The spinal column surrounds and protects your spinal cord, the main
pathway of communication between your brain and the rest of your body.
Your spinal column supports your body’s weight, provides posture while
allowing for flexibility and movement, and protects the nerves in your
The sudden onset of muscle spasm in the low back is surprisingly common.
In fact, approximately eight out of 10 adults will experience it at some
point during their lives.
Generally speaking, the cause of back pain and spasm can be attributed
to overuse, an accident or a sports injury. But more often than not, the
root cause of muscle spasm is a consequence of a seemingly trivial
injury to a structure within the lumbar spine. One thing, however, is
clear: if you’ve had one or more episodes of muscle spasm in the low
back, chances are it will happen again.
The muscles in the low back work in concert with the abdominal
musculature. Without them, extension and lateral movement of the spinal
column would be impossible. Back muscles also add stability by keeping
the spine erect and maintaining balance. That balance can be compromised
when the muscles are in spasm as a secondary response to even a slightly
injured lumbar joint or disc.
Muscle spasms are involuntary, spontaneous contractions of a muscle.
Although “back attacks” seem to occur out of the blue, the movement that
triggers the incident is generally preceded by a series of small strains
to the structures of the spine that develops slowly, over time. Once
injured, inflammation sets in. This, in turn, sensitizes the nerves,
causing the muscle/s to contract and spasm.
Conditions, such as degenerative disc disease or herniated disc, may
cause an acute episode of low back pain. A disc may herniate or bulge
and compress a nearby spinal nerve root causing irritation and
inflammation. The body attempts to immobilize the affected area to stop
pain by tightening the surrounding musculature and as a result, painful
muscle spasms occur.
Muscles can become too tight due to lack of exercise, too much exercise,
structural imbalances, dehydration and electrolyte loss, or any
combination thereof. In contrast, some muscle groups are too weak. When
muscular imbalances become chronic aberrant forces are transmitted to
the spine. Consequently, one movement outside of the norm can trigger an
injury to a spinal joint, ligament, or disc resulting in spasm and back
pain. Because these structures are already “primed,” the event that
triggers the spasm is nothing more than the proverbial straw that broke
the camel’s back.
Slipped Disc or Herniated Disc
Disks act as cushions between the vertebrae in your spine. They're
composed of an outer layer of tough cartilage that surrounds softer
cartilage in the center. It may help to think of them as miniature jelly
doughnuts, exactly the right size to fit between your vertebrae.
A bulging disk extends outside the space it should normally occupy. The
bulge typically affects a large portion of the disk, so it may look a
little like a hamburger that's too big for its bun. The part of the disk
that's bulging is typically the tough outer layer of cartilage. Bulging
usually is considered part of the normal aging process of the disk.
A herniated disk, on the other hand, results when a crack in the tough
outer layer of cartilage allows some of the softer inner cartilage to
protrude out of the disk. Herniated disks are also called ruptured disks
or slipped disks. Herniation occurs when the disc’s nucleus pushes
against the weak spot and the bulging disc material pushes into the
spinal canal, pressing against the spinal cord and nerve roots.
The lower back is a common place to experience herniated disk. This
area, called the lumbar or lower back is formed by five of the 24
vertebrae. When the jelly-like substance that forms the nucleus of the
disk pushes against its outer ring from wear and tear or injury, this
herniation causes pressure and pain in the lower back or the leg. If the
disk is very worn, the jelly-like center may squeeze all the way
through. Nonsurgical treatment may involve medication and physical
Nerve root injury can occur at any of the five vertebrae in the lumbar
region of the low back, causing pain, weakness, numbness and tingling
and affect the hip, thigh, leg, lower back and even the foot. Spinal
stenosis, degenerative disc disease and herniated disc can all cause
sciatica. Treatment begins with nonsurgical methods such as steroid
injections, but if pain relief is not successful, surgical procedures
such as laminectomy
with discectomy may be needed.
Spondylosis—Osteoarthritis of the Spine
Spondylosis refers to a stiffening of the spine, degenerative changes in
the vertebrae from age-related wear and tear affecting the spinal disks.
As the disks dehydrate and shrink, signs of osteoarthritis develop,
including bony projections along the edges of bones (bone spurs).
Spondylosis can occur in the lower back (lumbar), middle back (thoracic)
and neck (cervical) sections of the spine. As you age, the bones and
cartilage that make up your backbone and neck gradually develop wear and
tear. These changes can include:
Dehydrated disks. Disks act like cushions between the
vertebrae of your spine. By the age of 40, most people's spinal
disks begin drying out and shrinking, which allows more
bone-on-bone contact between the vertebrae.
Herniated disks. Age also affects the exterior of your
spinal disks. Cracks often appear, leading to bulging
(herniated) disks—which sometimes can press on the spinal cord
and nerve roots.
Bone spurs. Disk degeneration often results in the spine
producing extra amounts of bone in a misguided effort to
strengthen the spine. These bone spurs can sometimes pinch the
spinal cord and nerve roots.
Stiff ligaments. Ligaments are cords of tissue that
connect bone to bone. Spinal ligaments can stiffen with age,
making your neck less flexible.
Neck or lower back pain is very common and can be caused by the slow
breakdown of the bones from aging. Symptoms include pain and stiffness
in the neck or lower back.
Sometimes, cervical spondylosis results in a narrowing of the space
needed by the spinal cord and the nerve roots that pass through the
spine to the rest of your body. If the spinal cord or nerve roots become
pinched, you might experience:
Tingling, numbness and weakness in your arms, hands, legs or
Lack of coordination and difficulty walking
Loss of bladder or bowel control
Nonsurgical treatment with medication, soft collars, steroid or steroid
and anesthesia-based injections, physical therapy are the first line of
treatment. Surgery is reserved for people who have severe pain with
progressive neurologic symptoms whose pain has not been relieved by any
other method. If conservative treatment fails or if your neurological
signs and symptoms—such as weakness in your arms or legs—worsen, you
might need surgery to create more room for your spinal cord and nerve
The surgery might involve:
Removing a herniated disk or bone spurs
Removing part of a vertebra
Fusing a segment of the neck using bone graft and hardware
Cervical and Lumbar Spinal Stenosis
Spinal stenosis, both neck and lower back, are common for people age 60
and older. Lumbar or lower back stenosis is more common, but cervical
stenosis is more dangerous because it involves compression of the spinal
In lumbar stenosis, the spine nerve roots in the lower back are
compressed causing symptoms of sciatica including tingling, weakness or
numbness that radiates from the low back into the buttocks and legs,
especially with activity. The discomfort eases when you bend or sit.
Spinal stenosis in the neck can compress the spinal cord and lead to
total body weakness or even paralysis. The pain in the neck can feel
like numbness, weakness or tingling in the leg, arm, foot or hand.
Stenosis is caused by the narrowing of the open spaces within your spine
that puts pressure on the spinal cord and the nerves that travel along
the spine, particularly in the cervical and lumbar regions of the
spine—neck area and lower back, respectively. Spinal stenosis can cause
pain, numbness, muscle weakness and problems with bladder and bowel
It is most commonly caused by wear-and-tear changes in the spine related
to aging. Other causes include bone disease that causes an excess of
bone growth of around the spinal nerves as in osteoarthritis. Stenosis
can also result from herniated discs, thickened ligaments around the
spine, tumors on the spinal cord, within the membranes that cover the
spinal cord or in the space between the spinal cord and the vertebrae,
and spinal injuries from car accidents and other major trauma that cause
dislocations and multiple fractures that can put pressure on the spinal
cord and nerves.
Spinal stenosis is treated by anti-inflammatory medication and other
medications to reduce pain. Sometimes physical therapy helps, as well as
steroid injections in the space around the nerve root where there is
swelling and pressure.
Repeated steroid injections can weaken bones and connective tissue, so
they are limited a just a few per year. In severe cases, surgery may be
required to create additional space for the spinal cord and nerves. Laminectomy
or Spinal Fusion surgery may be required if the nonsurgical
treatments have not helped.
Spinal Cord Compression
A condition called cervical spondylotic myelopathy is a common neck
condition where the spinal canal becomes narrowed from normal wear and
tear over time. The squeezes the spinal cord and causes pain, numbness
and weakness. It is a common condition affecting older people,
particularly those who had a spinal injury at a younger age. Rheumatoid
arthritis, disk degeneration, tumors, infections and neck injuries can
all contribute to the development of spinal cord compression. It can
eventually cause difficulty walking with loss of balance and
Nonsurgical treatment with soft collars, exercise and steroidal
injections are the usual first line of treatment.
Scoliosis is a sideways curvature of the spine. Instead of the straight
line down the middle of the back, a spine with scoliosis curves in a “C”
or “s” shape. It can either be present at birth or develop in
adolescence. There are nonsurgical and surgical treatments, depending on
the severity of the curve, where it occurs on the spine, the child’s age
and health condition.
Nonsurgical treatment may include bracing or casting. Surgery is
recommended when the curve is very severe and may get worse.
Kyphosis is an exaggerated forward rounding of the spine that is common
in older women who have osteoporosis and those who have taken high doses
of corticosteroids. The spinal bones weaken to the point that they crack
and compress. Other types of kyphosis are seen in infants or teens due
to birth defects such as the malformation of the spine or the wedging of
the spinal bones over time.
Mild kyphosis causes few problems, but severe cases can cause pain and
be disfiguring. Treatment for kyphosis depends on your age, the cause of
the curvature and its effects.
Causes may be disc degeneration, Scheuermann’s disease that begins
during a growth spurt before puberty with the wedging together of
several vertebrae. Kyphosis is often the result of arthritis,
osteoporosis-related fractures or injury, muscular dystrophy, Paget’s
disease, spina bifida, polio, Marfan syndrome and Prader-Willi disease.
Some cancer treatments such as chemotherapy and radiation treatment can
weaken vertebrae and make them more prone to compression fractures.
There is a surgical procedure to correct kyphosis called kyphoplasty.
For more information, call 1.866.CALL.MLH.