Lower-back spasms (muscular back pain)

The symptoms

Muscular back pain usually comes on instantly. Pain radiates from both sides of the spine and the muscles feel as though they’re locked up. It can be severe and debilitating.

What’s going on?

Muscular back pain is the most common type of back pain. It involves the paraspinal muscles, also known as the erector spinae muscle group, which are strong muscles on either side of the spine that enable you to move, twist and bend. These muscles run from the back of the hip, along the spine, and all the way up to the bottom of the skull. They’re among the strongest in the body.

So what brings on the pain? In general, the paraspinous muscles are too tight, too weak, or both. A sudden twisting or wrenching, bending forward or even a direct impact on the muscle can set it off.

Other muscle groups can also contribute to back pain. If you have weak or tight hamstrings, core, glutes or hip flexors, it could affect your body alignment and mechanics, which could force your back muscles to compensate and overextend themselves.

Fix it

Employ dynamic rest: Bad back spasms will make you want to lie down for, oh, several years or so. Don’t. Don’t lie down even for an afternoon. Stay mobile, even if it means taking little shuffle steps around the house. Bed rest during spells of back pain only deconditions your muscles, which is the opposite of what you want to happen. During the acute stage, avoid straining your back, but do simple stretches to loosen your hamstrings, hip flexors and glutes (see examples opposite). All of these can help alleviate the spasms.

Ice it, then heat it: Apply ice for 15 minutes four to six times a day for the first two days. After 48 hours, using a heated pad at the same time intervals can help relieve the spasms.

Try an NSAID: A non-steroidal anti-inflammatory drug, such as ibuprofen or aspirin, can help with pain and inflammation. Vary your therapies: Effective back pain therapies are very individualised. For example, some patients respond well to massage therapy. Acupuncture can also be effective for muscular back pain. Chiropractic can help as well, but for muscular back

pain only (not discogenic pain).

Also, for chiropractic, your treatment should continue only for a limited time based on the severity of your injury and include a fitness and flexibility component. The point: try different therapies until you get results. Everyone responds differently to different things. Stretch and strengthen your kinetic chain: As the pain subsides, start the reconditioning process with basic core strengthening and stretching exercises. Go slow. Stretch your hamstrings, hip flexors, glutes and core. Do glute bridges and planks, adding reps and intensity as you improve. Once you’re pain-free, up your kinetic chain conditioning (see ‘Prevent it’, below). Also, do these regularly: Lying glute stretch: Lie on your back with your knees and hips bent. Cross your left leg over your right so that your left ankle sits across your right thigh. Grab your left knee with both hands and pull it towards the middle of your chest until you feel a comfortable stretch in your glutes. Hold for 30 secs, then repeat on the opposite side. Repeat twice for a total of three sets – and several times a day if you’re really tight. Hamstrings roll: Place a foam roller just above your knees, with your legs straight. Put your hands flat on the floor for support. Keep your back naturally arched. Roll your body forward until the roller reaches your glutes. Then roll back and forth. If rolling two legs is too easy, perform the movement by crossing your left leg over your right ankle. Repeat with the roller just above your left knee.

Prevent it

Back pain prevention isn’t just about strengthening your back muscles. Your back is working in combination with the rest of your core, glutes, hip flexors, hamstrings and quads for optimal performance. If you have weakness or imbalance in one of those areas, you can develop back pain. Your best results come when you target all of those areas. The exercises here can be added to any workout. Plank holds also work well.

SWISS-BALL PIKE

Assume a press-up position with your shins on a Swiss ball and arms completely straight. Position your hands slightly wider than shoulders. Your body should form a straight line from your head to your ankles. Without bending your knees, roll the Swiss ball towards your body by raising your hips as high as you can (push them toward the ceiling). Pause, then return the ball to the starting position by lowering your hips and rolling the ball backwards.

HIP RAISE

Lie on your back with your knees bent and your feet flat on the floor. Place your arms out to your sides at 45-degree angles, your palms facing up. Raise your hips so your body forms a straight line from your shoulders to your knees. Squeeze your glutes as you raise your hips. Make sure you’re pushing with your heels. To make it easier, you can position your feet so that your toes rise off the floor. Pause for 5 secs at the top of the position, then lower your body back to the starting position.

BACK EXTENSION

Position yourself in the back extension station and hook your feet under the anchors. Keeping your back naturally arched, place your hands behind your head and lower your upper body as far as you comfortably can. Squeeze your glutes and raise your torso until it’s in line with your lower body. Pause, then slowly lower your torso back to the starting position.

PRONE COBRA

Lie face down on the floor with your legs straight and your arms by your sides, palms down. Contract your glutes and the muscles of your lower back, and raise your head, chest, arms and legs off the floor. Simultaneously rotate your arms so that your thumbs point toward the ceiling. At this time, your hips should be the only parts of your body touching the floor. Hold this position for 30 secs. (Note: if you can’t hold it for the entire time, hold for 5 to 10 secs, rest for five, and repeat as many times as needed. If the exercise is too easy, you can hold light dumbbells while you do it.)