Back Pain and the Multifidus

Physical Therapy for Back Pain

If you’ve ever had physical therapy for back pain, you know the “bird dog” exercise. The one where you kneel on all fours and extend opposite arm and leg. A superb exercise and one we use in the Studio frequently to prevent low back pain.

One of the muscles targeted in this exercise is the Multifidus. This group of muscles weaves itself up and down your back interlocking the vertebral bones that make up your spine. Each individual Multifidus muscle originates on the transverse processes of the vertebrae and inserts into the spinous processes spanning two to four vertebrae per muscle. These muscles help to rotate the spine and extend the spine against resistance.

Because the Multifidus muscle spans a small number of vertebrae, it can exert fine control over the spine, affecting individual vertebral bodies. Additionally, each muscle is innervated by only one level of the spinal cord. Each spinal nerve exits next to an intervertebral disc. This segmental innervation leaves the Multifidus open to easy injury as it depends on a single nerve supply with no back up. For instance, herniation or inflammation of an intervetebral disc can result in injury to an individual spinal nerve and segmental Multifidus dysfunction.

Each vertebral bone connects to the one above and below at the facet joint.

A capsule highly sensitive to painful stimuli surrounds this joint. Attached directly to the joint capsule is the Multifidus muscle. It functions, in part, to keep the capsule from getting caught in the joint space with movement. Dysfunction of the multifidus increases the risk of the capsule getting pinched and causing injury.

Understanding where your body is in space (proprioception) is important to moving safely without injury. The Multifidus functions, in part, to provide proprioceptive feedback on the spine to the brain. Dysfunction can result in aberrant movement patterns.

The Multifidus muscle is active standing still, bending forward, rotating, lifting and walking.

It is not active when side-bending or extending the back without resistance. You can feel your own Multifidus muscles by placing your fingertips on either side of the spinal column in the low back and gently leaning forward.

Providing two-thirds of the muscular contraction that protects the back, the Multifidus is a key player in good back health. Pilates exercise three times a week will help relieve low back pain and prevent future episodes. Always see your Physician before starting an exercise program.

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