Reccurring low back pain (LBP) can be frustrating for both patients and physicians. LBP is extremely common in the population, with an estimated 80% experiencing low back pain sometime through out their lifetime. However, some studies imply that LBP recurrence is less extensive and affects between a third and half of LBP sufferers.
A group of researchers from the University of Queensland looked into why some people experienced a recurrence of their LBP while others didn’t. Their study demonstrated a link between recurrence LBP and altered muscle activity in the deep muscle fibers of the lumbar spine, in particularly the multifidus. This muscle is part of your core, runs along the length of your spine, takes some pressure off the vertebral disc and is extremely important in the stability of your back.
The multifidus muscle is activated even before any movement takes place, so as to protect the spine against injury from a sudden load of weight. A study that was published in the journal Pain in 2009, showed that the multifidus muscle exhibited later activation in those with recurrent low back pain than in the backs of healthy subjects. This can lead to possible problems, such as extra weight on the spine when it is not expecting it can lead to incorrect bending and rotating of the spine, increasing the likelihood of injury.
To take it one step further, the multifidus muscle itself is probably one of the largest contributors to spinal proprioception. Therefore, patients with a loss of proprioception are more likely to have a recurrence of LBP. According to O’Sullivan, “Proprioceptive deficit may lead to delayed neuromuscular protective reflexes and coordination such that muscle contraction occurs too late to protect the joint from excessive joint movement. It has been hypothesized that this may lead to abnormal loading transmitted repetitively across joint surfaces, resulting in pain and articular damage.”
It makes sense that retaining a well functioning and strong multifidus is one solution to preventing the occurrence of LBP. Chiropractors should be aiming to improve the function of the multifidus through rehabilitation exercises and give the patients the proprioceptive stimulation they need through adjustments.
Please call your Chiropractor at AHS on 9948 2826 or visit our clinic at 9/470 Sydney Rd in Balgowlah servicing the surrounding suburbs of Allambie, Balgowlah Heights, Seaforth, Fairlight and Manly on the Northern Beaches.
- O’Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, Quirke H.
Lumbar repositioning deficit in a specific low back pain population. SPINE 2003; 28 (1): 1074-1079
- MacDonald, D, Moseley, GL & Hodges, PW. (2009) Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain, 142(3): 183-188.