Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
The multifidus muscle plays an important role in the static and dynamic stability of the spine, so that a weakness of this muscle would be associated with low back pain.
What is the multifidus muscle, and what is its exact role? How is it related to back pain? This article explains everything you need to know about this spine stabilizer.
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Definition and anatomy
The multifidus muscle is part of the deep muscles of the back which, together with the longissimus and theiliocostal, allow extension of the spine.
It runs vertically the full length of the spine, since cervical spine until Lumbar spine where it is more developed. It is often divided into sections: cervical multifidus, dorsal multifidus and lumbar multifidus. More precisely, it begins at the level of the vertebrate C4 and attaches to the sacrum.
Role
When it contracts bilaterally (on either side of the column), it allows extension of the spine.
Its unilateral contraction allows a lateral inclination on the same side and a contralateral rotation of the column (for example, the right multifidus allows a rightward inclination and a leftward rotation of the trunk).
Link to back pain
Along with the transverse abdominis muscle and the pelvic floor muscles, the multifidus is an important stabilizer of the lumbar region. This protects the spine, and minimizes excessive movement of the vertebrae which could lead to degeneration et osteoarthritis.
Scientific studies showed that low back pain subjects, particularly those with chronic pain, exhibited reduced multifidus muscle activity compared to healthy subjects during the performance of certain exercises.
This could be explained by the fact that pain causes muscle avoidance and deconditioning, which can lead to weakness (especially of the multifold) and an increased risk of back injury.
Clinical implication
The multifidus muscle is worked regularly as part of a lumbar stabilization and sheathing program aimed at reducing lumbar pain and preventing recurrence of injury.
It is also the site of several manual treatments (massage, suction cups, acupuncture). A study has also shown that stimulation of the multifidus muscle by superficial needles potentiated the contraction of the transverse abdominis muscle, another muscle considered important in the treatment of low back pain.
Exercices
Here are exercises aimed at recruiting the multifidus muscles which are regularly prescribed by the physiotherapists :
Lie on your side with your spine in a neutral position.
Locate the multifidus muscle, on either side of the spinous processes (bony prominences in the center of the spine).
Take a deep breath. On the exhale, contract the multifidus muscle by imagining a line that connects the two posterior superior liliac spines. There should be no real movement of the hips, pelvis or spine. The contraction of the multifidus muscle should only be felt under your fingertips, as a slight pressure.
Hold the contraction for 3-5 seconds, and repeat 20 times with pauses as needed.
Once you are able to isolate and contract your multifidus muscle, you can practice contracting in various positions (sitting, standing, leaning, etc.). You can also progress with arm or leg movements to make the muscle activation more "functional".
Source
Goubert D, Van Oosterwijck J, Meeus M, Danneels L. Structural changes of lumbar muscles in non-specific low back pain. Pain physician. 2016;19(7):E985-99.
Anas Boukas( Physiotherapist, physiotherapist, consultant )
My name is Anas Boukas and I am a physiotherapist. My mission ? Helping people who are suffering before their pain worsens and becomes chronic. I am also of the opinion that an educated patient greatly increases their chances of recovery. This is why I created Healthforall Group, a network of medical sites, in association with several health professionals.
