We use our muscles all day, every day in order to create movement in the body so I tend to see a lot

of patients who have pain due to muscle spasm. This strong contraction of muscles can be the result of overuse or related to injury. But what exactly is a muscle spasm? A spasm or cramp of a muscle is an involuntary contraction that usually comes on suddenly and is very painful but resolves quickly. Muscle spasms mostly occur when the muscle is overused or tired. This fatigue can be associated with the muscle being overstretched or conversely held in a position for too long. This then can cause a loss of the normal energy and fluids the structure needs to continue to function properly. Muscle cells need the proper amount of water, glucose, sodium, calcium, magnesium and potassium to allow the proteins to function properly within them and lead to an organized contraction. If any of these essential elements are out of balance this results in the muscle becoming irritable and over excited and then forcefully contracting. This spasm can be in the belly of the muscle or near the tendon end or even in muscles surrounding the effected one. Over use doesnt have to be exercise related, everyday activities such as racking leaves or shovelling snow can cause spasm in the muscles of the neck or back that may not be used to doing this kind of activity. Also, loss of adequate blood supply doesnt have to be due to activity, atherosclerosis which causes narrowing of the blood vessels will also lead to muscle spasms and cramps even with a gentle activity such as walking. But without question the most common muscular back pain I see is due to a muscle strain of the lumbar spine. A muscle strain occurs when the actual fibres of the muscles are put under abnormal stretch that can even cause their fibres to tear. A lumbar spine sprain is when the ligaments of the lumbar spine the ropey, tough bands of tissue that connect bone to bone are torn at their attachments. Strains and sprains are difficult to differentiate as the symptoms are largely the same but since the treatment and prognosis are also the same the injuries are often referred to as a myoligamentous or musculoligamentous injury to represent both structures. This type of injury is second only to the common cold in causing time off work. This type of injury is so common because of the high stress put on the supporting structures of our low back. The large muscles of the lumbar spinal column are called the paraspinal muscles. They support the spine itself and hold up the weight of the trunk as well. Within the lumbar spine strong ligaments work to maintain the position of the spinal column on top of the pelvis. When these soft tissue structures muscles and ligaments and the bones are healthy and working as they should they create the control and strength needed for most of our activity. When we overuse or tire our tissues they become prone to injury. This is even more apparent when an injury has occurred in the past; lack of proper treatment leaves a shadow of weakness over the whole area. It is usually people who are doing activity that puts their back at risk that end up with a low back injury. It can be a sudden forceful movement, lifting of a heavy object or twisting in an unusual way. Also, repetitive movements over an extended time can cause the back muscles to spasm. Knowing how to properly lift can help to prevent many back injuries Once the strain/sprain has occurred the soft tissues become inflamed. The pain of inflammation is caused by tissue swelling that presses on nerves and by chemical substances that convert a molecular signal into an electrical impulse that spells pain for the body. The pain of this type of injury can be surprisingly intense and debilitating. Often patients need to remain in bed for up to 48 hours and can have residual symptoms for many weeks after. Almost all sufferers from this type of injury recover fully within 1 month though. The most common symptoms of a low back strain are isolated to the low back and usua lly dont travel into the legs like spinal injuries or conditions do. Patients complain of pain in the low back and upper buttocks, spasms of the back muscles and pain that is worse with movement and relieved by rest.
Contact Lindlay Horner, Founder of The Maple Clinic for more information: 121 Hever Avenue, West Kingsdown, Sevenoaks, TN15 6DT Email: info@themapleclinic.com - Tel: 01474 850500 The Maple Clinic Ltd. Reg No. 4122073

It is important to remember that although a significant number of low back pain symptoms I see are due to strains or sprains there are serious injuries that need to be evaluated properly. Spinal injuries including intervertebral discs need to be evaluated by a trained professional. Symptoms that could indicate a more serious problem are: Loss of control of bladder or bowels Progressive lower extremity Loss of sensation in the legs, buttocks or pelvic region Severe, constant pain Initial treatment of a strained/sprained low back is as I mentioned before REST. Your body wont let you move around much anyway, but this will give the tissues time to allow the inflammation to dissipate and the spasms to calm. The maximum time for bed rest is 48 hours, longer can lead to muscle weakness and stiffness. Let your body tell you when you can start to move around, start very gently with a little light stretches once the acute phase has stopped. On the short-term anti-inflammatory MEDICATIONS will help keep the inflammatory process stay to a reasonable level and will also help with the pain. Secondly, muscle relaxants will help to calm the intense muscle spasms. Both these types of medications should be prescribed by your doctor as they will know the best combination for you. Lastly, PHYSICAL THERAPY and exercises to help you recover from your injury and prevent another episode from occurring is essential. Strong as well as flexible low back muscles will mean the area will be more able to cope with the daily strains we put on it. The more deconditioned or weak our back is, the more likely it is to become injured again. Stretching within the pain free zone and using strengthening exercises specifically for the paraspinal muscles will help to condition the back and protect it from further episodes. Dont forget to include strengthening the muscles of the hips and abdomen as well. And make sure research the best lifting techniques in order to protect your back. If your symptoms continue in spite of resting and stretching then you should have your back checked out by a specialist such as the Osteopaths at the Maple Clinic. The cause of your back pain may not be what you think and so an evaluation and possibly further investigations may be necessary. Find out more at http://www.themapleclinic.com/index.htm

Contact Lindlay Horner, Founder of The Maple Clinic for more information: 121 Hever Avenue, West Kingsdown, Sevenoaks, TN15 6DT Email: info@themapleclinic.com - Tel: 01474 850500 The Maple Clinic Ltd. Reg No. 4122073