Related Experiment Video
Updated: Jun 17, 2026
06:28
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Selective changes in multifidus dimensions in patients with chronic low back pain
M J Stokes1, R G Cooper, G Morris
1Rheumatic Diseases Centre, University of Manchester, United Kingdom.
Summary
Low back pain patients show selective multifidus muscle changes, not generalized wasting. This suggests the multifidus muscle may adapt to stabilize the spine despite overall paraspinal muscle atrophy.
Area of Science:
- Spinal anatomy and biomechanics
- Musculoskeletal imaging
- Pain management
Background:
- Low back pain (LBP) with radicular symptoms is common.
- Paraspinal muscle atrophy is a known complication of LBP.
- The pattern of muscle wasting (generalized vs. selective) remains unclear.
Purpose of the Study:
- To investigate if paraspinal muscle wasting in patients with low back and unilateral radicular pain is generalized or selective.
- To compare the dimensions of multifidus and erector spinae muscles between symptomatic and asymptomatic sides.
Main Methods:
- Cross-sectional areas of paraspinal muscles (multifidus and erector spinae) were measured using computed tomographic (CT) lumbar spinal scans.
- Standardized transaxial views at the L4 vertebra level were used.
- 52 patients with recent (<18 months) or chronic (>18 months) LBP and radicular pain were included.
Main Results:
- Multifidus muscle dimensions were significantly larger on the side ipsilateral to the radicular pain.
- No significant difference was noted in erector spinae dimensions between sides.
- These selective changes were observed in both recent and chronic pain groups.
Conclusions:
- The findings indicate selective atrophy or adaptive changes in the multifidus muscle, rather than generalized paraspinal muscle wasting.
- These changes may represent an adaptive response of the multifidus to enhance lumbar spine stabilization.
- Further research is needed to understand the clinical implications of these selective muscle changes.
