Why does it occur?

Para-Spinal Muscles run along both sides of your spine to provide support and assist with spinal movement. When a nerve exiting your spinal cord becomes irritated, the muscles that nerve supplies may respond by going into spasm. A muscle can also go into spasm if pulled or strained from overuse or trauma.  Also, in general, any pain in the area of the spine may cause muscle spasms to occur as a natural protective mechanism to minimize the amount of pain or further damage to the area.  Either way, the result is a sensation of pain, stiffness and loss of motion in the affected area.  Common causes of muscle spasms include Herniated discs, flareups of Arthritis, and simply overuse of the muscles from activities such as shoveling snow or gardening.

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Symptoms:

Patients with a Para-Spinal Muscle Strain typically present with pain just next to the spine which may be accompanied by stiffness.  Pain may be anywhere from acute and severe to mild and chronic in nature.  Often, the muscles feel tight or hard because of the spasm, and are tender to the touch.  If the muscles are in enough spasm, the body may look to be contorted, twisted, or bent out of shape.

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Diagnostic Testing:

An X-ray is usually obtained during your office visit with Dr. Lee.  The X-ray is a valuable tool to assess the bones in your spine.  Dr. Lee will assess for any mal-alignment, arthritis spur formation, disc or joint space narrowing, or other bony pathology.  Depending on the exam and history, Dr. Lee may also order an MRI if your symptoms are significant, failing to improve over time, or if you have any signs of weakness.  An EMG (nerve study) may also be considered if there are neurologic symptoms that cannot be well localized.

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Treatment Options:

Treatment options will vary depending on the severity of symptoms and associated exam findings.  If there is an acute injury, ice for the first few days followed by alternating ice and heat application is often recommended.  Ice helps decrease inflammation associated with the muscle spasms while application of heat may help calm muscle spasms and bring more blood flow to the area.  NSAID’s such as Advil or Aleve (if not contraindicated) may be advised to reduce inflammation in the area. If your pain is acute and severe, stronger medications may be discussed to address the pain and spasms.  This is also one of the few times that muscle relaxer medications may also be helpful, and therefore can be prescribed if the symptoms are severe enough. 

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Physical Therapy is a very important aspect of treatment to stretch the surrounding musculature of the spine, help alleviate muscle spasms, and decrease pain. Typically heat is applied at the start of the PT visit and ice is applied at the end to ward off inflammation.  Modalities such as ultrasound and electrical stimulation can be helpful.  Injections can be useful to patients with severe pain, significant radicular symptoms, or symptoms that did not improve with Physical Therapy, activity modifications, and/or NSAID use.

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Surgical Treatment:

 

The vast majority of patients with Para-Spinal muscles spasms are treated successfully without the need for surgical intervention.  Surgery may be advised if the underlying cause of the muscle spasm requires surgery such as severe nerve compression causing weakness.  If a patient fails to improve with the above non-operative treatments, surgery may be discussed as a possible option.

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*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.