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Forum Name: Rheumatology Topics

Question: strange back cramping


 Almost51 - Wed Nov 12, 2008 2:30 pm

For the past couple of years and only on a few occasions (possibly only 5 or 6) I have had a very strange cramp that comes on--usually in the middle of the night and wakes me up. It usually is in the upper middle of my back deep inside, such as in my bones and extends outward to only the shoulder blades - however it's mostly in the center and on my right side. It has never gone around to the front and has never caused shortness of breath, racing heart or palpitations, and no angina or chest pains. It happened once when I was driving and lasted, as in the nighttime episodes, for several minutes (approximately 5 minutes) and then goes away. This is very unnerving each time it happens. Any suggestions on what it may be? Please help!!!
 Tom Plamondon PA-C - Fri Nov 14, 2008 1:18 pm

User avatar Sudden back pain that wakens a person (especially an older person >50y.o.) in the middle of the night may be a warning sign of serious malady or disease in the spine or chest (given the middle back location). Serious conditions include spinal tumor, spinal compression fracture, multiple myeloma, aortic aneurym, ischemia (lack of blood supply) to the heart...as well as pathology of the lungs.

A thorough history and physical f/b a CT scan would be my first step ...as well as cardiac workup (e.g. EKG or stress EKG or echocardiogram).

The end result may be the evaluation is negative and the cause is a simple muscle strain or bone mal-aligned fixable with chiropractic or physical therapy but more serious causes must be ruled out first.
 Almost51 - Fri Nov 14, 2008 8:54 pm

Thank you very much for your quick reply! To give you more insight, one week ago I had an allergic reaction to MSG and ended up in the ER. When I was giving my medical history to him, I told the ER doctor about the occasional back cramp that I described to you. I have occasional heart palpitations that started about 10 years ago, and that was when I got diagnosed with MVP. After giving all my medical history, the ER doctor ordered an EKG, X-rays and a blood workup that he said would determine if I was having, or had ever had, a heart attack. He also ordered my cholesterol and hormones checked. All of the tests came back in his exact word "perfect". My total cholesterol was 162, (which was even lower than in August when it was at 173). The good cholesterol is high, the bad is low and triglycerides are also on the low side. My BP usually averages 108/64. After the tests finally came back they sent me home. Also, about 10 years ago I was in a car accident. After 6 months I had an MRI which showed degenerative changes at multiple levels (C3-C6) including multiple ruptured and bulging discs, foraminal narrowing and C6-5 spondylolis with degenerative disc disease. Could this cramp possibly be related to the car accident problems?
 Tom Plamondon PA-C - Wed Nov 19, 2008 6:46 pm

User avatar Non fracture Injuries of the spine (especially whiplash injury) are notorious for lingering pain. 10 years would be a quite a stretch of time to say that the pain is a direct result of the MVA; however, if the ligaments or non contractile soft tissue of the spinal column were sprained during the accident, the back may be more prone to injury down the road. The principle is similar to an ankle sprain - once the ligaments are overstretched/damaged the ankle is prone to another sprain. This is why rehab is important.
I would consult an experienced orthopedic physical therapist. Your family physician can write the order.
 Almost51 - Fri May 01, 2009 5:15 pm

Hello, and thanks for being there for us! A few mornings ago - 30 minutes or so after waking up - I had another cramping up of my back. I was sitting at my computer (as I usually do most mornings) and my back muscles from midpoint up through my neck, and from side to side - including my jaw muscles - began to cramp up. I thought it was because I may have been sitting wrong, so I got up, stretched, walked around, stretched more, walked around more, but with no improvement. I finally went and lay down flat on my stomach. After about 10 minutes the cramping finally subsided. This time it was not the deep pain as I had described in my prior post from November, but seemed to "lock" my entire middle and upper back (muscle-wise), and actually felt like a very similar pain as with the deep interior pain described in my previous post. I took my blood pressure and it was 119/82, with no shortness of breath, heart palpitations, no squeezing feelings or anything of that nature, just scarey! Don't know if this would be related, but after this episode, I started my period (for the second time within a month) with significant bleeding. I would really appreciate any thoughts you may have as to what could be causing these strange back cramps every few months. Thank you in advance!
 Tom Plamondon PA-C - Wed May 06, 2009 9:38 pm

User avatar Hello,

Isolated neck muscles spasms: I would check the neck clinically with exam of range of motion, palpation, and posture. And a neck xray to look at the bony structures.

Underlying joint or ligament inflammation in the spine can elicit muscle spasms as you described.

Take care.
 DrJanJan - Thu Jul 08, 2010 8:56 am

I am experiencing similar symptoms as the previous individual. When I roll over, while trying to go to sleep, my mid-back/side cramps up. This cramp often includes my upper back. My feet and legs constantly get cramps in them, especially while sleeping, but also during the day.

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