Fully Recovered from Your First Big Back Injury? Likely not…

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low back multifidus

Have you recovered from your first big back injury?  I see this story time and time again. A patient tells me that a few years ago they had a big back blow-up, usually during or after some activity. This was the first time that their low back was ever this severe and they needed to basically lay on the couch for a few days before they could do anything. It took weeks to fully recover, but then everything seemed fine. They had no low back pain until the blow-up happened that brought them into my office. So did they ever fully recover? The answer, based on the research, is likely no. Back in the 1990s, a smart group of researchers in Australia (really the home of some of the most advanced spinal research) figured out that patients after a first episode of major back pain had smaller key stabilizing muscles in their back (multifidus). These muscles are critical for protecting the spine. Now a new research study shows that even when these important low back muscles look OK on a routine MRI, they’re really not. This study used sophisticated functional MRI to look at the tissue specific properties in the back muscles of patients who had a first major episode of back pain. Even if they had no symptoms at one month, their low back multifidus muscles were different, indicating that they weren’t as active as in normal patients. The upshot? If you have an episode of severe low back pain and then your back feels fine, it’s probably never really OK until these muscles get fixed. For more information on how these muscles work, what they do, and how they can be helped, see our medical practice’s book, Orthopedics 2.0 2nd Edition.

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