Condition: Lumbar Spasm
The lumbar spine is supported and manipulated by a complex set of muscles that allow flexion, extension, rotation, and lateral side bending. In combination with the muscles in the front of the abdomen, this forms what we call the core of the body.
Recent thinking has stressed the importance of strong abdominal/lumbar musculature in maintaining core support and preventing injuries and improving balance and gait.
A lumbar muscle spasm occurs when the muscle contracts in an irregular fashion and the contraction is maintained.
When this happens the blood supply to the muscle is diminished and metabolic products which would normally be carried away by the blood are released to the tissues and cause a worsening of inflammation, the pain can present as a sharp, squeezing, stabbing sensation or gripping pain.
The pain often travels along the length of the muscle and can affect any joint that the muscle is acting upon. In addition, there is tenderness over the specific point.
When the large muscles of the lumbar spine are affected these can mimic other conditions such as a herniated disc or lumbar facet syndrome.
In many instances the patient describes difficulty walking, sitting, standing, or turning in bed all of which caused an increase in pain.
Physical examination over these points causes a “snapping” sensation called a “trigger point”.
Treatment begins with conservative measures such as heat or ice application followed by physical therapy, manual therapy, stretching exercises, and over-the-counter anti-inflammatory medication or prescribed muscle relaxants.
If these do not help adequately, localized injections into the muscle using an ultrasound probe may be employed.
Ultrasound-guided trigger point injections either with or without steroid, PRP, and more recently amniotic fluid have been employed.
Post-procedure stretching and cooling spray are often employed to decrease the spasm.
The goal of therapy are to stretch the muscles and improve the blood flow, decrease the pain and allow the muscle to gradually revert to its previous state.
