Updated January 23, 2023
June 10, 2022

A Physical Therapy Guide to Muscle Spasm

Muscle spasm pain can happen at any time, anywhere in our body, but neck and lower back spasms are the most common. When muscle spasms become chronic, the pain interferes with our quality of life, making it difficult to do everyday tasks.

Fortunately, painful muscle spasms are rarely a long-term condition. You can learn how to manage a spasm with physical therapy. Read on to learn more about what to do.

The best way to treat muscle back spasms is to understand why they happen, how to prevent them, and what options you have for treatment.

Table of Contents

Understanding Muscle Spasm

A muscle spasm occurs when a single muscle or muscle group contracts involuntarily. This contraction, or tightening, of the muscle usually occurs in response to physical trauma, repetitive activities, or muscle strain. In some cases, stress or anxiety can also cause muscle spasms.

Muscle spasm is common, affecting more than half of adults at some point in their lives. The most familiar type is the "Charley horse" cramp,1 which occurs in the calf.

Most of the time, experiencing a muscle spasm in your back or other areas means your body is reacting to something or trying to tell you something is wrong. Knowing what triggers your back spasms can help in both prevention and treatment.

Symptoms of Back Spasms

The symptoms of muscle spasms aren't always straightforward but usually include sharp, sudden pain. Depending on where the spasm occurs, nerves or other tissues may be involved that cause radiating or additional pains.

Other symptoms of a muscle spasm include:

  • Sudden tightness of a muscle
  • Muscle twitching
  • Decreased range of motion
  • Dull ache or throbbing pain
  • Mild to severe muscle pain
  • Stiffness
  • Headache
  • Back pain

Back spasms usually go away with at-home treatment. Though soreness may last for hours or days, a muscle cramp usually lasts no more than a few minutes.

You should seek medical attention from a physical therapist or urgent care professional if your muscle spasm doesn't go away after an hour or two. Plus, if you're symptoms are accompanied by a change in bladder or bowel control, seek medical care from a healthcare provider immediately.

What Are the Most Common Causes of Neck and Back Spasms?

Like any medical issue, neck and back spasms can have many causes. Here are the most common ones:

  • Dehydration:2 Lack of water and overexertion are significant causes of pain from muscle cramping. Our muscles require water to function; not getting enough liquids or electrolytes is the fastest track to cramps.
  • Fatigue: Repetitive movements, strains, or fatigue can also cause muscle pain in the upper back and other areas. This injury or cramping can happen during strenuous activity or light physical exercise. There may be back pain or muscle weakness leading up to the actual spasm.
  • Posture or mechanical issues: Mechanical dysfunction and poor posture habits can also cause muscle spasms in your shoulder blades and back. Physical therapy can help resolve cramps and back pain caused by structural issues and promote good posture habits.
  • Medical conditions: Certain medical conditions can also cause neck or back spasms; a few examples are listed below. These conditions tend to be more severe and often require medical intervention.
    • Peripheral neuropathy is pain, numbness, or muscle weakness caused by nerve damage outside the brain and spinal cord. Nerves play a vital role in the function of our muscles, among other things.
    • Osteoarthritis, spinal stenosis, and degenerative disc disease are common degenerative disorders of the spine joints. When joints don't function properly, our back muscles pick up the extra slack, leading to back spasms and pain.
    • A herniated disc occurs when there is a problem with the soft tissue between the vertebrae of the neck or back. The herniated disc soft tissue can push out, restricting local blood flow and causing back pain and tightness in the neck, shoulders, and upper back.

Do I Have Other Risk Factors for a Neck or Back Spasm?

Several other causes of spasms aren't as common as those listed above but are still worth being aware of.

Here are a few other conditions or risk factors that may increase your chance:

  • Taking certain medications
  • Lack of movement or stretching
  • Thyroid or hormone disorders
  • Nerve disorders
  • Electrolyte depletion
  • Pregnancy
  • Lack of blood supply

How To Diagnose Back Spasm

If you experience sudden and sharp pain in your muscle that causes lasting discomfort, your CityPT physical therapist can determine if you have a muscle spasm with an in-depth physical examination.

Your therapist will ask you questions about your medical history, current medications, and lifestyle.

Diagnosis of muscle spasm will depend on several factors, such as:

  • The severity of the pain
  • The duration of pain
  • When the spasms occur

To assist your physical therapist in providing the best care, you may want to keep a record of when you have muscle spasms. Keeping track of your neck or back spasms is especially helpful if they happen frequently or semi-frequently and you haven't been able to identify a pattern yet.

What To Expect From Physical Therapy for Back Spasms

Physical therapy (PT) is a collaborative treatment in which a licensed clinician will provide professional medical advice to help you manage chronic pain caused by injury, surgery, or mechanical issues in the body.

Starting a comprehensive PT treatment plan is very different from taking medication. Your CityPT clinician will assist you in stretching, strengthening, and reducing inflammation in spasming muscles.

PT is an ongoing practice that you incorporate into your daily routine. Your therapist will teach you exercises and stretches to do at home to help you reduce pain and get back to your life. They will also factor in your lifestyle, activities, and daily habits to prevent future pain and injury best.

Although it isn't an instant fix, CityPT sessions provide relief in the long term. You should begin feeling better within a few days or weeks.

Simple Tips to Try for Muscle Cramps and Spasms

If you experience a spasm, there are several gentle at-home methods to try to ease the pain and relax the spasming muscle.

  • A heating pad, walking, or other light physical activity are beneficial for increasing blood flow to an affected area.
  • Cold therapy (ice pack) can provide immediate pain relief.
  • Self-massage or a professional massage of affected soft tissue can provide short-term pain relief.
  • Gently stretching the low back by lying down on your back and bringing your knees to your chest can also help.
  • For upper back spasms, gently stretch and move the chest, shoulders, and neck with arms swing, shoulder shrugs, etc.
  • Practicing relaxation techniques, such as deep breathing.
  • You can also talk to your physician healthcare provider about over-the-counter or prescribed medications for temporary pain relief, such as nonsteroidal anti-inflammatory drugs or a muscle relaxant.

What if conservative care doesn't work?

If conservative care, such as stretching, physical therapy, and over-the-counter medications, don't provide full relief, you may be advised to see a specialized healthcare provider, such as an orthopedist or a pain specialist.

You may need lab, imaging, or EMG testing to determine if there are medical causes of neck or back spasms. Surgery or an invasive procedure may be an option in very rare cases to address a secondary cause.

How Do I Prevent Neck and Back Spasms?

The best way to prevent a muscle spasm in the neck, back, or any muscle, is through consistent self-care, such as:

  • Stretching regularly
  • Staying active with regular exercise
  • Adequate hydration and electrolyte consumption
  • Eating a nutritious diet
  • Be familiar with any underlying conditions you have and keep them well managed
  • Stress management
  • Take frequent breaks when heavy lifting and practice good form

Is It Time To Get Treatment for Your Back Spasms?

If you're experiencing muscle spasms in your neck, back, or shoulder that recurs or persist for more than a few days, you should be evaluated by a CityPT clinician.

Spasms are common and rarely serious, but they can be associated with other medical issues. You will also want to figure out the root causes so you can relieve your pain and prevent them in the future.

If muscle tightness, cramping, and spasms have become frequent and your quality of life is affected, it may be time to book an appointment with a CityPT physical therapist.

This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide (or any guide) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.



  1. Vorvik L. Charley horse:Medlineplus medical encyclopedia. MedlinePlus. https://medlineplus.gov/ency/article/002066.htm. Published May 2021. Accessed September 6, 2022.

  2. Dehydration: Health Library. Cleveland clinic. https://my.clevelandclinic.org/health/treatments/9013-dehydration. Published Feb 2021. Accessed September 6, 2022.

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