Lower Back Pain

Strengthen Your Multifidus Muscles to Improve Spine Stability

Share

For individuals experiencing lower back pain can understanding the anatomy and function of the multifidus muscle help in injury prevention and in the development of a highly effective treatment plan?

Multifidus Muscle

The multifidus muscles are long and narrow on either side of the spinal column, which helps stabilize the lower region of the spine or lumbar spine. (Maryse Fortin, Luciana Gazzi Macedo 2013) Sitting too much, practicing unhealthy postures, and lack of movement can progress to the multifidus muscle weakening or atrophy, which can lead to spinal instability, vertebral compression, and back pain. (Paul W. Hodges, Lieven Danneels 2019)

Anatomy

Known as the deep layer, it is the innermost layer of the three muscle layers of the back and controls the movement of the spine. The other two layers, known as the intrinsic and superficial, are responsible for the thoracic cage/rib cage and shoulder movement. (Anouk Agten et al., 2020) The multifidus has attachment points at:

  • The thoracic spine of the middle back.
  • The lumbar spine of the lower back.
  • The iliac spine – the base of the wing-shaped iliac bone of the pelvis.
  • Sacrum – series of bones at the base of the spine connected to the tailbone.
  • When standing or moving, the multifidus muscle works with the transversus abdominus and pelvic floor muscles to stabilize the lumbar spine. (Christine Lynders 2019)

Muscle Function

The main function is to stabilize the lower back, but it also helps extend the lower spine whenever reaching or stretching. (Jennifer Padwal et al., 2020) Because the muscle has numerous attachment points and is serviced by a specific branch of nerves known as the posterior rami, it allows each vertebra to work individually and more efficiently.

  • This protects against spinal deterioration and the development of arthritis. (Jeffrey J Hebert et al., 2015)
  • The multifidus muscle works with two other deep muscle groups to stabilize and move the spine. (Jeffrey J Hebert et al., 2015)
  • The rotatores muscle enables unilateral rotation, turning from side to side, and bilateral extension or bending backward and forward.
  • The semispinalis muscle above the multifidus allows extension and rotation of the head, neck, and upper back.
  • The multifidus muscle ensures spinal strength because it has more attachment points to the spine than the other layers, which reduces spinal flexibility and rotation but increases strength and stability. (Anouk Agten et al., 2020)

Lower Back Pain

A weak multifidus muscle destabilizes the spine and provides less support to the vertebra. This adds pressure on muscles and connective tissues between and adjacent to the spinal column, increasing the risk of lower back pain symptoms. (Paul W. Hodges, Lieven Danneels 2019) The loss of muscle strength and stability can cause atrophy or wasting away. This can cause compression and other back problems. (Paul W. Hodges et al., 2015) Back problems associated with multifidus muscle deterioration include (Paul W. Hodges, Lieven Danneels 2019)

  • Herniated discs – also bulging or slipped discs.
  • Nerve entrapment or compression pinched nerve.
  • Sciatica
  • Referred pain – nerve pain originating from the spine felt in other areas.
  • Osteoarthritis – wear-and-tear arthritis
  • Spinal osteophytes – bone spurs
  • Weak abdominal or pelvic floor muscles can compromise the core, increasing the risk of chronic lower back pain and injury.

Individuals are recommended to consult a physical therapist and chiropractor who can help develop the appropriate treatment, rehabilitation, and strengthening plan based on age, injury, underlying conditions, and physical abilities.


Can Core Exercises Help with Back Pain?


References

Fortin, M., & Macedo, L. G. (2013). Multifidus and paraspinal muscle group cross-sectional areas of patients with low back pain and control patients: a systematic review with a focus on blinding. Physical therapy, 93(7), 873–888. doi.org/10.2522/ptj.20120457

Hodges, P. W., & Danneels, L. (2019). Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. The Journal of orthopaedic and sports physical therapy, 49(6), 464–476. doi.org/10.2519/jospt.2019.8827

Agten, A., Stevens, S., Verbrugghe, J., Eijnde, B. O., Timmermans, A., & Vandenabeele, F. (2020). The lumbar multifidus is characterised by larger type I muscle fibres compared to the erector spinae. Anatomy & cell biology, 53(2), 143–150. doi.org/10.5115/acb.20.009

Lynders C. (2019). The Critical Role of Development of the Transversus Abdominis in the Prevention and Treatment of Low Back Pain. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 15(3), 214–220. doi.org/10.1007/s11420-019-09717-8

Padwal, J., Berry, D. B., Hubbard, J. C., Zlomislic, V., Allen, R. T., Garfin, S. R., Ward, S. R., & Shahidi, B. (2020). Regional differences between superficial and deep lumbar multifidus in patients with chronic lumbar spine pathology. BMC musculoskeletal disorders, 21(1), 764. doi.org/10.1186/s12891-020-03791-4

Hebert, J. J., Koppenhaver, S. L., Teyhen, D. S., Walker, B. F., & Fritz, J. M. (2015). The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test. The spine journal : official journal of the North American Spine Society, 15(6), 1196–1202. doi.org/10.1016/j.spinee.2013.08.056

Hodges, P. W., James, G., Blomster, L., Hall, L., Schmid, A., Shu, C., Little, C., & Melrose, J. (2015). Multifidus Muscle Changes After Back Injury Are Characterized by Structural Remodeling of Muscle, Adipose and Connective Tissue, but Not Muscle Atrophy: Molecular and Morphological Evidence. Spine, 40(14), 1057–1071. doi.org/10.1097/BRS.0000000000000972

Post Disclaimer

Professional Scope of Practice *

The information herein on "Strengthen Your Multifidus Muscles to Improve Spine Stability" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.

Blog Information & Scope Discussions

Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.

We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.

Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*

Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.

We are here to help you and your family.

Blessings

Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Texas DC License # TX5807, New Mexico DC License # NM-DC2182

Licensed as a Registered Nurse (RN*) in Florida
Florida License RN License # RN9617241 (Control No. 3558029)
Compact Status: Multi-State License: Authorized to Practice in 40 States*

Presently Matriculated: ICHS: MSN* FNP (Family Nurse Practitioner Program)

Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
My Digital Business Card

Recent Posts

Correcting Your Sitting Posture for a Pain-Free Back

For individuals who sit at work for long hours, can years of practicing unhealthy posture… Read More

May 29, 2024

Trafficking Recognition in Chiropractic Clinics: A Clinical Approach (Part 1)

How do healthcare professionals provide a clinical approach to recognizing trafficking to individuals seeking a… Read More

May 29, 2024

Unlocking the Secrets of Tonic Water: Health Benefits and More

Can incorporating tonic water benefit individuals who want to drink more water? Tonic Water Tonic… Read More

May 28, 2024

Mastering the Pilates Neutral Spine: Benefits and Technique

For individuals wanting to try Pilates for back pain and exercise, can learning how to… Read More

May 24, 2024

Maintaining Endurance: The Secret to Sustained Activity

Can increasing endurance help individuals who want to improve their physical abilities or extend the… Read More

May 23, 2024

The Role of Nucleus Pulposus in Spinal Shock Absorption

Can understanding the nucleus pulposus help in body positioning and prevention for individuals wanting to… Read More

May 22, 2024