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Use It or Lose It: The Multifidus

The back muscle you want to keep strong to avoid low back pain

Recent fMRI studies looked at the muscles of currently pain-free chronic low back pain sufferers and compared them to normals. Researchers looked at muscle tissue characteristics as well as the muscle recruitment of lumbar multifidus, erector spinae, quadratus lumborum, and psoas. Significant changes were only observed in the multifidus, a deep spinal muscle between individual vertebra that senses position and controls subtle patterns of spinal movement.

Their conclusion:  “These findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain-free and functionally recovered the low back.”

These findings support the commonly observed maxim: “Once a back problem, always a back problem.”

TAKEAWAY:  For those of us who treat low back pain (LBP), in addition to providing relief, it is imperative also to retrain subtle patterns of motion. For the acute, first-time episode LBP patient, the goal is not to become a chronic, recurring back pain patient. For the chronic recurrent low back pain patient, the goal is to restore and then maintain functional symmetry of subtle motion to continually engage deep multifidus muscle fibers in their patterns of motion.

In other words:  Keep moving WELL to keep moving WELL.

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D’hooge R, Cagnie B, Crombez G, Vanderstraeten G, Achten E, Danneels L. (2013 Mar 29). Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI. Clin J Pain. Retrieved from


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