Multifidus muscle

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Multifidus muscle
Multifidi.png
Deep muscles of the back. (Multifidus shaded in red.)
Gray96.png
Sacrum, dorsal surface. (Multifidus attachment outlined in red.)
Details
Origin Sacrum, erector spinae aponeurosis, PSIS, and iliac crest
Insertion Spinous process
Nerve Posterior branches
Actions Provides proprioceptive feedback and input due to high muscle spindle density; Bilateral backward extension, unilateral ipsilateral side-bending and contralateral rotation.
Identifiers
Latin musculus multifidus spinae
TA98 A04.3.02.202
TA2 2276
FMA 22827
Anatomical terms of muscle

The multifidus (multifidus spinae; pl.: multifidi) muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis. While very thin, the multifidus muscle plays an important role in stabilizing the joints within the spine. The multifidus is one of the transversospinales.

Contents

Located just superficially to the spine itself, the multifidus muscle spans three joint segments and works to stabilize these joints at each level.

The stiffness and stability makes each vertebra work more effectively, and reduces the degeneration of the joint structures caused by friction from normal physical activity.

These fasciculi arise:

Each fasciculus, passing obliquely upward and medially, is inserted into the whole length of the spinous process of one of the vertebræ above.

These fasciculi vary in length: the most superficial, the longest, pass from one vertebra to the third or fourth above; those next in order run from one vertebra to the second or third above; while the deepest connect two adjacent vertebrae.

The multifidus lies deep relative to the spinal erectors, transverse abdominis, abdominal internal oblique muscle and abdominal external oblique muscle.

Atrophy and association with low back pain

Dysfunction in the lumbar multifidus muscles is strongly associated with low back pain. The dysfunction can be caused by inhibition of pain by the spine. The dysfunction frequently persists even after the pain has disappeared. Such persistence may help explain the high recurrence rates of low back pain. Persistent lumbar multifidus dysfunction is diagnosed by atrophic replacement of the multifidus with fat, as visualized by magnetic resonance imaging or ultrasound. [1] [2] One way to help recruit and strengthen the lumbar multifidus muscles is by tensing the pelvic floor muscles for a few seconds "as if stopping urination midstream". [3]

Additional images

See also

Related Research Articles

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References

PD-icon.svgThis article incorporates text in the public domain from page 400 of the 20th edition of Gray's Anatomy (1918)

  1. Freeman, Michael D.; Woodham, Mark A.; Woodham, Andrew W. (2010-01-01). "The role of the lumbar multifidus in chronic low back pain: a review". PM&R. 2 (2): 142–6. doi:10.1016/j.pmrj.2009.11.006. PMID   20193941. S2CID   22246810.
  2. Woodham, Mark; Woodham, Andrew; Skeate, Joseph G.; Freeman, Michael (May 2014). "Long-term lumbar multifidus muscle atrophy changes documented with magnetic resonance imaging: a case series". Journal of Radiology Case Reports. 8 (5): 27–34. doi:10.3941/jrcr.v8i5.1401. ISSN   1943-0922. PMC   4242062 . PMID   25426227.
  3. Chad Starkey, ed. (2012). "Additional Spine and Torso Therapeutic Exercises". Athletic Training and Sports Medicine: An Integrated Approach. Jones & Bartlett Publishers – American Academy of Orthopedic Surgeons. p. 583. ISBN   978-0-7637-9609-9.