Trigger Points in Multifidus may be the cause of a high percentage of back pain, and may increase the chance of back injuries occurring.
The multifidus muscles help to take pressure off the vertebral discs so that our body weight can be well distributed along the spine. Additionally, the superficial muscle group keeps our spine straight while the deep muscle group contributes significantly to the stability of our spine. These two groups of multifidus muscles are recruited during many actions in our daily living, which includes bending backward, sideways and even turning our body to the sides.
A number of studies have shown that the multifidus muscles get activated before any action is carried out so to protect our spine from injury. Take for example when you are about to carry an item or before moving your arm, the mutifidus muscles will start contracting prior to the actual movement of the body and the arm so as to prepare the spine for the movement and prevent it from getting hurt.
What is known about the relationship between Multifidus and back pain?
Many studies have been carried out to identify the relationship between back pain and mutifidus. One such study was published in 2002 in the European Spine Journal. The objective of the study was to compare the level of back muscle activity in healthy controls and patients with low back pain during coordination, stabilisation and strength exercises.
Electromyographic activities of the multifidus muscles and the iliocostalis lumborum were measured when the subjects performed the exercises. The results showed that low back pain subjects, especially those with chronic pain, displayed significantly smaller multifidus muscle activity as compared to healthy subjects during the coordination exercises, indicating that over the long term, back pain patients have a reduced ability to voluntarily recruit the multifidus muscles in order to maintain a neutral spine position.
With strength exercises, subjects with chronic low back pain also had significantly lower multifidus muscle activity as compared to healthy subjects. Possible explanations for this finding could be due to pain, pain avoidance and de-conditioning leading to reduced multifidus activity. Hence, when multifidus function is poor, one may be more susceptible to back injuries.
Trigger Points and Mutifidus
Trigger points in these muscles may refer pain to the lower back, abdomen, and neck in accordance with well documented pain maps. It is likely that trigger points in these muscles create the inefficiency that leads to a large percentage of common lower back pain, especially postural related injuries.
Whilst stretching alone is unlikely to dissipate trigger points, it may help avoid them becoming active, and accelerate healing as part of a broader trigger point therapy treatment program.
Here is a simple stretch that anyone can do at home or at work, and which we often recommend, especially to office workers and long distance drivers.
Most importantly, as always, invest in a good manual therapist!
While sitting on a chair with your feet flat on the ground, look straight ahead and keep your body upright. Slowly bend to the left or right while reaching towards the ground with one hand. Do not bend forward.
MUSCLES BEING STRETCHED
Primary muscles: Quadratus lumborum. External and internal obliques.
Secondary muscles: Iliocostalis lumborum. Intertransversarii. Rotatores. Multifidus.
INJURY WHERE STRETCH MAY BE USEFUL
Lower back muscle strain. Lower back ligament sprain. Abdominal muscle strain (obliques).
ADDITIONAL INFORMATION FOR PERFORMING THIS STRETCH CORRECTLY
Do not lean forward or backward: concentrate on keeping your upper body straight.
This blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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