Jeff LangmaidFounder, The Evidence Based Chiropractor

The Importance of the Multifidus Muscle for Back Pain

18 Jul 2023 · 1 min

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Jeff Langmaid discusses the clinical importance of the lumbar multifidus muscle in back pain management. In this excerpt he describes an 'aha' moment from comparing axial MRI T2-weighted images where one patient's multifidus was markedly atrophied (bright on T2) versus another with dense dark muscle, using this to argue that severe multifidus wasting indicates deconditioning and the need for longer-term rehabilitation rather than quick fixes.

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I take really seriously the multifidus muscle. This was one of those aha moments in my career when I was looking at an axial view of an MRI and I saw comparing one patient to the other. I never looked at the multifidus with any sort of realistic thought, let's put it that way. And I saw one was completely atrophied, totally white on the T2 weighted image. The other one was dark, dark, dark. And it just was such a stark difference that. That it was like, how the heck does this person think they're gonna get well when they have absolutely none of the stabilizing musculature to get there? Or let me rephrase that. How the heck do they think after one visit they're gonna get well when they got a lot of work to do? They are so deconditioned that it just really clicked with me to say this is an opportunity to really be able to understand at a higher level what's going on with the patient and then be able to accurately describe that during my report of.