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.

References 

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  2. Suni J, Rinne M, Natri A, Pasanen M, Parkkari J, Alaranta H. Control of the lumbar neutral zone decreases low back pain and improves self-evaluated work ability. Spine. 2006;31:E611–E620
  3. Von Korff M, Saunders K. The course of back pain in primary care. Spine. 1996;21:2833–2837
  4. Danneels L, Vanderstraeten G, Cambier D, et al. Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med. 2001;35:186–191
  5. Hides J, Stanton W, McMahon S, Sims K, Richardson C. Effect of stabilization training on multifidus muscle cross-sectional area among young elite-cricketers with low back pain. J Orthop Sports Phys Ther. 2008;38:101–108
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  7. Wilke H, Wolf S, Claes L, Arand M, Wiesend A. Stability of the lumbar spine with different muscle groups. Spine. 1995;20:192–198
  8. Ward S, Kim C, Eng C, et al. Architectural analysis and intraoperative measurements demonstrate the unique design of the multifidus muscle for the lumbar spine stability. J Bone Joint Surg. 2009;91:176–185
  9. Rosatelli AL, Ravichandiran K, Agur AM. Three-dimensional study of the musculotendinous architecture of lumbar multifidus and its functional implications. Clin Anat. 2008;21:539–546
  10. MacDonald D, Moseley G, Hodges P. The lumbar multifidus muscle: does the evidence support the clinical beliefs. Man Ther. 2006;11:254–263
  11. Macintosh J, Valencia F, Bogduk M, Munro R. The morphology of the lumbar multifidus. Clin Biomech. 1986;1:196–204
  12. Kjaer P, Bendix T, Sorensen J, Korsholm L, Leboeuf-Yde C. Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?. BMC Medicine. 2007;5:2
  13. Kader D, Wardlaw D, Smith F. Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clin Radiol. 2000;55:145–149
  14. Hides J, Stokes M, Saide M, Jull G, Cooper D. Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/ subacute low back pain. Spine. 1994;19:165–172
  15. Barker K, Shamley D, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain. Spine. 2004;29:E515–E519
  16. Danneels L, Vanderstraeten G, Cambier D, Witvrouw E, De Cuyper H. CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J. 2000;9:266–272
  17. Hides J, Richardson C, Jull G. Magnetic resonance imaging and ultrasonography of the lumbar multifidus muscle—comparison of two different modalities. Spine. 1995;20:54–58
  18. Indahl A, Kaigle A, Reikerås O, Holm S. Interaction between the porcine lumbar intervertebral disc, zygapophyseal joints, and paraspinal muscles. Spine. 1997;22:2834–2840
  19. Hodges P, Holm A, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine. 2006;31:2926–2933
  20. Hides J, Gilmore C, Stanton W, Bohlscheid E. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther. 2008;13:43–49Epub 2006 Oct 27
  21. Wallwork TL, Stanton WR, Freke M, Hides JA. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Man Ther. 2009;14:496–500Epub 2008 Nov 21
  22. Van K, Hides J, Richardson C. The use of real-time ultrasound imaging of lumbar multifidus muscle contraction in healthy subjects. J Orthop Sports Ther. 2006;36:920–925
  23. Sung P. Multifidus muscle median frequency before and after spinal stabilization exercises. Arch Phys Med Rehabil. 2003;84:1313–1318
  24. Hides J, Richardson C, Jull G. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine. 1996;21:2763–2769
  25. MacDonald D, Moseley G, Hodges P. Why do some patients keep hurting their back? (Evidence of ongoing back muscle dysfunction during remission from recurrent back pain). Pain. 2009;142:183–188

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 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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