Low back pain is on the increase, and affects as many as 84% of us. Persistent pain for more than 12 weeks can be defined as chronic low back pain, which is often multifactorial and challenging to treat. As many as 85% of patients with chronic lower back pain do not have a specific diagnosis for their symptoms through imaging and blood tests. Evidence suggests it influences lumbar motor control, alters brain function and structure, changes lumbar tactile acuity, decreases spinal mobility and compromises postural control (Hildebrandt, M., et al. 2017).
A subject of interest, is the presence of fatty infiltrate in muscles surrounding the lumbar spine, known as Multifidus. Multifidus muscles are important in providing segmental stability, and they function as dynamic stabilisers of the lumbar spine. In cases of those that suffer with chronic lower back pain, there is a high prevalence of fatty infiltrate in Multifidus muscles which is as a result of atrophy and pain inhibition. Metabolic or neuropathic mechanisms can also give rise to muscle degeneration.
It has been observed that those who suffer with chronic low back pain have an average of 23.6% of fatty infiltrate through the lumbar Multifidus muscles, in healthy subjects, as low as 14.5%. Fatty infiltrate has previously been thought to reduce lumbar spine support and impair movement, however, a recent study by Hildebrandt, M., et al. has shown it limits the flexibility of the lumbar spine than it affects the muscle function of the lower back. However, further investigation is required to reinforce or negate these findings.
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