The core connection: Why the Multifidus muscle is the most important immediate stabilizer of the spine

March 17, 2015

The Multifidus muscle is the most important stabilizer of your spine. Why do we know that? Well, we know that because as soon as we injure the spine, the multifidus muscle is the first to atrophy. It atrophies up to 25% in the first week of spinal injury, which is incredibly important as it is the primary stabilizer of the spine. It continues to increase to levels as much as 60% according to some research. It is innervated (under nervous system control) by the medial branch of the Dorsal Rami at each individual spinal level, which also control the facet joints of the spine. The atrophy is replaced with fatty infiltration of the muscle as the condition progresses into a more chronic condition, often visualized on MRI. As a provider, it is important to ask your radiologist for specific commenting on the fatty infilatration of the multifidus muscle.

Why is it so important to tell you about the nerve control over these muscles? For many reasons, but most importantly because this is the main site of corticosteroid injection and nerve blocks. But wait, wouldn't that cause atrophy of the multifidus level associated and therefore limit the primary stabilizing muscle of the vertebrae in that region? If you said YES, you're correct. That's why strengthening of this muscle, Chiropractic care and Physical Therapy is so imporant to to intervene as quickly as possible to limit atrophy. 

What are your best options? If the major cause of atrophy of the multifidus muscle is injury to the spine, then it would make the most sense to have that injury evaluated and treated with non-surgical/pharmaceutical intervention first to attempt to improve facet joint mobility and thus improve muscle tone of the multifidus muscle through activation of the medial branch of the dorsal ramus. Chiropractic adjustments are tremendously effective to restore this motion and improve the tone of the stabilizing muscles. Early intervention of Physical therapy and rehabilitation are important to reduce chronic changes and reduce fatty infiltration, limiting the further spread of dysfunction.

General core strenghtening and improving mobility of your spine are the most imporant ways to prevent weakening of this important muscle. Ask your provider what exercises would be appropriate for you and receive early intervention from your Chiropractor and/or Physical Therapist and keep moving.  At Portland Chiropractic Neurology, the only Chiropractic Neurology practice in the State of Maine, located here in Portland, we offer excellent rehabilitation to the Multifidus muscle group, along with many others. 

References:

1. Rapid Atrophy of the Lumbar Multifidus Follows Experimental Disc or Nerve Root Injury

Paul Hodges, PhD*, Allison Kaigle Holm, PhD†, Tommy Hansson, PhD†, Sten Holm, PhD†

Spine. 2006;31(25):2926-2933. 

2. The Lumbar Multifidus Muscles are Affected by Medial Branch Interventions for Facet Joint Syndrome: Potential Problems and Proposal of a Pericapsular Infiltration Technique