It has been estimated that 100 million days of work are lost each year to lower back pain. It is also estimated that 4 out of 5 people will at some point in their life suffer from back pain. For some the pain will come on slowlyover months or even years and for others the pain comes quickly from an injury. Some may have only stiffness but then get sharp pains after picking up a pencil off the floor. As I go on in practice, I seem to be getting more “I don’t know what I did” responses to my “What happened?” question.
There are many reasons given for lower back pain. Your doctor may say you have degeneration, disc herniation, strain, arthritis, slipped disc, stenosis, pinched nerve…. From what I have seen in my 21+ years of practice one of the main underlying causes of lower back pain is weakness in the back and core (stomach) muscles.
In this technological society, people are sitting more than ever. I have had patients sit for 5+ hours without getting up and they do this day after day after day. Over time the muscles in the lower back and core start to weaken, the vertebra start to lose their motion and the disc and joints wear and tear. Now you have degeneration, arthritis, disc herniation…
Giving a person a diagnosis of arthritis or degneration takes away their control. They think there is nothing that they can do because they have a “condition”. They are told they will have to learn how to manage their pain. They will come to me and say “I have been told I have arthritis and there is nothing I can do. I am not sure why I am even here.” This saddens me as there is a lot they can do.
I always ask for a patient’s MRI if they have had one and I look for atrophy (muscle wasting) of the Multifidus. Based on many research articles I have read, multifidus atrophy is responsible for lower back pain more than disc herniations, more than arthritis and more than degeneration. Over 90% of my patients with chronic lower back pain have atrophy of the multifidus.
The multifidus is an extremely important muscle, actually a group of muscles. There are two layers, deep and superficial, that attach from bone to bone in the spine and are responsible for stability and suspension. Although this muscle is in your back it is part of the “core”. With initiation of movement the multifidus needs to activate/contract to protect your spine. It activates before your large prime movers activate. If this muscle is weak then there is no stability to the spine and you are at risk for wearing and tearing of the disc and joints. That explains how someone can bend over to pick up a pencil and go into spasm. The pencil wasn’t heavy enough to do anything, there just wasn’t any stability to the spine to protect it.
Weakness of the multifidus leads to lower back pain, muscle spasms, degeneration, disc herniations, arthritis and nerve irritation.
What does multifidus atrophy look like?
Stayed tuned to learn how to activate your multifidus and core.
Yours in Health!