies will have the same result if you have poor sitting posture.

• Smoking. When you smoke, nutrients are blocked from reaching the discs in your back. And repeated coughing from heavy smoking can cause a back spasm.

• Race. An African-American woman has a two to three times greater chance than a Caucasian woman of having a part of the lower spine slip out of place. Slipped (or herniated) discs can cause spasms and pain by irritating the spinal nerves.

• Medical conditions. Osteoarthritis, spondylolysis (stress fracture in a spinal vertebrae) and spondylolisthesis (when the vertebrae move out of place) increase your vulnerability.

Finding relief

If you feel your back muscles start to spasm, stop whatever you’re doing and try to slowly and gently stretch and massage the muscle.

Stretch only as far as comfortable, and then hold the stretch for five seconds, if you can, while breathing deeply and slowly to relax. Remain in whatever position causes the least pain, but be aware that sitting may be stressful for your back at this point.

Hot or cold packs—or sometimes a combination of the two—can be an effective short-term remedy for back spasms. Heat will relax the muscle at first—it dilates the blood vessels, allowing more oxygen to reach the muscle.

Cold packs or ice (wrap these in a towel or cloth to protect your skin) may be helpful after the first spasm and when the pain has improved.

If your back is still sore and you’re considering taking an over-the-counter pain reliever, check with your doctor first, especially if you have another health condition. Some of these medications, including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, may put you at risk for serious side effects.

Bed rest isn’t advisable while you’re recovering. Walk around frequently to help ease stiffness and relieve pain.

When to see a doctor

Call your doctor if the pain continues for more than three days, if pain continues to be severe despite self-care, or if you’re experiencing pain with muscle weakness or numbness in your legs.

Muscle spasms are diagnosed by the presence of tight or hard muscles that are very tender to the touch. Diagnostic testing isn’t usually necessary unless pain persists for more than two weeks. Then your doctor may order an X-ray or magnetic resonance imaging (MRI) to rule out underlying causes such as an undetected disc injury.

Your physician may prescribe muscle relaxants, an anti-inflammatory or anti-spasm medication, and/or physical therapy. The American Pain Society and the American College of Physicians recommend that because of the risks involved, medication use should be based on the severity of pain and functional impairment—NSAIDs have gastrointestinal and cardiovascular health effects, and opioids may cause sedation and dependence.

Guidelines issued by the two groups encourage doctors to consider nonpharmacological treatments such as chiropractic care and massage therapy for patients who don’t improve with self-care.

If you do seek medical treatment, your doctor should try to identify the cause of the spasm to prevent recurrences. If you have an irritated nerve, you may need physical therapy or even surgery.

Preventing back spasms

Once you’ve recovered from a back spasm, you can take steps to avoid having to endure another. Having a healthy lifestyle is a good start to preventing any kind of back pain, including spasms.

Regular exercise will help. Ask your physician or orthopedist for a list of low-impact exercises appropriate for your age and designed to strengthen lower back and abdominal muscles. Stronger muscles mean you’ll be able to bear more weight and have greater flexibility.

Swimming or brisk walking can provide good cardiovascular exercise without putting undue stress on your back. And yoga helps to stretch and strengthen muscles and improve posture. Remember to stretch before exercising.

Depending on the severity of your spasm, you may need to stay away from activities that require sudden twisting movements, including golf, bowling, and tennis and other racquet sports. If your physician approves, you may be able to continue some of these activities as long as you modify your technique.