Exercise and The Spine
Muscle Pain
Muscle pain is responsible for most of the complaints involving the spine. Sometimes the pain arises from direct injury to the muscle, the result of overtraining or a strain/sprain. In other cases the muscle pain is secondary to pain arising from deeper spinal tissues leading to reflex muscle spasm called guarding spasm. Chronic muscle tension and contraction causes inflammation within the muscle and resultant muscle discomfort or pain.
Repeated injury and inflammation of muscle can lead to the development of adhesion (scar) formation between the membranes surrounding muscles and involving supportive connecting tissues. The combination of adhesions and restrictive muscle spasm/guarding limits movement, reduces local blood flow, promotes inflammation and often leads to pain. Adhesions set the stage for a “tug of war� contest between pain sensitive tissues. The presence of pain leads to limited use of the involved muscles causing them to weaken and atrophy. This whole process can become a vicious cycle.
A local problem involving one or more muscles is usually best treated with a targeted approach using massage, activity modification and stretching. This approach helps to reduce pain and restore normal function. Too often, treatment never resolves the dysfunctional joint or muscle pain because the correct balancing pattern of muscle exercise was not performed.
It can sometimes be very difficult to identify primary muscle pain. This is because the structures and tissues of the spine are intricately connected structurally, functionally as well as neurologically. Muscle pain does have a few unique characteristics which helps the spine specialist make the diagnosis. The specialist relies heavily on the reported history and the physical examination.
History
Repeated injury and inflammation of muscle can lead to the development of adhesion (scar) formation between the membranes surrounding muscles and involving supportive connecting tissues. The combination of adhesions and restrictive muscle spasm/guarding limits movement, reduces local blood flow, promotes inflammation and often leads to pain. Adhesions set the stage for a “tug of war� contest between pain sensitive tissues. The presence of pain leads to limited use of the involved muscles causing them to weaken and atrophy. This whole process can become a vicious cycle.
A local problem involving one or more muscles is usually best treated with a targeted approach using massage, activity modification and stretching. This approach helps to reduce pain and restore normal function. Too often, treatment never resolves the dysfunctional joint or muscle pain because the correct balancing pattern of muscle exercise was not performed.
It can sometimes be very difficult to identify primary muscle pain. This is because the structures and tissues of the spine are intricately connected structurally, functionally as well as neurologically. Muscle pain does have a few unique characteristics which helps the spine specialist make the diagnosis. The specialist relies heavily on the reported history and the physical examination.
History
- Pain that develops after a strain/sprain
- Pain that becomes progressively worse if you stay in one position
- Pain that becomes worse when using a muscle.
- Development of pain after an injury
Functional Characteristics
Examination Findings
- Pain that is worse in the morning
- Pain associated with a feeling of tightness and pulling
- Pain that radiates along the course of a muscle.
- Pain that goes away or diminished after movement
- Muscle spasm induced by movement or stretch
- Weakness with give way pain
Examination Findings
- Reactive muscle spasm or guarding when pressure is applied to a muscle
- Muscle soreness to touch
- A tight muscle which resists passive stretch
- Focal or generalized swelling of a muscle
- A tight sore muscle
- The presence of multiple tender points along a muscle. (trigger points)
- Elevated muscle enzymes on a blood test