Low Back Pain

The Truth About Rehabilitation.


      Few active individuals are able to escape completely from the pangs of back spasms, which are among the most common of all athletic injuries. Although they are nothing more than involuntary, intermittent, and sometimes prolonged contractions of the muscles of the back, back spasms can be quite painful and debilitating, indeed when an athlete first experiences back spasm the effect and psychological components worry the  most positive and confident person. 
Usually, spasms prey on the muscles in the lower back, rather than the upper regions of the torso.  Although with modern occupational systems revolving around lap tops and computers, the incidence of mid thoracic and cervical problems is increased.The origins of back spasms are diverse, but it is clear that they are often a response to an injury or inflammation of the spinal region. In many cases, the muscles of the back themselves are injured or inflamed, but the spine itself, including the thin cartilaginous discs between the spinal vertebrae and the ligaments which connect the vertebrae, may also be the source of the difficulty. Some back-spasm experts believe that spasms are a reaction by which the body attempts to immobilise the spine and thus prevent further injury.
       Naturally, the injuries that produce back spasms might be caused by ‘overuse’ (chronic muscular exertion without adequate recovery) or by a single, traumatic incident. In the case of overuse, repeated rotational movements of the spine, such as the swinging motions required for baseball, cricket, tennis, squash, handball, racquetball, or golf, may eventually lead to an injury or inflammation of the vertebrae, spinal discs, ligaments of the spine, or spinal muscles themselves, particularly in individuals whose lower back muscles are functionally weak.Radical training changes as well.
Sudden injuries which lead to spasms might result from a blow to the back, a fall on the back upon a hard surface (such as a basketball floor), a quick, forceful twisting of the spine during sporting activity, or a sudden change in direction while running. Radical changes in training also seem to increase the risk of back injury and spasms. For example, an increased frequency of back spasms has been noted in sprint runners who suddenly add uphill running, stadium-step running, or running against resistance to their training regimens. Anecdotally, it appears that back spasm may result from prolonged sitting or standing, especially if poor posture is utilised. If the spine is allowed to ‘sag’ forward near the hips during prolonged standing, increased strain is placed on the lower back muscles. Similarly, if one slouches while sitting, increased force is placed on the spine in a front-to-back direction, requiring the muscles of the low back to work extra hard to maintain spinal stability.The link between flexion of the back and spasms suggests that athletes who have poorly balanced core strength, ie, greater strength in the abs, compared with their lower back muscles, are more prone to lower back spasms. Superior strength in the abs tends to put the back in a chronically flexed position, which consequently places unusual strain on the lower back muscles, which are forced to try to pull the spine back into its normal configuration at the same time as they are stretched out because of the abnormal flexion.


What are the symptoms?

The main symptoms of back spasms include severe pain emanating from the back in the absence of motion, significant discomfort in the back upon movement of the legs or arms, and/or pain associated with rotation of the spine. Such symptoms are usually accompanied by a sensation of a lack of mobility of the spine. The discomfort and feeling of immobility may last from a few seconds up to several minutes, go away, and then return again after a brief respite. Spasms which appear suddenly during activity may disappear when a resting position is assumed; anecdotally, lying down seems to be more relieving than sitting. Subsequent movement, however, may cause the spasms to return.

An occasional spasm in your back – without any other indication of back pain – may be a warning signal that you have a muscular imbalance or that you have a ‘below-the-radar-screen’ injury to your back. In either case, you should exercise great care with your back, attempting to avoid situations in which the back is placed under great strain, and you should also begin to carry out strengthening exercises for your back.

 This Article First Appeared in the Journal of Sports Therapy (1996)