When muscles become inflamed, they can also spasm, or contract tightly, as a response to injury. While they are the body’s way of protecting itself from further injury, they often produce excruciating and often debilitating pain. Muscle spasms are common in the low back (lumbar) muscles.
There are a variety of causes of muscle spasms, and each cause depends on certain predisposing factors and anatomic areas of involvement. Spasms may occur when a muscle is overused and tired, particularly if it is overstretched or if it has been held in the same position for a prolonged period of time. In effect, the muscle cell runs out of energy and fluid and becomes hyperexcitable and then develops a forceful contraction. This spasm may involve part of a muscle, the whole muscle, or even adjacent muscles.
The symptoms of muscle spasm depend upon the muscle involved and the circumstances leading up to the spasm. Skeletal muscle spasm usually involves muscles that are being asked to do excessive work. There is acute onset of pain as the muscle contracts. A bulging muscle may be seen or felt underneath the skin where the muscle is located. Most often, the spasm resolves spontaneously after a few seconds though it may last many minutes or longer. Usually, the patient will feel the need to stretch the muscle involved, thus relieving the spasm and resolving the episode.
The treatment of smooth muscle spasm also depends upon the underlying cause. Often, pain control will occur simultaneously with the care provider’s efforts to make the diagnosis.
There is no one effective treatment for the dystonias. Medication may used to try to restore balance to the brain’s neurotransmitters. The decision as to which medication to use depends upon the patient’s presentation. It may take trial and error to find the right medication in the right dose to control symptoms.
- Anti-Parkinsonism drugs, like trihexyphenidyl HCl (Artane) and benztropine mesylate (Cogentin) decrease acetylcholine levels.
- Muscle relaxants like diazepam (Valium) and baclofen (Lioresal) affect GABA receptors.
- Levodopa (Sinemet) and reserpine (Harmonyl) affect dopamine levels.
- Carbamazepine (Tegretol), a seizure-control drug, may be useful in some patients.
- Botulinum toxin type A (Botox) may be injected into a specific muscle to paralyze it and relieve the muscle spasm. This was initially used for blepharospasms but is now able to be used where other muscles are involved.