What Are Important Back Pain Muscles?

by Chris Centeno, MD /

back pain muscles

If you or a loved one suffers from chronic low back pain and you’ve never heard of the multifidus muscle before, now’s the time to learn about one of the most important back pain muscles. This remarkably important muscle that stabilizes your spine, goes largely ignored by most doctors and surgeons. New research sheds even more light on just how this muscle goes about it’s business of protecting your back from catastrophic failure.

Why is Spine Stability Important?

You have many muscles in your back. Most are there to hold you upright and to allow you to bend forward, to the side, rotate, or straighten up. Basically, most of them move the spine. But when your back “goes out”, it means that a different kind of stability muscle has failed to do it’s job.

Stability is a big deal in the spine. Think about it for a moment. Your back and neck are made up of a single column of vertebrae stacked like kids blocks, one on top of the other, 24 block high! Do you remember how hard it was to keep 10 or 15 blocks stacked without the whole thing crashing down, let alone 24?

To keep your vertebrae from falling apart, two systems are at play. One is passive and the other is active. The passive system which is made up of the ligaments, acts like duct tape to hold the blocks together. The active system is made up of stability muscles that keep the blocks aligned with micrometer precision as you move.

The stability muscles need to keep everythingmultifidus thumb lined up because important nerves travel through the vertebra bones including the spinal cord and nerve roots that power your body. When the stability muscles fail, these nerves can get pinched, leading to that “Oh S$%t” moment when your back goes out. Since the nerves also power the stability muscles, pissed off nerves turn this stability system off, leading to even more unstable havoc.

The Multifidus is the Major Spine Stability Player

Of all the spine stability muscles, the most important and best studied is the multifidus. This muscle lives at each level of the spine, stabilizing one vertebral block on another. While it’s very easy to observe this muscle on MRI scans as being smaller and weaker in patients with chronic low back pain, most radiologists and surgeons ignore it. Why? Certainly not because of the research, since there are tons of it showing that MRI evidence of atrophy of the muscle is bad news.

A new research study sheds some additional light on how the multifidus goes off line, and it turns out that all of this is pretty complex. The Canadian researchers looked at the muscle moving with ultrasound imaging and also measured brain activity with magnetic stimulation. What they found was that the maps of how we should activate various muscles that live in the brain for multifidus, were different for patients with chronic low back pain versus pain-free patients.

This is a really interesting finding, as most experts have believed that the loss of control of the multifidus muscles had more to do with irritated nerves or painful low back structures. Basically, a simple loop that when irritated or interfered with, shuts down the system. Now it appears the brain is also involved in why these muscles aren’t working.

The upshot? If you have chronic back pain and you’ve never before heard of the mutifidus, or had anyone determine whether yours is fried or healthy on your MRI, you should read our tutorial about how to read your back MRI for this issue. How can you fix the muscle if it’s damaged or weak? Surgery is not the answer, as most of those procedures kill off the muscle. Focusing on identifying what’s wrong with your back and treating those areas with regenerative injections (not steroids) is usually the best option.

To read more about how that works, see our page on treating back pain with platelets and stem cells.

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2 thoughts on “What Are Important Back Pain Muscles?

  1. Florence Aders

    Does Medicare cover this lrocedure

    1. Regenexx Team Post author

      Florence,
      No, Medicare does not cover these procedures.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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