Simple lower back spasms
is rarely dangerous
Diagnostic Criteria
- presence of tight lower back muscles and symptoms which improves significantly with heat and massage
- absence of
1. neurological symptoms such as pins and needles, diminished strength/reflex, altered sensation
2. history of trauma or dangerous mechanism
Prognosis
- most symptoms rapidly resolve within a month and fully in 6 weeks
Do you need any imaging?
Imaging is rarely required.
Changes of the spinal structure is increasingly common as we get older. Such age-related changes of the spinal i.e the discs, joints and openings for the nerves are often found in people who are SYMPTOM-FREE! Most findings on scan are likely to be present pre-injury unless you had a traumatic injury.
Therefore, the results of the scan will also not influence management of your injury.
Cause of back spasms
- doing too much too soon
- sustained position for extended period
- unaccustomed/awkward movement
- high stress
- poor sleep
Management
- stay active
- avoid bed rest for extended period
- gentle range of motion exercise for the lower back
- pelvic tilt
- knee drops
- avoid bracing behaviour
- NSAID
- improving sleep and stress
Hip
Gluteal tendinopathy
Greater trochanteric bursistis
Cam/Pincer lesion
Hip osteoarthritis
Knee
ACL tear
Meniscus Lesion
Patella tendinopathy
Hip osteoarthritis
Leg
Calf strain
Achilles Tendinopathy
Achilles paratendinopathy
Tibialis posterior tendinopathy
Achilles tendon rupture
Ankle
Inversion sprain
Eversion sprain
High ankle sprain
Fracture
Foot
Plantar fasciitis
Referral for imaging/to ED
In the presence of trauma, significant neurological changes and persisting symptoms you may be referred for imaging.