Tuesday, March 17, 2009

Multifidi and Low Back Pain


Everyone at some point or another will have low back pain. The statistics don't lie. 80% of Americans will experience it at some point and 90% of those will have repeated bouts. Low Back pain can have many, many causes. To many to go over in this blog post. But one that comes to mind is the paraspinal muscle dysfunction. Paraspinals refer to the rotatores and multifidi. They are small muscles that run from the sacrum up to C2. We're going to talk specifically about the multifidi around the lumbar spine. While the errector spinae will have more of a gross movement roll, big moves, big motions, the multifidi will have more of a segmental stability role. They have also been shown to have a large roll with proprioception. So when these muscles get tight and short they can compress the lumbars and create a facet hypomobility. If they become inhibited and weak they can lead to disc dysfunction.

So how can you tell if your tight or weak and inhibited? A short and tight multifidi will usually be present in and exaggerated lordosis. The lordosis will sometimes even be present when you bend forward. A weak, inhibited multifidi will often present with a bit of muscular atrophy. So more of a visual assessment. When there is weakness here, you won't have the ability to resist flexion/rotation and will have increased loading on the disc. Over time this can lead to disc symptoms like sciatica.

I usually see the tight short muscles first. Over time with increasing pain and lack of mobility at the segment that is locked. You will start to get atrophy of the multifidi and even some fatty penetration of the muscle fibers. So short, tight, local pain, becomes weak, inhibited radiating pain.

The good news is that joint mobilization has been shown to fascilitate the multifidi. A good chiropractor or manual therapist can work wonders and finally some proof!
http://www.jospt.org/issues/articleID.1303,type.2/article_detail.asp

After getting adjusted (mobilized), then you can start on some strengthening, rehab protocols. More on that later. Until then, if your having back pain, see if your in the short, tight category or the weak and inhibited one. So you know what to do about it!

1 comment:

Socialfuel said...

Recently, a business associate shared with me an intriguing story about someone with back pain...

Michelle Onoff is a successful yoga instructor. Yet for some reason, she suffered with lower back pain.

As a chiropractor, and someone in the healthcare field, I was fascinated by this.

I don't know about you, but I was under the impression that yoga instructors, given their active, stretch-filled, muscle-focused, posture-perfect profession and lifestyle, would be the LAST PEOPLE ON EARTH to experience back pain.

Actually, I was kind of shocked.

If a health-minded yoga instructor can be dealt a crippling back pain blow, what does this say about the rest of us?

Here's Michelle story in her own words. I think it'll inspire hope if you're suffering...

"I was feeling very weak in my core area. And I was having some radiating pain in my lower back.

And I was going to the doctors, and they were telling me things like you need to have disc replacement.

You need to have all these surgeries...

You need to be on these pain medications;

And they wanted to put me through a lot of surgical procedures...

I didn’t want to do ANY of that. But the pain was so bad... I needed some relief.

So I went to two neurosurgeons and I went to a back pain specialist...

The surgeons wanted to operate on me in different places...

… and the back pain specialist wanted to do various procedures, including implanting something permanent in my spine.

I’ve had four procedures that involved needles in my spine, epidurals in my spine and that only gave me a little bit of temporary relief for a couple days.

But it did not cure or really help anything.

It just put a band-aid on a pain for couple of days and that was it.

After my first session of Back Pain Relief4Life, I felt an opening in my back that I haven’t felt in a long time.

I felt stronger to my core and I felt that that radiating burning heat pain that I was feeling, seem to dissipate a little bit.

It seemed to just open up my back in general.

And then after my second session today, I noticed EVEN MORE the stretch in my lower back and more strengthening in muscles that had been weak that I think might help support my lower back.

I was VERY SKEPTICAL about doing Back Pain Relief4Life. Because, as I am a yoga instructor, I feel very knowledgeable in anatomy. And how to help people that come to me in pain.

But I was not aware of certain muscles that I was not using in the body that might help my lower back."

- Michelle Onoff

Here's the back pain program she's referring to:

==>Back Pain Relief 4 Life

I share this with you today because if you suffer from back pain (like 3/4 of the population), I'm told this pain relief program WORKS WONDERS.

People, in as little as 16 minutes, have experienced nothing less than total relief. Do nothing more than a specific sequence of 8 simple, pain-relieving movements.

Sounds incredible, but yet Michelle is a prime example.

See for yourself. Especially if you're being told surgery, needles and medication are in your immediate future.

==>Back Pain Relief 4 Life

You've got nothing to lose.

Rajinder Singh

PS: My personal takeaway? Michelle was humble to admit yoga wasn't working for her.

To me? That takes guts.

She was also smart enough to stay away from drugs and surgery when there were other more natural options.

But sometimes, one gets to the point where you'll try ANYTHING to get even a little bit of relief. If you're at that point, I encourage you to check out:

==>Back Pain Relief 4 Life