How to Treat Paraspinal Muscle Spasm, According to Physical Therapists

It’s rare to meet someone who’s ever complained about a paraspinal muscle spasm. Unlike your quads or biceps, the paraspinal muscles, which run down the left and right sides of your spine, aren’t exactly household names. But every time you bend backward, rotate, or lean to the side, the paraspinals — the back’s so-called “action” muscles — are put to work.

Despite the lack of attention they may get, paraspinal muscle spasms are common, and often, by the time someone seeks help, they’ve been dealing with the discomfort for a while, says Dorian Logan, PT, DPT, a physical therapist at Hinge Health. “People often just put up with muscle spasms until they finally get tired of feeling achy, tired, and sore all the time.” But don’t wait to get relief: There’s a lot you can do to calm muscle spasms near your spine so you can feel more comfortable and confident as you go about your daily activities. 

Read on to learn more about what causes paraspinal spasms and how to prevent and treat them — especially with stretches and exercises from our Hinge Health physical therapists.

What Are the Paraspinal Muscles?

The paraspinal muscles are a group of three muscles — the iliocostalis, longissimus, and the spinalis — that run vertically alongside the entirety of your spinal column. They extend from the base of your skull to your lower back and hips.  

Each muscle group has a specific role, but overall, the paraspinals are indispensable for stability and movement. You use them whenever you lean to either side, arch your back, or twist your torso to look behind you. They provide constant support to stabilize your spine, reducing strain on other parts of your body and minimizing the risk of injury. They’re also essential for maintaining posture. “If you’re upright, your paraspinal muscles are working,” says Dr. Logan.

What Causes a Paraspinal Muscle Spasm?

Muscle spasms can occur anywhere in the body when muscles tense up and contract all by themselves. The most common reasons you may experience a paraspinal muscle spasm include:

• Muscle strain. This can be due to an injury or overuse — for instance, you worked hard raking leaves in your yard, leaving your back muscles sore the next day. 

• Staying in the same position for a long time. When you stay in one position for too long, whether sitting or standing, your paraspinal muscles have to work harder to hold you upright because they never get a break, explains Dr. Logan. “This can lead to fatigue, and, over time, the muscles may start to spasm because they’re so fatigued.”

• Muscle weakness. Without regular exercise to improve their strength, the paraspinals are less capable of supporting your spine and more prone to pain and spasms. 

It’s important to note that some neurological and autoimmune conditions, including rheumatoid arthritis, may cause muscle spasms. If you try conservative measures, such as exercise therapy, to treat paraspinal muscle spasms and don’t see any positive response, seek guidance from your primary care provider.

Paraspinal Muscle Spasm Symptoms

Everyone’s perception of symptoms is unique to them, but most people describe the symptoms of paraspinal muscle spasms as: 

• Pain (sharp and intense in the case of a muscle strain, but more achy when traced to muscle weakness or a lack of movement)

• Tightness

• Stiffness

• Cramping

“You’re more likely to experience these symptoms if you bend forward, sideways, or backward,” says Dr. Logan. “You may feel pain every time you twist toward the backseat in your car, for example.” Among athletes, golfers — who routinely rotate to their left or right when swinging a club — are particularly prone to paraspinal muscle spasms. Others may feel a sense of fatigue in their back muscles simply from sitting for a long stretch of time. 

Since the paraspinal muscles overlap along the entire spinal column, symptoms can occur from your skull down to your lower back. Lower back pain is extremely common with paraspinal muscle spasms, but according to Dr. Logan, it’s not unusual for the paraspinal muscles in the neck and mid-back to be affected too. “A lot of times, because of how we lean forward and stick our heads out, the neck and mid-back muscles can become fatigued because they’re working overtime.”

The above stretches recommended by Hinge Health physical therapists target every aspect of your paraspinal muscles — from your neck to your lower back. Do them as needed to release tension from spasming muscles, advises Dr. Logan. “Often, stretching is enough to relieve symptoms of a spasm,” she reports. If your muscle spasms continue, consider consulting a physical therapist (PT) for more personalized support. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatment Options for Paraspinal Muscle Spasm

Paraspinal muscle spasms can usually be managed with conservative treatments, including: 

• Physical therapy. “The stretches above are a good place to start and can act as the first line of defense to treat paraspinal muscle spasms,” says Dr. Logan. However, working with a PT can provide more tailored exercises and recommendations. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Self-massage. Massage can help relieve the tension that causes muscles to contract and spasm. To reach the paraspinal muscles on either side of your spine, Dr. Logan recommends using a tennis ball to massage the area while leaning against a wall. Another option: Roll away tension with a foam roller.

• Ice or heat therapy. While both ice and heat can bring relief to sore paraspinal muscles, generally, if the spasms haven’t been going on for more than a week or two, stick with ice to reduce swelling and inflammation. If they’re something you’ve been dealing with for a while, the muscles may respond better to heat – especially before stretching, says Dr. Logan. That said, use whichever feels better to you. 

• Over-the-counter pain medication.  Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for pain associated with paraspinal muscle spasms. It’s important to make sure that you are safely able to take these medications, based on your medical history.

How to Prevent Paraspinal Muscle Spasm

There are some simple steps you can take to help avoid paraspinal muscle spasms in the future. These include:

• Moving more and changing positions. Try incorporating more movement snacks into your day, which are small ways to give your body a break from inactivity. “Adding regular, short intervals of movement can be far more beneficial to the health of your muscles and bones than people realize,” says Dr. Logan.

• Staying hydrated. “Drinking enough water is a good way to ensure your muscles have the correct balance of certain ions so they can contract appropriately and not stay in a state of tension, which may trigger a spasm,” says Dr. Logan.

• Eating a well-balanced diet. A deficiency in certain nutrients — like magnesium, potassium, calcium, and vitamin D — can contribute to muscle spasms. 

• Reducing stress. If you’ve ever felt tense after a stressful day, then you know how stress can impact your body, particularly around your neck and back. Over time, this type of chronic tension can lead to spasms, including in your paraspinal muscles. Self-care strategies, including getting enough sleep and spending time in nature, can help your body better handle stress. Meditation and deep breathing can also help quiet your mind and relax your body. 

PT Tip: Keep Your Paraspinals Strong

Anytime you extend your spine to sit or stand up, your paraspinals are engaged. These muscles assist in keeping you upright and helping maintain your balance. “Strengthening them with moves like shoulder rows, bird dogs, and chin tucks is important to maintain their health and function,” says Dr. Logan. These moves, which may improve core strength, can also help you find a more comfortable posture at your desk, in your car, or on your feet — so you’re less likely to have pain along your spine.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Meredith, G. R., Rakow, D. A., Eldermire, E. R. B., Madsen, C. G., Shelley, S. P., & Sachs, N. A. (2020). Minimum Time Dose in Nature to Positively Impact the Mental Health of College-Aged Students, and How to Measure It: A Scoping Review. Frontiers in Psychology, 10(2942). doi:10.3389/fpsyg.2019.02942

2. Noonan, A. M., & Brown, S. H. M. (2021). Paraspinal muscle pathophysiology associated with low back pain and spine degenerative disorders. JOR SPINE, 4(3). doi:10.1002/jsp2.1171

3. Paraspinal Muscles. (n.d.). Physiopedia. Retrieved from https://www.physio-pedia.com/Paraspinal_Muscles