Intense, unrelenting pain in your lower back muscles prevents you from bending forward to do something as simple as putting on your pants. Severe, uncomfortable muscle tightness that feels like pulling your lower back into a question mark. Suddenly, you feel much older than you actually are because you can’t move, hesitating with every small motion to avoid that gripping sting shooting up your spine. This is what a lower back muscle spasm feels like. And, even though everyone gets a muscle spasm in their lower back at some point, most people fail to recognize that there might be a bigger problem lurking underneath.

Usually, you first try to wait and see if the muscle spasm will subside by itself. But what if it doesn’t go away? What if it doesn’t ease? Or even worse, it gets even worse. This happens because lower back muscle spasms are a way that your body protectively guards other vulnerable structures like joints, nerves, and ligaments. Thinking back, you might remember something that caused the back muscle spasm in the first place. “It must have been that heavy box I picked up.” However, in most cases, it is not what you did but an ongoing chronic problem where your body is not strong enough to meet the demands of the movements you want it to do. Now, your body tries to protect you from causing damage to other tissues by activating muscle spasms in your back.

You must get help to get to the root of the problem and get the proper treatment.

Let’s first look at the underlying structure of your lower back to understand where and how lower back muscles fit in.

The basic structure

Your spine is what gives your upper body structure. The part referred to as your ‘lower back’ consists of five bones (vertebrae) stacked on each other. They are named L1-L5. These vertebrae are large and thick as they greatly support the weight of your upper body. Between each vertebra is a disc made up of a gel-like material. These discs act as shock absorbers and are responsible for most of the mobility of your spine without sacrificing the supportive strength of your vertebral column. Ligaments connect the different bones and provide extra stability. Between each vertebra, a nerve root exits on each side, branching out to connect to other nerves.

The complex anatomy of your lower back is a remarkable combination of solid vertebrae linked by joint capsules, flexible ligaments, large muscles, and susceptible nerves. Given its sheer size and solid stability, would you be surprised to hear that it is also the most flexible part of your spine?

Muscles allow movement

All muscles are made of elastic tissue that can contract and relax, allowing you to move. Each muscle consists of thousands of tiny muscle fibers; the more robust the muscle, the more fibers. With more movement and muscle contractions, muscles grow bigger (hypertrophy), but with less movement, they become smaller and weaker (atrophy).

Lower back muscles

Some muscles help with movement, and others with stability. Thus, they are called mobilizers or stabilizers.

• Stabilizing muscles are found in deep tissue layers, attaching directly to the lumbar spine. Therefore, they exert a segmental stabilizing force between each lumbar segment of your spine. They activate before you even move so that your spine is already stabilized as you start moving. Throughout the day, they stay activated and contract at a low intensity, ensuring each vertebra stays in place. If each vertebra is stable, your whole lumbar spine segment is stable. In the end, instability is what leads to injury. These muscles are called local or stabilizers because they only connect to your lower back.
• Mobilizing muscles are big, strong muscles responsible for moving your upper body. These muscles cross multiple segments (connecting different parts of your body) and do not attach directly to the vertebrae. Because they span large areas, they are also called global muscles or global mobilizers. They generate a lot of force, move your spine, and give you the necessary strength to pick up something heavy.

Different directions of movement

The muscles in your lower back are divided into four groups, moving your lower back in four directions.

• Backward motion is the spine Extensors: Erector spinae/sacrospinalis (global mobilizer) and Multifidus (local stabilizer)
• Forward motion the the spine Flexors: Rectus abdominis (global mobiliser), External obliques (global mobiliser), Iliopsoas (global mobiliser), Internal obliques (local stabiliser) and Transversus abdominis (local stabiliser)
• Sideways and turning motion are the spine’s lateral flexors and rotators: Quadratus lumborum (global mobilizer), External obliques (global mobilizer), Internal obliques (local stabilizer), and Intertransversarii (local stabilizer)

Take note: Stabilisers and mobilizers work together and take over each other’s jobs when one of them is injured. That means that mobilizer muscles can take over the stabilizer’s role while also moving the spine. You already know how well you can do the work of two or three other colleagues…

What is your core, and where does ‘core strength’ come from?

Your core is a set of specific muscles positioned to create a cylinder, like a cold drink can. It forms a protective cylinder around your spine that helps to keep it stable. The main core muscles are your diaphragm, pelvic floor muscles, transversus abdominis, and multifidus.

The term’ core strength’ is a term we all know but rarely understand. Most people think a weak core is why they get back pain and muscle spasms. However, core strength or core stability is your body’s ability to control your core and generate force outwards from a stable base. This includes optimal force generation from your core muscles and force transfer to allow mobilizing muscles to focus on exerting power. Good core stability is using the right muscles at the right time and intensity to control your lower back during movement.

Muscles in your lower back allow you to move, bend, and twist your upper body. Although the muscles are divided into different groups,  each responsible for a different action, they never work in isolation.

When you bend forward to pick up a heavy box, you don’t think about each muscle you should contract. You move when you want to move. Your brain coordinates this muscle firing pattern precisely, knowing when and at what speed each muscle must contract or relax. Usually, there’s an inverse contraction between muscle groups; when the flexors contract, the extensors must relax, or when the left side’s muscles contract to turn you, the right muscles must relax. So, you can understand that a misfire or uncoordinated contraction between these muscles causes problems.

Together, different muscles give your spine the stability it needs

Lower back muscles and ligaments prevent the vertebrae in your lower back from moving or shifting out of place. Ligaments provide static stability, as they can’t move or contract. Muscles provide dynamic stability, which means that even though they move your spine, they still keep it as stable as possible. Without stability, any movement puts increased pressure on your lumbar discs, joints, and nerves and causes an injury.

Flexors, extensors, rotators, and lateral flexors provide the best stability when they work together. An excellent example of this is when you sit. You probably thought that your lower back is ‘rested’ when you sit. Even though you are not moving, all these muscles contract to keep you upright. This is where local stabilizers and global mobilizers come in as well. While sitting, your local stabilizers work hard to stabilize your spine, but your global mobilizers are not entirely relaxed. Together, they give the best stability. This unique system becomes broken when there’s pain; the mobilizer muscles are activated to protect your spine, causing a lower back muscle spasm.

A muscle spasm is a “persistent, involuntary muscle contraction.” This involuntary muscle contraction causes pain by decreasing circulation to the area. This pain warns that the lower back muscle tissue lacks oxygen and prevents nutrients like Calcium and magnesium from reaching the muscle fibers to relax them. So, regardless of sufficient nutrition or supplements, it might not reach the target site.

There were warning signs. Believe me

Lower back muscle spasms usually start with stiffness, discomfort, and a feeling of “something is not right in my back.” This is your warning sign of a deeper, more complex problem, and your body is trying to bring it to your attention.

Ignoring the early signs and pushing through the pain puts you on course for more serious and powerful lower back muscle spasms. By doing this, your body limits your movements to protect deeper, vulnerable structures like lumbar joints, ligaments, discs, and nerves. It protects you from further injury. Don’t ignore it or mask it with meds. Get it checked and know what you’re dealing with.

Your lifestyle contributes too.

In today’s world, we sit more than anything else. Work has become something where you sit, looking at the work on your desk or computer screen daily. You don’t get enough sleep, your stress levels increase, and physical exercise and overall well-being take the backseat.

Your lower back, especially the lowest lumbar joints and discs (L4/L5), carries your upper body’s weight. If you are overweight or lack the necessary core stability and lower back muscle strength, your spine takes a lot of strain daily. Ultimately, this causes instability.

Instability causes increased pressure on the intervertebral discs, joints, and nerves, leading to injuries like a bulging disc, lower back joint pain, or nerve compression. Lower back muscle spasms will always accompany injuries like these. We call this muscle guarding. Muscles protect the injured site by forming painful spasms in your lower back.

Take a step back and look at the bigger picture.

Imagine your lower back as a strong tower of Jenga blocks stacked one on top of the other, with all the pieces intact.

Stage 1 – Healthy and strong

You have a strong lower back, no underlying injuries, and an overall healthy lifestyle that allows you proper sleep, enough exercise, good health, and manageable stress. This is a body that works in perfect harmony and can react to any load that you put on it. The tower of Jenga blocks is stable and solid.

Stage 2 – Falling apart bit by bit

Now, one by one, the Jenga blocks are removed. If you don’t get enough sleep, remove a block. Are you working long hours in a terrible posture? Remove a block. Weak lower back muscles? Remove a block. With each block removed, the chance of the tower collapsing becomes higher. When a sufficient number of blocks are removed, the tower becomes so unstable that it still stands, but the slightest movement will topple the whole structure.

Stage 3 – The last block

The last block is removed, and now the muscles in your lower back attempt to desperately save your vertebrae from shifting or your spine from collapsing, the same way the tower is about to collapse. This is how you end up with a painful muscle spasm in your lower back.

Stage 2 is where most of us are, and rarely ever return to Stage 1.

You thought you fixed it.

We try to find ways to return to Stage 1 by trying to fool our system. We desperately try to build the tower of Jenga blocks back up and make it work by taking medication, going for massages, or doing some stretches. This way, you feel better and fool your body into believing that “it’s all back to normal.” But you have not built the tower of Jenga blocks back up to its original state of stability; you only do damage control. The tower is standing but on the verge of collapsing again.

To prevent lower back muscle spasms from returning repeatedly, you need to start building the blocks from the bottom up and not just repositioning the last one. Part of the reason we don’t do this is that we feel better halfway through. The first sign of relief gives us reason to believe we have ‘fixed’ the problem. But the fact is, it will just be a matter of time before it all comes back again.

Pushed to the limit

A back muscle injury occurs when your back muscles are forced to contract under pressure or remain contracted for a long time. It becomes too much, the muscle can no longer hold the contraction, and this combination of muscle fatigue and overload leads to muscle strain. It is pushed beyond its limits, beyond the point of simply spasming. Now, you end up with a torn lower back muscle with inflammation causing swelling and further irritation. The muscles surrounding the injured muscle now spasm protectively to prevent further injury. Now, you are left in even worse pain.

Muscle spasms are caused in response to instability and underlying injuries.

The instability of your spine leads to increased pressure on structures like your discs, joints, and nerves, which can lead to injuries like a herniated disc, osteoarthritis, or nerve compression. In addition, protective muscle spasms form to prevent you from injuring yourself even further. If the instability and inflammation are ongoing, the muscle spasms are likely to keep recurring.

Back muscle spasms due to a muscle strain

A lower back muscle injury occurs when the muscles get overstretched or torn. The injured muscle and surrounding muscles will spasm in an attempt to protect you from worsening the injury. Pain and stiffness make it impossible for you to move. This protects you from bending too far and overstretching or completely tearing the injured back muscle.

Overload

Bending forward puts the muscles in your lower back in a stretched position. These muscles must pull your upper body back up to get back up. Now, imagine how much harder they need to contract when you bend forward to pick up a heavy box from the ground. If the effort is too much, you end up with a muscle strain and protective muscle spasms in your lower back due to overexertion.

Sustained strain and fatigue

Carrying a hefty hiking backpack or carrying furniture around the house puts a heavy load on your back. Your muscles grow tired from contracting under extra pressure, causing a muscle spasm in your lower back.

Repetitive overuse

While picking up the children’s toys, you bend and twist your body awkwardly to reach them and get back up to put them back in their place. A repetitive movement like this means the muscles in your back must contract and relax repeatedly. Your muscles get tired, and while you want to push through to finish the task, you could strain a back muscle or end up with a severe muscle spasm.

Slipping or falling

You slip on a wet floor, and in the wink of an eye, you’ve fallen over, hurting your back. The sudden, unsuspected motion, combined with tissue damage from the fall, leads to intense lower back muscle spasms.

Sitting for many hours on end

We were never made to sit in front of a desk or computer for such a long time without breaks or interruptions. Although you feel ‘rested’ while sitting, your spine is not actually relaxed. The local stabilizers in your lower back must contract and work while seated to keep you upright. They get tired and fail to support your back. The pressure and the weight of your upper body squash the discs and joints together, not just for a few minutes, but for hours on end. Your body detects the tissue damage and causes lower back muscle spasms in response.

Overloading the wrong muscles

If your local stabilizers don’t have the endurance or capacity to contract when you sit for hours, they won’t do a good job stabilizing your lumbar spine. To compensate, your global mobilizers will be recruited to help with stabilization. If this continues, the local stabilizers grow weak and won’t automatically activate as you move. Now, global mobilizers have to get used to the dual role of stabilizing and moving your spine. They can’t maintain contractions like this for long, leading to muscle pain and spasms in your lower back.

An excellent way to determine the severity of your lower back muscle spasm is to look at how much it limits your activity. Can you bend, sit, get up to stand, walk, run, or exercise? The lower the required load to perform a motion, the worse the problem. A severe lower back muscle spasm is so disabling that simply putting on pants is excruciating.

Muscle pain tends to be a radiating dull ache, but when a nerve gets pinched in your lower back, the pain will be sharp and sudden and slow to disappear. These intermittent sharp pains quickly escalate, causing more widespread pain and recruiting larger mobilizing muscles to join. This causes the pain to spread to your hips and buttocks or radiate up the spine to your upper back.

How frequently you get these lower back spasms also gives us a clear sign that they might become constant soon if the underlying primary cause is not fixed.

Recurring, chronic muscle spasms in your lower back are a secondary problem caused by an underlying injury. Instability and repeated pressure and compression of the joints, discs, and nerves in your lower back cause these protective muscle spasms. If you ignore the warning signs and push through the pain, you could be injuring yourself even further. With time and recurring lower back muscle spasms, you become afraid of doing specific movements. You never know when your back will seize up again. Now, you think twice before you play with your kids. It could happen at any moment, and you know by now how bad it is. You want to avoid those aching spasms at all costs.

What is the difference between a lower back muscle spasm and a muscle strain?

A muscle strain is physical muscle tissue damage caused by torn fibers, and a muscle spasm is a continued, involuntary muscle contraction. Muscle spasms usually serve as a warning to stop doing what you’re doing because it could lead to a muscle strain. Lower back muscle spasms can be eased quite quickly with the right treatment, whereas a muscle strain is a tear in the muscle that needs a longer time to heal the injured tissue.

Our physiotherapists are experts in human anatomy and movement, with the necessary experience to diagnose a muscle spasm or muscle strain in your lower back. We understand how muscles work in coordination and can accurately diagnose which muscle has been injured and if any underlying structures in your lower back can cause a muscle-guarding reaction. The starting point is to do a full clinical assessment and get the necessary information about your back pain.

During your first evaluation, we will stretch and stress the muscles in your lower back to determine which one has been injured. Our practitioners can then accurately identify where your spasm is coming from. To make sure we cover everything, we will also test other structures, such as joints, discs, and nerves. Our practitioners spend enough time screening and testing all the components that could be involved, which is why we are the best at diagnosing this type of problem.

Muscles cannot be seen on an X-ray, so it will not be effective in diagnosing a muscle spasm. However, X-rays will show the integrity and alignment of joints in your spine. This will enable us to see if something is wrong with the structure of the bones in your spine or if there is a loss of disc space.

Your physiotherapist will refer you to get x-rays taken if deemed necessary.

Diagnostic ultrasound can be used to show the presence of a muscle tear (muscle strains), inflammation, swelling, or simply increased contraction of a muscle (muscle spasms).

If you need an ultrasound, your physiotherapist will refer you.

An MRI scan can show us all of the structures in your lower back, including soft tissue, discs, nerves, and bones. However, for a muscle spasm, an image like this is unnecessary and very expensive. If your physiotherapist suspects anything more than just a muscle spasm, you will be referred to the right specialist.

A lower back muscle spasm might start as a protective mechanism. However, if you do nothing about it and the muscle spasm continues to bother you, it will prevent you from regaining full movement. Your body will adapt, your muscles will weaken, joints will stiffen, and your spine will become less stable. You will become stuck in a cycle of pain, not knowing if it is safe to move or not.

The sooner you know what’s causing the muscle spasms in your lower back, the better. A lower back muscle spasm rarely resolves by itself; over time, the intervals between the episodes become more frequent, rising with intensity and taking longer to disappear. At first, it might be mild with years between flare-ups, but later, it builds up into a more intense lower back pain for longer, more resistant to medication to eventually get it under control.

Treatments like medication might ease the pain, but they won’t prevent the lower back muscle spasm from coming back if something more profound is causing it. If it were a muscle strain and not just a muscle spasm, it would take longer for the tear to heal. You may feel frustrated that the pain in your lower back isn’t easing, but there could be something else that needs your attention. If you don’t take the warning signs seriously, your back could suffer more critical and possibly irreversible damage.

Waiting too long and not getting a proper diagnosis.

A common problem is that patients wait too long before seeking help. By the time they come to us for treatment, they have had issues with recurring lower back muscle pain and spasms for months or even years. The problem with this attitude is that by the time they see us, the problem is much more advanced and will take much longer to heal.

If you don’t get a proper diagnosis from the start, it wastes time. If anyone treating your lower back muscle spasm is not looking for the cause, they will keep treating it incorrectly. This is ineffective, and the muscle spasms will return. Over time, you learn that you never know when a severe muscle spasm is going to hit you, and that is scary. You start to think twice about doing the things you love, like gardening or playing with your kids, because you anticipate that you’ll have pain. The longer you wait, the bigger your chances of causing permanent damage.

Trying out but not completing different forms of treatment.

Often, patients try to get relief by taking medication or getting a voltaren injection in the hopes that it will ease their pain. They also try massages, foam rolling, cupping, or stretching. However, these treatments only mask the pain and stiffness of a lower back muscle spasm. By trying any of these treatments in isolation, you are not addressing the root of the problem. Many people then feel that their lower back spasm is easing halfway through their treatment program, so they stop. They never get back to ‘normal,’ and the improvement is unsustained at best. Not to mention the lack of strengthening core stability and local stabilizers to handle more load.

Wearing a brace to ‘support’ your back is also not a good treatment for lower back spasms. The brace might give you the stability you need, but once you take it off, you simply feel weak and sore. Wearing a brace for longer than four weeks without other types of treatment is a big problem because you could become very dependent on it.

Resting too much or too little

Resting too much leaves you weaker than before, and moving too much can cause extra spasms, inflammation, or even injury to the muscle. Finding the balance between resting and making safe movements is critical. Let us help you get the proper treatment for your lower back muscle spasms and stop it from bothering you again.

We can provide the best treatment for muscle pain and spasms in your lower back. We understand that you want to pick something up confidently without fear of ‘spasming up’ or doing a deadlift in the gym. That is why we are here to provide guidance and answers. Physiotherapists implement a very effective and structured plan of action that treats all the aspects of your back spasms and gets you back to your life as soon and safely as possible. Our physiotherapy treatment program will help you improve your muscle strength to regain control of your local stabilizers and restore normal movement of your lower back.

First, we’ll test all the muscles, joints, nerves, and discs in your lower back to determine the extent and classify the severity of your lower back spasms and any other structure triggering it. Our priority is to protect it from further injury and control the healing environment by limiting motion. We use numerous techniques to accelerate tissue healing inside the muscle and even divert forces away from the painful area, which brings considerable relief to back spasms.

Our goals for lower back spasms are mainly:

1. Relieve the muscle tension in the muscles.
2. Divert compression forces away from the injured site.
3. Rest overworked muscles and provide some stability.
4. Recruit local stabilizers to control intersegmental motion.
5. Desensitize nerve pathways.
6. Re-evaluate to monitor progress and magnify the effect.

We will examine different aspects, like testing your lower back’s ability to bend and turn in different directions. Muscle strength, range of motion, flexibility, and stability are the crucial components we must regain. Treatment for back muscle spasms also incorporates guiding you through a rehabilitation program of gradual strengthening, control, and conditioning. Committing to the treatment plan improves your chances of successful long-term recovery.

A lower back muscle spasm is usually a secondary problem to a deeper underlying problem. So, we must first determine if there are any other structures, like nerves, joints, or discs, that the lower back muscle spasm is trying to protect. “Releasing” your lower back muscle spasm without understanding why it is there in the first place will be the wrong place to start. Just like a faulty component that cannot simply be replaced by a new one, we need to help you understand how it broke in the first place.

We get patients pain-free with a full range of motion within 4 weeks, but that’s without stressing the spine under load, speed, and multi-directional forces. Depending on the severity, you will need physiotherapy treatment twice a week for the first two weeks. After this, your treatment sessions are spread out to once a week or once every two weeks. How fast you recover will greatly be up to you. If you complete your physiotherapy treatment program, you should be able to recover completely and return to your sport in 6 to 8 Weeks.

• Your doctor may prescribe anti-inflammatory medication or give you a Voltaren injection to ease the muscle spasm. Both of these medications will temporarily relieve the pain and stiffness you are experiencing. However, they will not be the solution to your problem. Once the medication’s effect wears off and you try to get back to working or exercising, your pain could simply return.
• Getting your back or neck ‘aligned’ or ‘clicked’ in the hopes of improving the lower back muscle spasm will not help or change your pain. It could even worsen or trigger a lower back muscle spasm again.
• A biokineticist can help you in the final stages or get you back to actively training for your sport.
• Wearing a back brace to give your back extra stability might ease the spasm and make you feel better while wearing it, but it won’t solve your problem. Dependence and joint stiffness may even worsen your situation.
• Stretching or foam-rolling your back might temporarily ease your lower back muscle pain, but the muscle spasm will return if the real problem isn’t addressed.

Surgery is not an option for lower back muscle pain or spasms. Recurring muscle spasms in your back are due to the loss of stability or other underlying injuries. An orthopedic surgeon sometimes opts to ‘fixate’ your spine to decrease compression on discs, nerves, and joints. However, this reduces the movement of your spine and the movement between each vertebra (segment). When an unstable spinal segment has been neglected for too long, there’s no other option but surgery, and you run the risk of future surgeries because the levels above and below the fixation will wear out and degenerate faster. That means that future surgeries will be inevitable.

If your physiotherapist finds the underlying cause of your lower back muscle spasms worrying, you will be referred to the right specialist.

• Disc bulge/herniated disc: This causes pain in your lower back, with the possibility of pain spreading down your leg. It is especially painful when you bend forward, sit, or drive.
• Spondylolisthesis: One vertebra slides forward on top of the vertebra below it. This causes your spine to become unstable, leading to pain when you bend forward, especially when you try to come back up. You will feel the need to push yourself up with your hands.
• Sacroiliitis: A deep buttock and lower back pain usually only on one side when you stand, walk or climb stairs.
• Lower back OA is pain caused by degeneration in the joints in your spine. The pain feels worse when you overdo it by walking too far, standing too long, or sitting too long. It also feels worse in cold weather and the mornings but better when you rest.
• Sciatic nerve pain: Pain, pins and needles, and numbness spreading down your leg. Caused by compression or irritation of your sciatic nerve.

• Lower back muscle pain
• Muscle spasms in lower back
• Pulled muscle in lower back
• Low back muscle spasm
• Low back muscle cramp