Multifidus muscle dysfunction is associated with the multifidus muscle injury (MMI), which ultimately result in the low‐back pain. Increasing evidence shows that microRNAs (miRs) may be involved in multifidus muscle dysfunction. In this study, we tested the hypothesis that downregulation of let‐7b‐5p may inhibit the multifidus muscle dysfunction development and progression. The target prediction program and luciferase activity determination confirmed electron transfer flavoprotein alpha subunit (ETFA) as a direct target gene of let‐7b‐5p. To study the mechanisms and functions of let‐7b‐5p in relation to ETFA in MMI progression, we prepared rats with experimental MMI, and a lentivirus‐based packaging system was designed to upregulate expressions of let‐7b‐5p, and downregulate the expression of ETFA. ETFA was identified as a target gene of let‐7b‐5p. Older age, a longer duration of pain, and higher visual analog scale and Oswestry disability index scores for the patients with chronic low‐back pain were linked to a more severe degree of degenerative muscle atrophy and fatty infiltration. Increased expression of let‐7b‐5p and decreased expression of ETFA and vitamin D receptor (VDR) were positively correlated with multifidus muscle dysfunction. Downregulated let‐7b‐5p could inhibit infiltration of collagen fibers, reverse the ultrastructural changes of multifidus muscle, and induce the VDR expression, thereby repair the MMI. The results provided a potential basis for let‐7b‐5p that could support targeted intervention in multifidus muscle dysfunction. Collectively, this study confirmed that downregulation of let‐7b‐5p has a potential inhibitory effect on the development of the function of the musculus myocytes by upregulating ETFA.