PM&R
Volume 2, Issue 2 , Pages 142-146, February 2010

The Role of the Lumbar Multifidus in Chronic Low Back Pain: A Review

  • Michael D. Freeman, PhD, MPH, DC

      Affiliations

    • Department of Public Health and Preventive Medicine, Oregon Health and Science University School of Medicine 1234 SW 18th Ave, Portland, OR 97205†
    • Corresponding Author InformationAddress correspondence to: M.F.
    • ,
  • Mark A. Woodham, DC

      Affiliations

    • Private practice, Tacoma, WA‡
    • ,
  • Andrew W. Woodham, BA

      Affiliations

    • Department of Genetic, Molecular, and Cellular Biology, University of Southern California, Los Angeles, CA§

Received 15 May 2009; accepted 19 November 2009.

Low back pain (LBP), a highly prevalent problem in society, is often a recurrent condition. Recent advances in the understanding of the biomechanics of LBP have highlighted the importance of muscular stabilization of the “neutral zone” range of motion in the low back. The lumbar multifidus muscles (LMM) are important stabilizers of this neutral zone, and dysfunction in these muscles is strongly associated with LBP. The dysfunction is a result of pain inhibition from the spine, and it tends to continue even after the pain has resolved, likely contributing to the high recurrence rate of LBP. Persisting LMM dysfunction is identified by atrophic replacement of multifidus muscle with fat, a condition that is best seen on magnetic resonance imaging. Muscle training directed at teaching patients to activate their LMM is an important feature of any clinical approach to the LBP patient with demonstrated LMM dysfunction or atrophy.

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  • † Disclosure: nothing to disclose
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: nothing to disclose

 This CME activity is designated for 1.0 AMA PRA Category 1 Credit™ and can be completed online at me.aapmr.org. Log on to www.me.aapmr.org, go to Lifelong Learning (CME) and select Journal-based CME from the drop down menu. This activity is FREE to AAPM&R members and $25 for non-members.

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)01585-8

doi:10.1016/j.pmrj.2009.11.006

PM&R
Volume 2, Issue 2 , Pages 142-146, February 2010

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