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Carson Robertson
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Muscles and Back Pain

Back pain and spinal joint pain have an interesting relationship. In some cases we see musclespasms and guarding that prevent any type of movements. Other times we see weakness around muscles and joint complexes that affect its normal movements. When muscles are not functioning as they should they leave the joints in a vulnerable position, makingit easier for the area to become injured.

You may have had a friend describe a situation where they bent down to get a sock off the ground and felt their back slip, and then began experiencing severe pain. It was not the weight of the sock that caused the injury, but the inability of the low back muscles to stabilize the spine. The slipping joints and abnormal movement created a severe back sprain.

Exactly what happens around the spine is still being studied. At certain times we see muscle hypertonicityor increase in muscle tension in an injured region. Other times we see atrophy or muscle weakness. The multifidusmuscle is a major back extensor that controls many of our movements. This is a muscle that tends to show atrophy with chronic injuries. This means that people with chronic back pain tend to loose strength in one of the biggest and strongest muscles that control low back extension. The paraspinalmuscles run along the spine that control extension and movements of spinal joints. At times we can see hypertonicityor hypotonicityaround these regions. It is debated whether this is a response to the injured areaor a region above or below that segmental region.

Muscle hypertonicityor hypotonicityby itself may not be a great wayto identify joint dysfunction. It is probably just an indicatorof dysfunction in the region. By itself muscle hypertonicityorhypotonicityis not a definitive sign. Analyzing levels of pain, range of motion, strength, endurance, and functional muscle pattern activity gives indication of level of injury and future risk.

Studies will continue to evaluate the role muscles play in joint dysfunction. The research abstract is listed below.The following article discusses back pain and exercises for back pain. The abstract is below for your reading. More informationon low back pain and exercise videos for strength and endurance.

More information on therapeutic treatments utilizing Physical Therapy or Chiropractic can be directed to Google+.

Journal of Manipulative and Physiological Therapeutics

Volume 27, Issue 5 , Pages 348-357,June 2004

ParaspinalMuscles and Intervertebral Dysfunction: Part Two

Gary Fryer, BAppSc(Osteo), Tony Morris, PhD, Peter Gibbons, MB, BS, DO

Abstract

Background

One of the diagnostic characteristics of the manipulablespinal lesion—a musculoskeletal disturbance that is claimed to be detected with manual palpation and corrected with manipulation—is said to be altered segmental tissue texture. Little evidence for the nature of abnormal paraspinaltissue texture exists, but indirect evidence from experimental studies supports the plausibility of the concept of protective muscle spasm, although investigations of increased paraspinalelectromyography (EMG) associated with low back pain suggests complex changes in motor control rather than simple protective reflexes.

Objectives

To review the literature for evidence that may support or refute proposed explanations for clinically observed altered paraspinaltissue texture associated with the manipulablespinallesion. This review aims to highlight areas that require further research and make recommendations for future studies.

Data Source

MEDLINE and CINAHL databases were searched using various combinations of the keywords paraspinal, muscle, palpation, EMG, spine, low back pain, pain, myofascial, hardness, manipulation, reliability, and somatic dysfunction, along with searching the bibliographies of selected articles and textbooks.

Data Extraction

All relevant data were used.

Results

Decreased paraspinalmuscle activity and strength associated with low back pain is well established, and there is evidence of changes in muscle fiber composition and localized selective multifidusatrophy. Disturbances in microcirculation have been implicated in nonparaspinalmuscle pain. The effect of spinal manipulation on paraspinalEMG activity is inconclusive but promising.

Conclusion

Little direct evidence exists to support the existence or nature of paraspinaltissue texture change that is claimed to be detected with palpation. The proposal of segmental reflex paraspinalmuscle contractionwas not supported, at least in association with low back pain. There appears to be a complex relationship between deep paraspinalmuscle inhibition during dynamic activity and nonvoluntaryguarding behavior during static activity. The relationship betweenthese findings and palpable tissue change is speculative, but increased activity, decreased activity, or both may be responsible for paraspinaltissues detected as abnormal with palpation. Recommendations are outlined for future research. PubMed

© 2004 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.