Recurring lumbar spasms

[djo.dadof2]

For my entire life I've suffered lumbar spasms every few months. They're cripplingly painful in the moment and for a few weeks afterwards, but are not caused by any pathology that has been diagnosed and they have never actually occurred while I was training. Rather, they happen when I'm having dinner or tying my shoes or sneezing, etc. I'm convinced that the root cause is merely constant over-stimulation of some muscles deep in the lower spine area leading eventually to a spasm when the muscle finally has enough and throws a red flag. I deal with it when it happens, although I am always nervous about when it will happen next so I am a bit timid in movements like the squat and deadlift. When it does happen it sets my training back because I am unable to do much for the long time it takes to recover.

So, I'm looking for advice on the following:

• How can I reduce the likelihood of such spasms? I already know about not sitting for too long, doing deadbugs, and all that. I do that and I still have 2-3 spasms a year.
• How can I train without fear of triggering a spasm? If you've never had one you might be tempted to tell me to just nut up and get over it, but believe me when I tell you that the pain is something that instills a constant significant fear that cannot simply be ignored.
• How can I minimize the impact on my training when it does happen? I'd like to start recovery immediately. I've considered the Starr protocol but I'm worried that since it's not really a muscle tear then it could be a bad idea.

[djo.dadof2]

Maybe people take the weekend off, but I could use some help here. I either want to solve this so I can train and become the strongest version of myself, or give up and take up knitting.

[Will Morris]

For my entire life I've suffered lumbar spasms every few months.

Words have meaning. When I read this, this communicates that this is something you have dealt with from your earliest memories. Is this the case, or do you need to clarify what you mean?

As for your second post, yes, I do take most of the weekend off. I can appreciate you want a solution, but you also are not paying me for my time. I am not compensated at all for helping you out, so please keep the snide comments to yourself next time.

[jfsully]

So, I'm looking for advice on the following:

• How can I reduce the likelihood of such spasms? I already know about not sitting for too long, doing deadbugs, and all that. I do that and I still have 2-3 spasms a year.
• How can I train without fear of triggering a spasm? If you've never had one you might be tempted to tell me to just nut up and get over it, but believe me when I tell you that the pain is something that instills a constant significant fear that cannot simply be ignored.
• How can I minimize the impact on my training when it does happen? I'd like to start recovery immediately. I've considered the Starr protocol but I'm worried that since it's not really a muscle tear then it could be a bad idea.

1. Get your back and "core" stronger with squats, deadlifts, and presses. You can still do the deadbugs if you want, but it sounds like they don't really work.

2. This is tough, but the more you train without "spasm," the less scary training will be. And the more "spasms" you train through, the less impossible they will seem.

3. Lower the weights to where you can do the movement properly, even if it still hurts a bit (if you can still lift with good form, the pain is not severe and should be considered workable). Work your way back up from there. Be patient. Continue to progress any lift that you are able to.

You will have to take it on faith that many people here have had the same severity of pain that you do, and they keep training. And that the training is the treatment.

The worst back pain I ever had (back then I would have called it a spasm, or "threw my back out") was about 10 years ago, when I did not train at all and was in mediocre shape. I "injured" myself by picking up a briefcase (maybe 8 lbs) and turning toward the door at the same time. I had sudden severe pain, was sweating and had tunnel vision. It took me about 15 minutes to get seated in my car after I got the door open. Had to recline the drivers seat and just peer over the dashboard, and had no prayer of checking my blind spots, so I drove slow and badly 40 miles home. I don't remember what I did back then, but I am sure I lied down, used a heating pad, and pounded ibuprofen. Maybe some hot soaks. Pain was terrible for a few days, lingered for several weeks. If that happened today, I would head to the squat rack for some light squats and deadlifts. Maybe rack pulls if the pain was worst near the floor. Currently, my HLM program is paused as I work through an "ab tweak." Feels like a broken rib, except there is no rib where it hurts. For a few days I lived in fear of having to sneeze, because it felt like being stabbed. Even so, I could deload and still do a meaningful squat (about 65% of 1rm) for sets of 5. Deadlifts are tougher, I can pull about 50% from the rack (starting about 6 inches above the floor). After a few days of this, with gradual progression of weights, I can sneeze without fear, and I sometimes even will cough on purpose to see how it feels. It will suck to have lost 7-10 days of "progress," but I can live with it.

So yeah, this happens. Your situation isn't unique, and the regular advice will help you. Back tweaks are not injuries. You will not worsen things by working through them. You will improve things by doing so, actually.

[djo.dadof2]

Will, I just realized that I am in error. I did not appreciate that posts to this forum are directed to you and I would have phrased my initial message differently and not posted the second if I'd know that at the time. I hope that this gives context to my previous messages.

[Will Morris]

Apparently we both made mistaken assumptions. I apologize for that.

So, there are several things to unpack here. Having back spasms from the time you were a toddler / young adolescent would be one thing and would potentially lead us down an entirely different, much more sinister path.....having them since you were a young teenager is something different. If you are okay with sharing, what type of activities were you involved in during your young teenage years? There may be something about the activities that predated the condition that is worth exploring.

What do you think about your father telling you that you would always have back pain? Did he provide an explanation on why this was the case? Was he someone who suffered from chronic, persistent back pain? This is, unfortunately, one of the major conundrums with dealing with chronic pain patients.

[djo.dadof2]

Thanks for the comments! I'm happy to have found SS for this and other reasons.

I played hockey for a few years and started some resistance exercise (I won't call it strength training) as a teen. Pretty standard stuff for a Canadian kid. The resistance work was guided almost exclusively by the Encyclopedia of Modern Bodybuilding (this was pre-internet) so it was high reps of what we'd now call assistance movements. I've never had an incidence of back pain during any of these activities although it's certainly possible that they've contributed to them.

My dad hurt his back when I was a child lifting me over his head, and has basically blamed that/me for his own chronic back pain ever since although I've doubted it was the cause of more than one event. He's had occasional back pain for as long as I can remember though. I've taken for granted that I would be prone to back pain for my whole life because of his remarks, and no doubt that's lead to some bad movement patterns as I've tried doing stupid things like lifting with my legs instead of my back. I think it was an unhelpful thing to tell me, although I take responsibility for whatever I've done with the advice.

In the last week I've done a lot of reading, particularly the books by Dr. Stuart McGill. A lot of it makes sense. One thing that I wonder about though is that, as with Chiropractors, no matter what the diagnosis ends up being, the treatment is always the same. In this case it's the Big 3 exercises (curl up, bird dog, side plank), although those do strike me as useful accessory movements to safely strengthen muscles in the area. His work suggests that poor motor engrams around stabilizing my lumbar (plus the fact that I work a desk job and therefore sit around 10 hours a day) have produced both weak and fatigued lumbar support muscles, which manifest in micro movements in the spine under shear stress, which my body reacts to with a spasm to protect my spine. Major self-diagnosis there but, again, the treatment plan is clear: train for strength using good form.

I've started training again after taking just a few days off to get over the acute pain of the latest incident. I'm happily already at very close to the weight that I was doing before the incident, so all's at least as well as it was before. This has actually been one of the fastest and (mentally) easiest incidents to recover from because of the advice and information in the SS book and the youtube videos. You all deserve my gratitude.

[Will Morris]

Thanks for the comments! I'm happy to have found SS for this and other reasons.

I played hockey for a few years and started some resistance exercise (I won't call it strength training) as a teen. Pretty standard stuff for a Canadian kid. The resistance work was guided almost exclusively by the Encyclopedia of Modern Bodybuilding (this was pre-internet) so it was high reps of what we'd now call assistance movements. I've never had an incidence of back pain during any of these activities although it's certainly possible that they've contributed to them.

My dad hurt his back when I was a child lifting me over his head, and has basically blamed that/me for his own chronic back pain ever since although I've doubted it was the cause of more than one event. He's had occasional back pain for as long as I can remember though. I've taken for granted that I would be prone to back pain for my whole life because of his remarks, and no doubt that's lead to some bad movement patterns as I've tried doing stupid things like lifting with my legs instead of my back. I think it was an unhelpful thing to tell me, although I take responsibility for whatever I've done with the advice.

In the last week I've done a lot of reading, particularly the books by Dr. Stuart McGill. A lot of it makes sense. One thing that I wonder about though is that, as with Chiropractors, no matter what the diagnosis ends up being, the treatment is always the same. In this case it's the Big 3 exercises (curl up, bird dog, side plank), although those do strike me as useful accessory movements to safely strengthen muscles in the area. His work suggests that poor motor engrams around stabilizing my lumbar (plus the fact that I work a desk job and therefore sit around 10 hours a day) have produced both weak and fatigued lumbar support muscles, which manifest in micro movements in the spine under shear stress, which my body reacts to with a spasm to protect my spine. Major self-diagnosis there but, again, the treatment plan is clear: train for strength using good form.

I've started training again after taking just a few days off to get over the acute pain of the latest incident. I'm happily already at very close to the weight that I was doing before the incident, so all's at least as well as it was before. This has actually been one of the fastest and (mentally) easiest incidents to recover from because of the advice and information in the SS book and the youtube videos. You all deserve my gratitude.

Glad you found your way here, and, again, I apologize for the misunderstanding. In all the time I have been moderating this injury board, your follow-up message here is one of the best posts I've seen here.

One of the interesting things about chronic back pain / chronic pain syndrome is that it is very strongly hereditary. I say hereditary because it is passed from parent to child, although, there is no compelling evidence that these conditions have an actual genetic component. Keep in mind, I am a Physical Therapist and not a molecular geneticist, so I am almost certainly not up on the latest molecular genetics discoveries in chronic pain. But, from a clinical perspective, these conditions do become hereditary in the fact that maladaptive traits, catastrophizing, fear avoidant behavior, etc all become learned traits in children with chronic pain suffering parents. You may take responsibility for what you did with the advice, but this is a well documented downstream effect of the chronic pain experience. Certainly, your father's wording was not appropriate, but I'd suggest it wasn't provided out of malice. As someone who suffered back pain, it might have been his way of trying to protect you.

Stuart McGill is a brilliant man. His Big Three permeate all things physical therapy. I have moved away from using these exercises in the clinic because I have seen a clearer, more direct improvement in patients where I use squats, deadlifts, and there are a few other back rehab exercises I have developed with the barbell. But, as you said, I use these different exercises for exactly the same reason: train solid motor patterns that safely strengthen the muscles in use with a progressive resistance.

No gratitude is needed.

The credit belongs to the man who is actually in the arena......