Low back pain (LBP) is one of the leading causes of disability worldwide, affecting about 80% of the population at some point in their lifetime. Episodes of LBP generally resolve in a few weeks, however, up to 2/3 of patients experience a flare up within one year and about 15% will develop chronic low back pain (CLBP), defined as LBP lasting more than 3 months. CLBP is affected by a multitude of factors, including physical, emotional, cognitive, lifestyle, social, and behavioural factors. All of these must be considered as they will guide the assessment and treatment of the individual patient.
Two other important physical factors are structure and function of back muscles; particularly the lumbar multifidus and erector spine. The deep multifidus mainly provides compressive forces that are important for segmental control, while the superficial multifidus and erector spinae contribute to lumbar spine extension, and with asymmetric contraction, to side bending and rotation.
Emerging evidence suggests that changes in back muscle function and structure are time-dependent on a continuum from acute to chronic LBP. This suggests that different treatments would be required depending on the time point on the continuum a patient may occupy. We must also consider the large variability in the features of back muscle structure and function and how their role is likely to differ between individuals with back pain. As a result, interventions must always be based on a thorough examination which considers the specific presentation and the other multidimensional feature of CLBP.
The objective of this paper was to provide a state-of-the-art update on the features of back muscle structure and function in patients with CLBP.
RESEARCH REVIEW: The Role of Back Muscle Dysfunction in Chronic Low Back Pain
This paper was published in Journal of Clinical Medicine (2023)
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