The Muscle of Low Back Pain
When it comes to low back pain there isn’t a muscle that has been more thoroughly imaged, dissected and analyzed than the Multifidus.
The Multifidus muscles are a unique set of muscles that come in three sizes. The layer of Multifidus that are closest to the spine attach one vertebrae directly to the vertebrae above. The layer of Multifidus that lie on top of the deep layer attach one vertebrae to the vertebrae that is either 2 or 3 vertebrae above and the most superficial layer of Multifidus muscles attach from one vertebrae to a vertebrae that is 3 to 5 vertebrae above.
Why do these muscles attach in this way and span anywhere from 1 to 5 vertebrae?
Stabilization.
The Multifidus’s main purpose is to stabilize the spine. Due to its extensive connection from vertebrae to vertebrae and its short and thick composition it’s really good at doing this. The Multifidus is like every other muscle in the body. It is as strong as it needs to be, meaning that if we use it, it stays strong, if we don’t it gets weaker. For a muscle whose purpose is to stabilize the spine getting weaker means our risk of injury increases.
Multifidus Muscle
Due to the short and thick nature of the Multifidus muscles the muscles are able to create a large amount of force in a small area. This is important to note since individuals without low back pain have larger and more symmetrical/balanced Multifidus muscles in the lower back suggesting that we need these muscles to be well developed and balanced to keep us pain free.
Multifidus & Low Back Pain
Here is what the research has shown when it comes to low back pain and the Multifidus Muscles.
As Multifidus symmetry and strength increases the risk of injury and pain decreases. 1.
Dysfunction of the Multifidus muscle is caused by spinal pain inhibiting proper muscle activation. 2.
Individuals with chronic low back pain have significantly smaller Multifidus muscles compared to those with no pain. 3.
Any atrophy or injury to the Multifidus muscle is expected to compromise spinal function. 4.
Patients with acute (6 weeks) low back pain do not show asymmetry of Multifidus muscles but individuals with chronic one-sided low back pain show weakening of the Multifidus muscle on the side of pain. 5.
Why?
We now know that low back and the Multifidus muscle are closely related, but why?
First as noted above the Multifidus muscle is a stabilizer. When it is weak it increases the likelihood of the spine being unstable increasing the risk of injury and developing pain.
However, when we injure the spine, specifically the facets, the area that is injured sends signals to inhibit or stop the Multifidus muscle from working properly. This then leads to the Multifidus muscle getting weak, more instability and then a greater risk of injury.
If we do not engage the Multifidus muscle on a regular basis then there is no reason for it to stay strong. It then gets weaker, leading to instability, an increase risk of injury, pain and so on.
What Do We Do Now?
Move. If weakness of the Multifidus muscles increase our risk of instability, injury and pain that leaves us one option. Stop the inhibition of the Multifidus muscle by relieving the pain and then strengthen the Multifidus muscle. How do we strengthen the Multifidus Muscle? With the three exercises below.
Bird-Dogs
Dead-Bugs
Supermans
To see how to perform these movements click the video below.
Research has shown that performing these movements 2-3 times a week can help strengthen the Mulitifus Muscles and help decrease low back pain.