Is the Multifidus the key to stopping chronic lumbar pain?
Scientists have recently discovered something very interesting about chronic, recurrent low back pain. One muscle tends to atrophy in people whose low back pain keeps coming back: the multifidus muscle. It appears to waste away from disuse, predisposing people to endless bouts of low back pain.
The multifidus muscle is the deepest muscle of the back. It is actually a series of tiny muscles that cross only 1-4 vertebral levels. This series of muscles is the main stabiliser of lumbar vertebral movement. It ensures that the sliding joints of the lower back move in a smooth stable fashion.
It is thought that during an episode of acute lower back pain, the brain sometimes switches the multifidus off (to protect the muscle from overuse or damage). But sometimes it never ‘turns back on again’ and instead wastes away. Without the stabilising effect of this muscle, back pain then tends to come back time and time again.
The level of atrophy of the muscle can be measured on MRI. Large parts of the muscle bulk turns into fat as they are no longer used. So, for people with chronic back pain, exercises to stimulate, activate, and strengthen the multifidus can help to end this endless cycle.
How to activate your multifidus muscle
Simply using a percussion massage gun on the lumbar area of the multifidus can help to remind the brain to use this muscle again. But research indicates that a simple Bird Dog is one of the best exercises. A full Bird Dog would be too much for someone in a lot of lumbar pain, so doing a progression of exercises to slowly use the muscle again is the key. You can start in the ‘table top’ (or ‘four point’) position and simply raise one knee off the ground, hold it for 5-10 seconds and repeat several times.
Over time, as the pain reduces, you can start to raise the leg further and further until it reaches the horizontal position of a full Bird Dog. Research has shown that it is the hold (maintaining the position) of the raised leg that produces the greatest benefit… but build it up slowly!
Check out this video with other lower back pain exercises.