Back pain is a common complaint.
The Australian Institute of Health and Welfare report that in 2017-18 up to 38% of Australians had back pain that at least moderately interfered with their daily lives.
The causes of back pain are diverse – strained muscles, injury, structural problems, and improper posture, to name a few.
Dysfunction in the multifidus muscle is one of the most overlooked causes of back pain.
In fact, many people have never even heard of the multifidus muscle, but this deep core muscle is essential to the strength and stability of your spine.
Here we will shed some light on the multifidus muscle, outlining the symptoms of a multifidus issue, how it is diagnosed and how the team at The Brisbane Spine Clinic can help.
What is the multifidus
The multifidus muscle is the innermost layer of muscle in your back. Known as the deep layer it’s responsible for the movement of the spine, allowing your back to extend when reaching, bending, or stretching. It works together with the transverse abdominous and pelvic floor muscles to give stability to the spine.
A thin muscle, running down both sides of the spine, the multifidus attaches at every vertebra, meaning it’s involved with the stability and health of the spine at every vertebral joint.
Because the multifidus muscle helps your spine to stay stable, weakening of this muscle – from immobility, an inactive lifestyle, or pre-existing conditions- gives less support to each vertebra in the spine, causing instability and often chronic lower back pain.
This weakening may cause important muscle tissue to waste away and be replaced with fat. In medical terms, this is known as the deconditioning of the multifidus muscle.
The increase in fat in your multifidus has been linked to higher levels of inflammatory chemicals in the body.
Image sourced from Google Images.
Symptoms of a multifidus muscle issue
Deconditioning of the multifidus is a problem because the loss of muscle mass often results in issues of the lower back and core beyond just pain. Other symptoms can include:
- Tightness
- Asymmetry
- Instability of the spine/trunk
- Herniated discs (bulging/slipped disks)
- Nerve entrapment (pinched nerve)
- Referred Pain (when pain coming from spinal nerves goes to other areas in the body)
- Poor posture
- Over-compensation in secondary stabiliser muscles
- Poor quality movement and hip/back movement patterns
- Osteoarthritis
- Osteophytes (bone spurs)
If you have weak abdominal or pelvic floor muscles, as well as a weak multifidus muscle, your whole core could be compromised. In this case, the chance of low back pain or injury could be increased.
How is a multifidus issue identified?
An MRI provides an amazing amount of info including; what your multifidus is doing, how much muscle you’ve lost, and how we can approach rehabilitation and recovery.
MRI scans that show the level of deconditioning, weakening, and fattening in the multifidus can be used to grade you and understand the level of remedial exercise and strengthening necessary and specific to your case. Essentially, this means that you will receive a treatment program individualised to your needs.
Once the cause is identified, our approach to the treatment of a deconditioned muscle is a well-planned strengthening and rehabilitation process depending on the level of deconditioning and the symptoms caused.
How can The Brisbane Spine Clinic help
Exercise and activity are great for preventing multifidus muscle pain symptoms. Atrophy and degeneration might be real risks as you get older, but they’re not set in stone. Exercise can reduce your risk and strengthen the multifidus before it becomes a problem.
If pain is present, seeking treatment from a qualified spinal consultant like the team at The Brisbane Spine Clinic could help. We aim to provide a greater degree of control by returning to healthier levels of muscle mass in the region.
Our physiotherapy focuses on training the spinal erectors, and the multifidus in particular, as part of integrated movement. Our goal is to increase the strength in your back.
Multifidus degeneration is often overlooked but once identified, we can categorise the severity of the problem and determine how to deal with it. Our goal is to give you the best chance to recover and rehabilitate.
If you are dealing with back pain, call us at 07 3841 3070 or book an appointment online for one of our Spine Special Consults, and we can help identify the true cause of your back pain and the steps required to treat it.
References
Australian Institute of Health and Welfare. (2020). Back Problems.
https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/about
Gökşen, A., Kocaman, H., Merve Arman, G., & Lütfi Selçuk, M. (2022). Comprehensive analysis of muscles wasting in disc herniation. Journal of Biomechanics, 145, 111391. https://doi.org/10.1016/j.jbiomech.2022.111391
James, G., Chen, X., Diwan, A. et al. (2021). Fat infiltration in the multifidus muscle is related to
inflammatory cytokine expression in the muscle and epidural adipose tissue in individuals undergoing surgery for intervertebral disc herniation. European Spine Journal. (30) 837–845. https://doi.org/10.1007/s00586-020-06514-
Physiopedia. (2022). Lumbar Multifidus. https://www.physio-pedia.com/Lumbar_Multifidus
