Multifidus Spasms Elicited by Prolonged Lumbar Flexion

Williams, Mathew; Solomonow, Moshe; Zhou, Bing; Baratta, R.; Harris, Mitchel B.

doi:10.1097/00007632-200011150-00014

Cited by 71 publications

(45 citation statements)

References 25 publications

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“…There is evidence from humans and animal models, including ovine 58, porcine 59, 60, and feline 61 that induced local injury compromises neural drive to the MF, seen as changes in electrical activity on MF electromyography. Experimentally induced intervertebral disc degeneration in the cat induces pathophysiologic changes to the MF 62.…”

Section: Introductionmentioning

confidence: 99%

Muscle Control and Non-specific Chronic Low Back Pain

Russo¹,

Deckers

Eldabe

et al. 2018

Neuromodulation: Technology at the Neural Interface

129

118

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ObjectivesChronic low back pain (CLBP) is the most prevalent of the painful musculoskeletal conditions. CLBP is a heterogeneous condition with many causes and diagnoses, but there are few established therapies with strong evidence of effectiveness (or cost effectiveness). CLBP for which it is not possible to identify any specific cause is often referred to as non‐specific chronic LBP (NSCLBP). One type of NSCLBP is continuing and recurrent primarily nociceptive CLBP due to vertebral joint overload subsequent to functional instability of the lumbar spine. This condition may occur due to disruption of the motor control system to the key stabilizing muscles in the lumbar spine, particularly the lumbar multifidus muscle (MF).MethodsThis review presents the evidence for MF involvement in CLBP, mechanisms of action of disruption of control of the MF, and options for restoring control of the MF as a treatment for NSCLBP.ResultsImaging assessment of motor control dysfunction of the MF in individual patients is fraught with difficulty. MRI or ultrasound imaging techniques, while reliable, have limited diagnostic or predictive utility. For some patients, restoration of motor control to the MF with specific exercises can be effective, but population results are not persuasive since most patients are unable to voluntarily contract the MF and may be inhibited from doing so due to arthrogenic muscle inhibition.ConclusionsTargeting MF control with restorative neurostimulation promises a new treatment option.

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Section: Introductionmentioning

confidence: 99%

Muscle Control and Non-specific Chronic Low Back Pain

Russo¹,

Deckers

Eldabe

et al. 2018

Neuromodulation: Technology at the Neural Interface

129

118

View full text Add to dashboard Cite

show abstract

“…Ianuzzi et al [13] established scaling for size differences in cats versus humans for intervertebral angles, joint movements, yield points and torque limits, closing the gap for size differences. Williams et al, have [56] also shown that the physiological strain of cat supraspinous ligaments is nearly identical to that of humans [34] requiring no scaling conversion as it is expressed in percent elongation. Smit [44] and Wilke et al [54,55] also validated the use of quadruped spine as an appropriate model for a human spine.…”

Section: Discussionmentioning

confidence: 96%

“…The discs in the lumbar spine were also deformed, expanding in their dorsal aspects while narrowing in their ventral aspects during the flexion phase. Schematic diagram and X-ray verification of the elicited flexionextension are available in a previous report [56]. Overall, the neuromuscular response represents the reflexive activation from afferents in several lumbar viscoelastic components similar to those active during flexion-extension.…”

Section: Instrumentationmentioning

confidence: 90%

Motor control of lumbar instability following exposure to various cyclic load magnitudes

et al. 2009

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The motor control system may compensate for lumbar instability following cyclic work with differential response to load magnitude. In vivo felines were exposed to a cumulative 1 h of cyclic work at 0.25 Hz. One group exposed to light whereas the second to heavy load while recording lumbar displacement and multifidus EMG during work and in single test cycles over 7 h rest post-work. Significant laxity and reduced reflexive EMG activity were evident immediately post-work in both groups. EMG and laxity recovered over 7 h rest in the group exposed to light load whereas in the group exposed to heavy load, motor control compensation was triggered within 1-2 h postwork. The compensation was expressed by earlier and stronger muscular activation than in baseline. It is concluded that cyclic work is deleterious to spine stability immediately after work. Work with heavy loads elicits delayed motor control compensation whereas work with light loads leaves the spine unstable and exposed to injury for several hours. Overall, prolonged cyclic or repetitive work elicits a transient instability disorder, regardless of the load handled, exposing the individual to potential injury.

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“…Occupational risk factors for low back pain include forceful lifting, bending and twisting of the trunk, whole body vibration and heavy manual labor (Gerr and Mani, 2000), and prolonged flexion of the lumbar spine can cause low back pain and muscle spasms (Williams, et al 2000). We wish to examine the guidance of relaxation, analyze posture and motion, and examine the working environment with a self-help tool in order to find ways to make the job easier for staff nurses.…”

Section: Discussionmentioning

confidence: 99%

Consideration of Low Back Pain in Health and Welfare Workers.

Kai

2001

J Phys Ther Sci

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Abstract.Once low back pain (LBP) occurs, it is easily prolonged and may become a chronic problem. LBP is an occupational problem among nursing staff at welfare facilities, and we investigated LBP and related matters in nursing staff, who work in health and welfare facilities for the elderly and at a special nursing home. The results concerning staff with LBP and those without LBP were analyzed statistically. There were significant differences between staff with LBP and those without LBP in pain, physical tiredness, mental tiredness, and the physical condition of the pain. Result items without significant difference were stress on the job, master of the basic nursing techniques, and LBP as an occupational injury. Because there is no difference when considering the mastering basic nursing techniques, there is a possibility that many of the people with LBP are contributing to the injury unconsciously, due to improper posture and environment. Especially, the posture used in changing diapers was suggested to be closely related to the appearance of the disease of LBP.

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Multifidus Spasms Elicited by Prolonged Lumbar Flexion

Abstract: Prolonged flexion of the lumbar spine results in tension-relaxation and laxity of its viscoelastic structures, loss of reflexive muscular activity within 3 minutes and electromyogram spasms in the multifidus and other posterior muscles.

Cited by 71 publications

References 25 publications

Muscle Control and Non-specific Chronic Low Back Pain

Muscle Control and Non-specific Chronic Low Back Pain

Motor control of lumbar instability following exposure to various cyclic load magnitudes

Consideration of Low Back Pain in Health and Welfare Workers.

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