"Uncontrollable" back spasms

[Sanam]

This is a situation I've only encountered once since graduating from massage school. It was kinda exciting and yet frustrating at the same time.

An older client that I'd treated on-and-off for a year came in complaining of severe back spasms that came and went. Most of our prior sessions had to do with long-running hip problems that seemed mostly under control, with only occasional back spasms. Her right hip had problems that usually required glute, sacral, and low back work. She normally used a cane, and occasionally had minor issues with her lats, erectors, and traps.

Before meeting me, she often took muscle relaxers. Over time, she got down to taking only one every now and then. We hoped to eliminate her need for them over time, but it was a distinct improvement.

When she came in the last time, she'd been suffering from "uncontrollable" back spasms for 1-2 days. The spasms sometimes hit her right side, other times her left - and were more intense on that side. We started her prone, and as spasms hit her, she'd twist and turn as her muscles visibly changed tone. The spasms sometimes centered in her lats and obliques, other times her QLs and erectors. Whenever one area calmed down and she'd start to relax in relief, another would hit her somewhere else. I felt bad seeing the tears roll down her cheeks, and tried a variety of things to get the spasms under control.

We tried static compression holds, fascial work, gentle trigger point work, hot packs, rhythmic rocking of the hips, and some creative combinations of the above. In the past, I've had success with all of the above methods, but NOTHING made a lasting impact... the most we managed was to extend the length of time between spasms, though the intensity seemed to remain the same.

For the first time in my career, I found myself wishing she had her muscle relaxers with her, to see if they would give her some relief.

It's been a couple months since I saw this client, but still find myself thinking about the experience. Based on what I knew then, I can't think of what else I might have done. Since moving my practice to the new place, I haven't seen her again to discuss it.

So, has anyone else run into a similar situation? Got any thoughts about how to handle something like it in the future?

Thanks!

 

[Clarence]

I haven't been in that kind of situation but it sounds as though the issue is beyond what massage can help. Uncontrolled spasms can be from a number of things, such as any spinal issues or even electrolyte imbalance. She should be referred to her primary care physician for that problem, unless she already has?

Why was she taking muscle relaxers? Sometimes it is prescribed to help relieve the type of spasming it sounds like your client experiences.

I doubt there would be anything you could do but it sounds like you did the right thing by attending to her comfort (as well as possible) and being present with her.

 

[windy gurl]

Maybe try using cold and heat??? Cupping??? Sometimes things have to run their course too. Its a shame she was in so much pain.

 

[A pocket full of stones]

I now keep a spasm-relief product in the office -- Big Gun, I get it online from http://www.renaissancegreen.com -- that is a wonder on spasms. That would have been my first thought to try. But the spasms you describe were so extreme, I have to wonder if this points to a neurological issue (MS or some other shorting-out disorder comes to mind, but I'm no neurologist).

 

[Tailight<3]

I've seen that condition. I have no idea what causes it, but the only thing that relieved it at all (slight) was working the neck, and icing. Presumably the icing slows down the nerve signals, but the woman can't go around packed in ice all day, that's for sure. We tried a number of things:

heat, ice, cupping, triggerpoint therapy, plain deep swedish, Big Gun, some chinese stuff that is for spasms, blah blah blah.

She went to a neurologist. I think the neuro is convinced it's a neuro issue, but couldn't tell her what it was. I also wondered if it was some type of demyelinating disorder, or toxic exposure.

 

[blizz123]

It sounds like something somewhere was sitting on a nerve. I sent someone to the doctor ASAP a couple weeks ago with the same thing.....pain relief and muscle relaxants are a good thing! Next a diagnosis is needed. Then we know how we can help, in conjunction with whatever is being done to get whatever it is OFF that nerve.

 

[my own pavement]

Okay, sounds like I didn't miss something obvious... that's a relief. This client had been taking muscle relaxants regularly for years due to chronic hip and back problems that left her with a permanent limp and various muscle development imbalances. With semi-regular treatments her need for relaxers was greatly reduced, but now it seems she may never get off them. *shrug*

Just gotta keep learning... and yes, I did recommend she contact her physician soon for more help. Hopefully I'll see her again some day, and learn what happened next.

 

[HLEK87]

...

 

[after H0urS]

In my experience the body reacts with muscle spasms to protect an area or prevent an injury. Most people that I have seen with back spasms have disk issues or subluxaions that are affecting nerves.
IMHO - there is nothing that you can do to help this client on your own. I would NOT try to "fix" her on my own and I would not refer to a regular physician but I would suggest that she see a chiropractor. She will need x-rays to see what's happening.
In tandem with a qualified Chiro you will be able to provide supportive and corrective work. If the films do not show anything then they will probably refer to a neurologist.

Muscle relaxers will never fix the problem. If she has been on them a long time she has turned off her connection with what her body has been trying to tell her.

 

[d.e]

Obviously without evaluation, this is just a guess and what I might check for during a session.

Sounds to me like facilitated segments. If I am working with a client and we see relief from an issue, it will come back if the associated spinal segments are not addressed. Sometimes it comes back in a month or two, sometimes the next day. The vast majority of time, if the problem returns I will find that the spinal segment has been re-facilitated and needs to be addressed again.

That's just my take considering that you were making good progress and decreasing meds.


Brian

 

[Sacked Lunch]

Another thing to take into consideration is the other medications she may be taking. The one that comes to mind right away is albuterol, often found in asthma inhalers. If taken regularly, they can cause severe muscle spasms. Personal experience...if I take it for more than a day or two, my intercostals and erector spinae lock up so tight I can barely breathe. It may not be the cause, but it might be worth checking into.

 

[lebronjames#1]

If this person should come back into the office for additional treatment and the back spasming starts up while she is there, try something I just learned at a continuing education class Sunday........

make fingertip connection with Ren 15 and Pericardium 6 acupuncture points........ okay, in landmarks that is the point on the body just below the xyphoid process [Ren 15] and then on either arm 2 finger widths "up" the inside of the forearm from the wrist crease in the middle of the forearm [Pc6]. According to the acupuncturist teaching the class an overview of Hara Diagnosis those 2 points will stop epileptic seizures and/or anything that mimics convulsive or seizure-like body behavior. During bodywork for myself on Monday, my body decided to go into convulsive spasms mimicing a problem I had during a recent anaphalactic shock episode. My LMT applied Ren 15 and Pc 6 right away and within less than a minute, the body settled down and the problem passed.

for what it's worth...... :2cents: