Going through this now, the way it always happens. Twisted wrong while lifting, back goes “twang” and find myself limping and bent. It feels like a feedback loop of: muscle tightened/swollen → pinches nerve → causing muscle tightened/swollen → repeat until miserable.
Finally a trip to the doc to get cortisone shots, muscle relaxers, etc. The whole process immediately begins to unwind, and I’m feeling nearly well within 24 hours.
What exactly is happening in these situations? Is there really a “pinched nerve” like so many of us (non-medical folk) believe? Or is something else at play? It’s amazing to me how quickly I can end up couch-bound, and how quickly it corrects once the muscles are medically relaxed.
Thanks in advance for any info on this. This has always puzzled me.
There’s different things. Muscles can go into a feedback loop where they exert maximum force even though you’re not trying to make them do so, and you get a cramp. I don’t understand why or how this works.
But as to “pinched nerves”, literally that’s what’s happening. A classic example is the nerve root exiting the lower back through the little windows between vertebrae and forming the sciatic nerve running down the leg Actually, I think there may be multiple roots that join to form that nerve. If one of your disks between vertebrae bulge or rupture, it can crush the nerve and impair its function. It can really hurt, and cause paralysis (I have this, a partly paralyzed lower leg after a massive pulp extrusion at L5S1). It’s an injury literally in your lower back that feels painful in your leg, because that’s the region the nerve serves. A herniated disk can hurt where the disk is, or where the nerve goes (called “radiculopathy”), or both. Surgery to relieve pressure on the nerve is highly successful at treating the extremity pain. But, if there’s back pain, surgical outcomes are much more variable.
Thank you for the answer. I didn’t realize they really were “pinched” nerves. My assumption was that I was using a layman’s approximation of some more complicated problem. Also I was confused on why these resulted in shooting pains down my leg. (In fact, that was one of the Doc’s questions.)
It’s still puzzling how I can strain my arm or wrist chopping wood or something, but still be able to move and function. But straining my back results in a near total shut-down – there seems to be no mild version of back injury.
Napier’s explanation is pretty good - I’d never entirely understood the mechanics of a “muscle spasm” either. But yeah, a pinched nerve is a real thing and, I gather, is pretty damn unpleasant. A friend had spinal surgery quite a few years ago as she had developed pain in her legs, and some numbness as well. In her case, the surgery was a success; a lot of back surgery for pain is pretty iffy, but it sounds like her scenario was more along the lines of what Napier describes.
Re a spasm: I tend to get them in my shoulder area - sort of between the shoulder blade and the spine. It’s been quite a few years since I’ve had one, thankfully. I had one in the lower back once - from getting dressed (who knew that was dangerous!) - moved wrong, somehow, and SPROING. Luckily, ibuprofen and a day of rest solved it.
The last time I had the shoulder sort, I was on largeish doses of Vitamin I for about 5 days and it wasn’t going ANYWHERE. I scheduled a massage, told the therapist what the issue was, and she spent nearly an hour working on JUST that area. I swear she left bruises - it felt that way, anyway - but the next day, the pain was gone. I don’t know whether the massage did the trick, or the muscle stopped acting up out of sheer terror that I’d put it through that again.
Traditionally, I’d use heat on such a problem. I have no idea whether cold is a better choice; I’ve found that cold is better for knee pain, for example; as lovely as a hot tub soak might be if my knees are acting up, I find I pay for that for about 3 weeks. I think it has something to do with the heat increasing swelling and inflammation.
Oh, and if you do experience pain / numbness in one leg, look at how you sit, and whether you keep anything in your back pocket. About 30 years ago, I cured a coworker’s sciatica when I looked over and saw he was carrying a somewhat thick wallet, and told him to move it to a different pocket. “Credit card sciatica” is a real thing. I told him he owed me 50 bucks for the consult. Deadbeat never ponied up!
Doesn’t sound like that’s what the OP has going on, though.
My doctor asked about that too. I told him I’d bought a boat recently, which completely cures the thick wallet issues. He laughed, I laughed.
Usually heat gives me relief from these things, but this time the Doc sent me home with lidocaine patches. These are a first for me, but they work really well. Only drawback is that hot-tubs and heating pads are forbidden when they’re used. Presumably it affects the absorption rates or something.
That - and if your skin is numbed, you might not feel a burning sensation if you leave the heating pad on too long (presumably less an issue with a hot tub, as other body parts would notice you’d started to cook).
I got a really bad back spasm right after Thanksgiving and passed-out, falling face-first on the hardwood. Luckily I did not hit anything on the way down. I have had this happen (the back pain, not the passing-out) several times in the last 10 or so years, usually from doing something awkward. My back does give a few warning signs, usually, and this last time I ignored them. I use ibuprofen and a cold pad to get some relief.
My understanding is that it’s a pinched nerve somewhere and the combo of the ibuprofen and cold pad helps reduce swelling and pressure on the irritated nerve.
The spinal cord is basically the highway of the nervous system. Anything that happens there has an excellent chance of having knock-on effects in a different body part. There’s not nearly so much chance of that happening for the extremities.
Here’s my understanding of a back spasm, quite possibly wrong. The brain, right or wrong, detects a problem with the spine/spinal cord and commands the muscles in the affected area to painfully tense up so as to form a sort of bio-splint and is intended to help prevent local movement and further damage to the perceived injury. This is called guarding and, unfortunately, a lot of the cites in terms of spine stuff are chiropractic in nature. A stiff neck is the same phenomenon.
I get them right at/immediately above my tailbone and it’s just the worst. I’ve had maybe four serious ones in the last 15 years where I’m walking crooked for 2-3 weeks and it’s problematic for a good (bad) month. The first lower back spasm I ever had was by far the worst and I’d literally thought I’d been shot. The onset was instant and stands to this day as my basis for 10/10 pain. I was in medical shock.
The doctor won’t give a patient very many cortisone shots.
My mom had a hip flexor problem. A cortisone shot cleared it up for a few months. She went back for another shot. He gave her a 2nd shot. He told her she’d have to get physical therapy. No more cortizone shots for at least a year.
She had weekly PT for several months. Going through a treatment plan.
My mom just had spinal surgery a month ago. She had ZERO pain in her back but stabbing and burning pain in her leg, and was walking with a cane for over a year. She couldn’t lift her foot off the ground whatsoever. Since she has relapsing-remitting multiple sclerosis, she had to go through a lot of tests and therapy to rule out MS. Finally she went to a spine surgeon who said “oh yeah your lower spine is totally mangled. I can fix you right up!” Her spine was curved, he straightened it up and put in pins.
Her nerves were being pinched for so long that it’s taking a while for her legs to get back to working and without pain. She showed me today she can lift her foot way off the ground by herself, something she hasn’t been able to do for over a year.
Yep. In addition to systemic effects (which happen even with something localized like that), a doctor once told me that it risks damaging nearby tendons. When I was dealing with sesamoiditis, and fighting with insurance to cover orthotics as opposed to repeated injections, I was told I could not have more than 3 in a year.
A funny side note: referred pain! Sometimes I’ll poke one part of the body and feel it elsewhere - always on the same side. I’ll jab a finger into my leg, say, and feel a sharpish sensation in my torso. Not reliably - seems to be random, though if it happens, I can repeat it right then (just not an hour or two later).
I assume it’s due to the nerve pathways from the one spot being right next door to the pathways to the other, and some sort of spillover of signals.
