If you've ever experienced a muscle spasm in your upper back, you know how painful it is. A back spasm is a sudden tightness and pain in your back muscles. It's estimated that up to 10% of men and 20% of women experience upper back pain, including spasms. Most of the time, back spasms can be treated at home with ice, heat, over-the-counter medications, and some gentle stretching and strengthening exercises. Sometimes upper back muscle spasms require care from a doctor or further investigation.

Here, learn more about what causes upper back muscle spasms and how to prevent and treat them - especially with stretches and exercises from our Hinge Health physical therapists.

¿Qué causa los espasmos musculares en la parte superior de la espalda?

Los espasmos en esta zona con frecuencia son causados por tensión en los músculos romboides, destaca Heather Broach, DPT, fisioterapeuta de Hinge Health. Estos músculos conectan la parte interna de los omóplatos con la columna vertebral. Si están tensos o desgarrados, pueden tener espasmos (contraerse). A continuación, presentamos otras razones comunes por las que puedes padecerlos:

• Uso excesivo. Esto es especialmente común al realizar actividades que suponen hacer movimientos por encima de la cabeza, como levantamiento de pesas, jugar tenis o incluso simplemente estirar los brazos para colocar objetos en un estante elevado.

• Lesión aguda. Ya se trate de un accidente automovilístico o una caída, las lesiones pueden hacer que los músculos se desgarren y el tejido circundante se hinche, lo que puede desencadenar un espasmo, afirma la Dra. Broach. 

• Problemas de postura. Esto es particularmente probable si pasas mucho tiempo sentado frente a una computadora.

• Hernia discal. Los discos actúan como amortiguadores entre los huesos (vértebras) de la columna vertebral. Si un disco se abulta y sobresale de su lugar, puede ejercer presión sobre un nervio y hacer que los músculos circundantes de la parte superior de la espalda se contraigan en respuesta, comenta la Dra. Broach.

• Deshidratación. Si alguna vez has sufrido calambres al deshidratarte, sabes que beber abundantes líquidos es importante para prevenir los espasmos musculares en los brazos o las pantorrillas. La deshidratación también puede contribuir a los espasmos en los músculos de la espalda.

Symptoms of Muscle Spasms in the Upper Back

Some common upper back spasms symptoms include:

• Pain in your upper back between your shoulder blades and spine (as mild as a dull ache or as severe as a sharp pain)

• A knot or tightness in your upper back muscles

• Pain when you move your shoulders

• Pain when you breathe

Risk Factors for Back Spasms

While upper back pain spasms can happen to anyone, certain risk factors may make them more likely, such as:

• Smoking. Smokers are at greater risk for chronic back pain in general, since lighting up damages blood vessels that nourish your spine. About one-third of current smokers report back pain, compared to less than a quarter of people who never smoke.

• Being overweight. If you already have a back condition, you have an increased risk of upper back spasms due to your excess weight putting pressure on your spine.

• Slouching. Posture issues won't cause upper back spasms, but if you're already predisposed to them, it can make them worse. There's no such thing as perfect posture, but making sure to get up and change positions regularly throughout the day can help prevent pain.

• Stress and anxiety. When you're stressed, your body releases hormones such as adrenaline and cortisol, which can cause back muscles to tense and spasm in anticipation of physical fight or flight. "I once had a patient who would develop terrible migraines and upper back spasms on Mondays," Dr. Broach recalls. "It turns out she spent her weekends with her mother, who was in an assisted living facility. This left her stressed and anxious, which triggered her spasms."

When to See a Doctor

Most of the time, upper back spasms resolve on their own with home treatment, says Dr. Broach. But if you don't start to feel better after a couple days, or they return, see your doctor. They can develop a treatment plan and/or prescribe physical therapy. If you experience any of the following symptoms along with your back spasms, however, see your healthcare provider right away:

• Loss of bladder or bowel control

• Muscle weakness in your arms or legs

• Numbness, weakness, or loss of a sense of feeling on one side of your body

• Loss of balance and coordination

Back Spasm Treatment: How Are Back Spasms Treated?

The following tips from our Hinge Health physical therapists and medical doctors can provide relief for back muscle spasms.

Ice and heat therapy. "Ice is best for the first 48 hours after an acute injury. But after that, heat becomes your best friend," says Dr. Broach. Moist heat, such as a hot water bottle, heated gel pack, or moist heat wraps, are best, she notes. "Heat brings blood to the tissue, to make sure it gets maximum hydration," she explains.

Over-the-counter (OTC) medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve) tend to work better than acetaminophen (Tylenol) for upper back spasms, since they reduce inflammation. It's important to make sure that you are safely able to take these medications, based on your medical history.

Some doctors recommend taking the recommended dose regularly for three to five days while you have spasm symptoms, rather than only turning to it when your discomfort becomes unbearable.

Muscle relaxants. These are prescription medications that may be taken for a short period of time for back spasm relief. But they can cause drowsiness, don't work for everyone, and some doctors recommend that you shouldn't drive while you take them.

Physical therapy. If you experience upper back spasms frequently, your doctor may recommend physical therapy. A physical therapist will teach you stretching and strengthening exercises to help beef up surrounding muscles. "The stronger your back and core muscles are, the less likely they are to spasm," explains Dr. Broach.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Electrotherapy. This is a form of therapy that uses electrical currents to help relieve pain. One common tool is a transcutaneous electrical nerve stimulation (TENS) device, which is a small, battery-operated machine that has leads connected to sticky pads called electrodes. The theory is that these currents modify pain signals on their way to your brain, and/or the electrical shocks themselves stimulate release of your body's endorphins, says Dr. Broach.