Deep Muscles Multifidus muscle atrophy associated with low back pain
Dysfunction in the lumbar multifidus muscles is strongly associated with low back pain. The dysfunction can be caused by inhibition of pain by the spine. The dysfunction frequently persists even after the pain has disappeared. Such persistence may help explain the high recurrence rates of low back pain. Persistent lumbar multifidus dysfunction is diagnosed by atrophic replacement of the multifidus with fat, as visualized by magnetic resonance imaging (MRI).
One way we support patients to us for a standing MRI is to provide advice on strategies about how to recruit and strengthen the lumbar multifidus muscles. For patients who have not responded to conservative care our advice can provide you with a better outcome.
The deep layer of paraspinal muscles, the Multifidus, are invariably innervated by only a single nerve root – the one below the spinous process from which they originate. Thus, if these muscles are sampled and are abnormal, the abnormalities are specific to the root (and level) supplying that muscle.The medial branch of the posterior division of the lumbar nerves run close to the articular process of the vertebrae and end in the multifidi muscle. The Multifidus spans three joint segments and stabilises these joints at each level.
Deep muscles of the back. (Multifidus shaded in red.)