My lower back/sides gave out yesterday, still hurting. Tips?
October 13, 2021 12:41 PM   Subscribe

YANMD. Yesterday, the oddest thing happened—my lower back all of a sudden "bunched over" and my stomach felt incredibly heavy, every little movement hurt (spasm-like feel on the lower back and lower sides). Called my doctor, got a RX, but it's still not helping.

This happened yesterday while I was doing #2. During a push (which was normal, not straining at all), all of a sudden, my back just kind of "bunched" over (hard to explain, but that's the best term I can think of). Getting up hurt; my stomach and back both felt heavy, and I had trouble breathing. I put ice on my back, called my doctor, got a same-day appointment, got looked over, got prescribed Cyclobenzaprine (flexeril), and went home. Felt somewhat better, but the pain was still pretty intense, especially when moving or shifting at all. Kind of spasm-like/stiff/painful, if that makes sense. Very annoying. I took the Flexeril as prescribed before bedtime, and it didn't really help. Took another pill this morning, still didn't help much. I have ordered a heating pad and will try exercising a bit, as instructed by the doctor.

My doctor performed tests for kidney stones (x-ray and urine), nothing. He suggested I might have somehow put pressure on my back when carrying a bag of somewhat heavy groceries on Monday for ~30 minutes, and this triggered some kind of lower back/side pain. It was completely unexpected because my back was perfectly fine, right before that fateful #2 push, then boom, continued pain.

I'm concerned because discussions online say Flexeril is supposed to sedate you and help relax your muscles. Unfortunately, that's not really the case for me; other than feeling somewhat more relaxed, my muscles are still very tight and stiff. I have to support myself when I get up or get down, otherwise my lower back/sides kind of "scream" or "tighten", for lack of better terms. It's really kind of scary, and I feel immobile. It's especially hard because I'm single and live alone, so don't have a support system, on top of being Deaf. I'm scared that I've somehow entered a nightmare and won't ever get better (although logically I know that's probably not true).

My questions:
1) Again, YANMD, but what could be going on? I find it hard to believe a simple carrying of something a bit heavy could trigger this (especially as I've done it many times before). I did suspect initially kidney stones, but that was ruled out by tests.
2) For those of you who took Flexeril before, did it not kick in and work the first couple of days? Is this normal?
3) This morning, when getting out of bed, it hurt pretty badly to get out of bed (no items nearby to hold on/support me getting up). When laying on my couch, however, I have items to hold on and reach out to, which helps me get up with less pain. Given that, should I sleep on my couch instead of my bed, for the next days until this hopefully goes away?
4) Anything else I should know — have anyone here experienced similarly before, and how did you get through it/heal? I really am hoping this is a temporary, short thing (~1 week), not a long-term thing.
5) If the Flexeril does not work at all within the week, and I still am experiencing this acute pain, are there any specific keywords or ailments that I should mention to my doctor, to check for?

Thank you, this is so frustrating and came on so suddenly and unexpected, and is really uncomfortable. I really am hoping to shed some light on this.
posted by dubious_dude to Health & Fitness (24 answers total) 2 users marked this as a favorite
I've had my back give out in a similar manner. My understanding was inflamed muscles squeezing some nerves. For now, advil, heating pads, hot showers, some rest, though don't be completely immobile, see if you can move out hurting yourself. For me the worst is the first 3 days.

Longer term, find a good PT to get though the initial injury, and then a gym where you can get coached on how to strengthen your core, legs, etc. I've been doing strength training for 2ish years, and it helps quite a bit.

That kinda pain sucks. Good luck!
posted by pyro979 at 12:56 PM on October 13 [2 favorites]

Forgot to say, apparently a lot my issues was from sitting all day. I now work mostly from a standing desk.
posted by pyro979 at 12:57 PM on October 13

So you're not getting any younger, that's what's going on.

Sadly, yes, it's true that you can cause yourself a lot of back pain by basically doing nothing at all - my worst back pain so far came on when I was 19, very fit and going for a walk. It hurt so badly that I couldn't get home and had to call my family to pick me up. The worst subsided in a couple of days. Like, you can really be doing nothing weird and your back will just seize up on you.

Chances are that this is a totally 100% normal back spasm that will fade away over the course of the next week. The flexeril isn't going to fix it, it's just going to make you feel less bad. If it's not making you feel less bad, stop taking it. I have taken advil with good results on a back spasm, although again it didn't make me better instantly.

After you're feeling better, getting some PT or otherwise doing some core strength workouts will lower the risk of a repeat.

Why not try the couch tonight and see how you feel tomorrow? Assuming you're reasonably comfortable on the couch, it's unlikely that you'll make anything worse and you can stop if it doesn't seem to help.

Bad back spasms are really unpleasant and they can definitely be scary because of the mobility issue, but they are mostly just a pain, so to speak.
posted by Frowner at 1:00 PM on October 13 [5 favorites]

I agree with pyro979 except for the heat treatment. I had something not quite as painful sounding as what you describe and was using a heating pad and taking hot showers to no avail. When I got to the physical therapist I was told I should have been icing it the whole time. If you think about it logically it makes sense. You want the inflammation to be reduced so you ice it. Applying heat will draw blood to the area and make it worse especially if there is nerve pinching going on.
posted by eatcake at 1:01 PM on October 13 [3 favorites]

Could you have popped a disc in your spine? Or pinched a nerve? If drugs aren't helping, it means the damage is still there, or the drug is not getting to where it's needed.

Flexeril is a muscle relaxant, so it's used for sore muscles and such. If it's not helping your pain, the problem is not with the muscles.

I suggest getting a back / spine specialist appt (not a chiro, that's for later, if you ever go that way)
posted by kschang at 1:10 PM on October 13 [1 favorite]

Just as a reference, I've heard of people who broke their ribs just by carrying something excessive.

So if muscle relaxant isn't working (and it should work within hours) I'd suspect the problem is, again, not with the muscles.
posted by kschang at 1:23 PM on October 13

I'm so sorry this is happening to you -- I've had countless instances of low back spasms, and it's scary and demoralizing every time. But I promise it will get better!

There is a lot of good advice in this thread. My suggestions: use ice OR heat depending on what makes it feel better; stop the Flexeril if it's not working and perhaps try an NSAID; try not to be TOTALLY immobile, as gentle movement will help; definitely use your arms/legs to get yourself up from lying/sitting; and consult a physical therapist as soon as you can.
posted by leftover_scrabble_rack at 1:48 PM on October 13

Flexeril will dumb you down after a while. I had to take it when I had bad back in my thirties. You might want a CT of your abdomen to make sure this pain is not referred from an abdominal issue, or vascular issue, or even gyn. PT can show you how to get up and down without aggravating the nerve pain.
posted by Oyéah at 1:57 PM on October 13 [1 favorite]

I'm sorry to say it's happened to me too. In my experience it's going to take you 5-7 days to start feeling better. Use ice if it feels good. Use heat if it feels good. Baby yourself for those days until you're in less pain. Then get to physical therapy and start working on the areas that help your back stay strong and healthy. (For me this meant I needed a lot more core strength.)
posted by BlahLaLa at 2:09 PM on October 13

Talk to your doctor about getting a referral to a physical therapist. I wish I had done this when I first injured my lower back when I was younger as I would have saved myself a lot of pain and frustration over the years. I didn't know then, but my experience with physical therapy recently has convinced me it's a great approach for healing these kinds of injuries and pains.
posted by bluedaisy at 2:26 PM on October 13

Oh hi I'm taking flexeril right now.

Last winter my lower back suddenly started hurting out of seemingly nowhere, very similar symptoms to what you've got. My body was just like ok sorry but you are done bending over now forever lol. Rude.

I had a telemedicine appointment and was prescribed something that didn't help at all and directed to do some stretches that had no effect, and then 2 weeks later I did another telemedicine appointment where I was prescribed flexeril and directed to take a ton of advil. THAT provided relief, finally, after a few days. (It wasn't until I was actually on the muscle relaxer that the stretches could help at all, everything was just too bunched up before to even make a dent.)

Both doctors figured I probably injured myself shoveling snow, and with all the snow we had last season I don't doubt it. Even though the exact triggering spasm didn't happen while shoveling, the repetitive strain set me up for failure.

Anyway, that was back in January. This weekend I was bathing my dogs and--BOOM--suddenly same thing. My back just fucked itself up right then and there, and I was DONE bending over. But I still had plenty of advil and leftover muscle relaxer, so I've been self treating since Sunday, and I'm about at the end of it happy to say.

Anyway, this is my regimen:

-omeprazole (prilosec) 1x a day because ibuprofen will fuck your stomach up
-flexeril 2-3x a day
-a bunch of advil (when I first spasmd I took 800mg right off the bat, and I've been doing 400mg every several hours since then) It's more than the bottle says to take but not more than what my doctor prescribed back in January
-lidocaine pain patch on the exact worst area of my back
-stretching once the initial spasm subsided, you can find lower back stretches on the internet

It has worked for me twice now so I'm going to stick with this plan in the future.
posted by phunniemee at 2:29 PM on October 13 [2 favorites]

I took Flexeril a few years ago for muscle pain and it didn't do a thing for me. I have found ibuprofen more effective for muscle pains/spasms. You might ask your doctor about it. Or, some practices have a nurse on call, and that's the kind of thing you can ask them, rather than having to go back for another doctor's appointment.
posted by tuesdayschild at 2:29 PM on October 13

So if muscle relaxant isn't working (and it should work within hours)

For what it's worth, at least for me, the muscle relaxant "works" by loosening you up and making you more mobile, which allows you to start to heal. It does NOT relieve pain. That's why you take it in conjunction with an anti inflammatory pain reliever. Advil alone did not help me. Flexeril alone does not help me. You gotta do both.
posted by phunniemee at 2:32 PM on October 13 [3 favorites]

Yes, this sounds completely within the realm of "welcome to the joy of getting older, sometimes your back will completely give out when you do something completely innocuous like "sneeze" or "turn your body at a slightly weird angle when standing up from a chair", and then you will be in screaming hell for at least a week.

I have taken Flexeril and did not experience a dramatic improvement. It made it perhaps a little bit easier to move, in conjunction with ibuprofen and heat, and the ability to move around and not baby my back completely is what seemed to drive the actual improvement after the first few days.

When you're feeling better, yes, talk to a PT about starting some kind of exercise regimen to help with your core strength, try to keep going on some of that stretching, etc.

Couch vs bed could go either way - it could be really helpful to have assistance getting up, but if your couch makes you sleep in odd positions that hurt your back, it might do as much harm as good. Try it tonight and see how it goes. If you decide it's not for you, maybe you can try something like temporarily moving a chair next to your bed to ease yourself into sitting and then standing?

Good luck, I'm sorry, back spasms are not at all fun. I hope you're feeling better soon!
posted by Stacey at 4:19 PM on October 13

I find it hard to believe a simple carrying of something a bit heavy could trigger this (especially as I've done it many times before)

Yup, that's how it works - welcome to your aging meat machine.

Every one of my back attacks (of various severity and various areas affected) was "triggered" by something minor and on the surface unrelated to doing anything strenuous or even particularly associated with my back - sneezing, turning my neck to look over my shoulder, getting out of bed, etc etc etc.

After my worst incident, the one where I was prescribed Flexeril, my doctor(s) said most likely I had strained/stressed some muscles and then mostly unconsciously moved and positioned myself oddly to relieve the strain, which then put odd strains on other muscles, which eventually went "NOPE" and the cascading effect of those muscles giving up put further stress on the lower back muscles which then REALLY went "NOPE" and that's when everything spasmed. And I couldn't move without intense agonizing pain.

Given that, should I sleep on my couch instead of my bed, for the next days until this hopefully goes away?

Sure, if that's what works - you need to sleep. During the worst of my worst attack I was sleeping sitting up on the couch.

the muscle relaxant "works" by loosening you up and making you more mobile, which allows you to start to heal. It does NOT relieve pain. That's why you take it in conjunction with an anti inflammatory pain reliever. Advil alone did not help me. Flexeril alone does not help me. You gotta do both.

Yup yup yup yup, strong second for what phunniemee says here, and this is in fact what my doctor told me. I was prescribed both Flexeril and a separate pain relief medication, I forget what. The Flexeril alone just made me a little spacey.

I bet what it is is your doctor is hoping that the Flexeril plus I guess OTC pain med/anti-inflammatories like ibuprofen or acetaminophen will loosen everything up over a week or two. And since you're (I think) fairly young, that would be all that's necessary. (Long term, you should work on strengthening your core muscles.)

If you don't see significant improvement in a week or two, physical therapy is the next step. But your doctor/insurance needed to try the simpler cheaper method of some minor drugs like Flexeril first.

I really am hoping this is a temporary, short thing (~1 week), not a long-term thing.

For whatever it's worth, my worst attack, the Flexeril one, we tried the drugs for 2 weeks, and then it was a month (maybe two?) of physical therapy once a week, including short sessions of mechanical traction. I believe I had some minor nerve damage, as my left foot is a little bit numb all the time, but otherwise I'm fine.

So a week might be optimistic, but I also wouldn't get too freaked about possible long term issues just yet.
posted by soundguy99 at 4:22 PM on October 13

I don't know what's causing this, but if you don't have a cane, get yourself one ASAP! When I throw my back out they really help getting up from bed, chairs, toilets, etc.
posted by Ursula Hitler at 4:42 PM on October 13 [1 favorite]

Response by poster: Very helpful and reassuring, thanks so much! @soundguy99, I'm in my mid-30's, so fairly young is about right (although I'm a kid at heart!). I noticed that for the most part, so far, when I walk, it's okay (very minor little "seizings" but nothing that stops me from continuing to walk); when I sit or lie down for a long time, it hurts more. I definitely have became a couch potato lately, so that could be one reason why!

What I think I'm going to do is keep trying the Flexeril, icing more, heating if need be, doing small exercises (walking mainly), take Ibuprofens here and there, and try to ride this out. If, within a week or so, there's no progress, then I'll ask for a referral to a back/spine specialist within Kaiser (if they have one), to get my spine and back checked out. This happened yesterday, so I'll need to give it a bit more time.

Thanks, @phunniemee, for resetting my expectations about Flexeril, that does make sense, and I did feel a bit more relaxed last night, so I guess that's it doing its job. I have to remind myself that medicine doesn't always work miracles.

I'll try putting a chair up next to my bed to use as support also, for the time being, if the couch doesn't work out.

Hoping this isn't more major, like a slipped disc, but based on what I saw online for symptoms of slipped discs - I don't have any numbness in my arms/legs, my legs are perfectly fine (so far), so definitely hope this is just one of those spasms that will eventually go away with care (and a good reminder for me to start planning better exercise and working out regimens for myself).

Btw, @Frowner, I loved your terminology of "seize up" - that's exactly what's happening!
posted by dubious_dude at 5:20 PM on October 13

Earlier this year I wrenched my back while trying to load something heavy into my car. I tried Advil, a hot water bottle, an electric massager, and a foam roller, nothing seemed to help. So I went and got a massage, telling the masseuse I needed extra attention on my lower back. A day after the massage I was back to normal.

I am not in any was averse to modern medicine; just a data point for you.
posted by ejs at 6:01 PM on October 13

I can't tolerate oral NSAIDs because of GERD, but a Toradol shot was immensely helpful for my back problems (not the typical back spasm/throwing out your back thing, but still).

Also, I had a bad reaction to Flexeril, but Tizanadine worked much better for me. It's also a muscle relaxant I believe. So if it turns out the Flexeril just isn't doing it, just know that there are also other options out there.

Honestly, the thing that has helped me the most with my back pain (again, different from yours, but still), is when my PT does myofascial release. I was super skeptical but it really helps.
posted by litera scripta manet at 6:24 PM on October 13

I once threw out my back turning off the cold water spigot after washing my hands. Seriously, I was just innocently washing my hands and whammo, right rhomboid strain, took me a week to feel normal again. Welcome to middle age. Agree that icing right after helps, as well as a high quality massage 3-4 days later.
posted by potrzebie at 7:22 PM on October 13

When I had a muscle spasm in my lower back, I spent a couple days in bed with heating pads and it didn't seem to do any good. I was barely functional- I couldn't even open heavy doors.

What fixed me was going to a friend who does myofascial release. She basically got into the area that was spasming and was able to release the muscle through careful application of pressure. I don't know exactly what technique she was using, but she's certified in myofascial release so if there's someone similarly expert in that local to you I would really consider trying to get an appointment. It worked way, way better than I expected- one appointment and I was, if not back to normal, functional and beginning to heal. It was like magic.

I'm not sure what the other options are for this sort of hands-on work for back spasms, but I can testify that it can absolutely work.
posted by BungaDunga at 8:07 PM on October 13

I'm concerned because discussions online say Flexeril is supposed to sedate you and help relax your muscles. Unfortunately, that's not really the case for me; other than feeling somewhat more relaxed, my muscles are still very tight and stiff.

this is fairly normal for "muscle relaxants," which do not do what the name would lead you to believe. doesn't mean anything about the nature of your muscle spasms necessarily. a number of drugs in a number of different drug classes are called muscle relaxants, which is misleading to different degrees, and while the actual mechanisms are a little obscure to me, subjectively, when they "work" they work by relaxing you mentally so much that you unconsciously unclench what you cannot consciously relax, or by making you so heavy-feeling and drowsy that you fall asleep (and then you relax in the way that you do in sleep.) if you have certain kinds of pain, the only way to make it stop is to fall asleep, so muscle relaxants can be helpful in a way that even good painkillers are not. though you have to be careful with them for the same reasons.

you are basically being treated as if you have a spine injury. it's not usually helpful, but it's standard. if that makes you feel better. there's a lot of fairly useless shit you will be put through for several weeks and the main purpose of it is to keep you occupied while the problem mysteriously resolves itself. which I hope it does do, whatever the cause; the lower back has mysterious ways, so it may.
posted by queenofbithynia at 8:23 PM on October 13

These kinds of intense muscle spasms in the back take several days to resolve. Just keep doing what you’re doing. If you’re reluctant to take pain killers don’t be. That kind of pain makes you move reluctantly and awkwardly, tensing all kinds of other muscles, which doesn’t help you. So if pain killers help you stay more mobile/move more while the spasms settle down they are helping even if they don’t make you pain free.
posted by koahiatamadl at 11:51 AM on October 15

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