Lumbar Muscle Dysfunction During Remission of Unilateral Recurrent Nonspecific Low-back Pain

Abstract

Lower T2-rest values have been suggested to correlate with a conversion of the multifidus' fiber typing toward the glycolytic muscle spectrum. Elevated T2 shifts correspond with increased levels of metabolic activity in the multifidus in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide evidence of concurrent alterations in the multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain free and functionally recovered.

The effect of experimental low back pain on lumbar muscle activity in people with a history of clinical low back pain: a muscle functional MRI study

“…The same study setup has been used to demonstrate preexisting dysfunctions in people in remission of recurrent LBP. Specifically, this population showed increased MF activity during trunk extension on both body sides and at multiple levels compared with healthy controls, while no changes were evident in ES or PS activity (D'Hooge et al 2013).…”

“…Compared with healthy controls, divergences in motor output during a variety of lumbar tasks (D'Hooge et al 2013;Jones et al 2012;Macdonald et al 2009Macdonald et al , 2010Macdonald et al , 2011 and in lumbar muscle structure (D'Hooge et al 2012;Hides et al 1996) were present subsequent to resolution of LBP. In addition, the cortical representation of specific lumbar muscles appeared to be reorganized (Tsao et al 2011), and changes at the proprioceptive level (Brumagne et al 2000) have been described, during remission of LBP.…”

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

“…There would seem to be at least two possible explanations for this. The first is that unequal restraint (MSI) could add to increased muscle metabolic demands during activities of daily living causing recurrent muscle pain [35]. The second may relate to the rapid accelerations associated with inadequate restraint at an injured level, which has been suggested to be a nociceptive pain generator producing a single point of pain.…”

Muscle Control and Non-specific Chronic Low Back Pain

“…Induced pain studies in humans confirm that local pain of the spinal column leads to reduction of neural drive to the adjacent MF, apparent on functional MRI 66 and ultrasound 67, 68. EMG studies of populations of patients with acute or chronic LBP show altered recruitment of the MF 69, 70 due to pain, pain avoidance, and deconditioning. Pain has been experimentally shown to reduce neural drive not only to the MF, but also the lumbar erector spinae muscles in both healthy volunteers and back pain patients 71.…”