What is the Multifidus muscle and why stimulate it with ReActiv8 ?
The Multifidus muscle group is very unique. It lies deeply against the posterior aspect of your spinal column and has a unique function of spanning individual spinal segments, from one vertebra to the next adjacent vertebra. It is referred to as the intersegmental spinal stabiliser. If this muscle is poorly coordinated and poorly functioning along with being weak the spinal segments become unstable against each other, in particular during bending tasks. Two bones that are not moving correctly against one another will develop arthritis of that joint which is pathological and painful. Note that arthritis or degeneritis which means joint inflammation is distinct from arthrosis and degeneration which is a normal pain free aging processes not afflicted by inflammation. Movement Dysfunction transforms normal pain free ageing joints into painful ageing joints. If we eliminate the Movement Dysfunction we eliminate the inflammation and pain. Restoring activity and most importantly coordination of the Multifidus Muscle restores stability to the spinal joints.
The ReActiv8 Nsystem has a unique and specific goal of restoring activity and health to the Multifidus muscle. Daily activation of the Multifidus muscle is provided by electrical stimulation from the implanted “battery” (Pulse Generator). Combining this with complimentary and synergistic Movement Proficiency focused rehabilitation offers what I regard to be the most effective strategy developed to resolve Movement Dysfunction and Lumbar intersegmental Instability, resulting in significant and sustained improvement in Chronic Low Back Pain.
What does Movement Dysfunction and Multifidus atrophy look like clinically and radiologically (on MRI) ?
Clinicians who understand Movement Theory are quickly able to identify Movement Dysfunction. It is most recognisable when patients are performing relatively trivial bending tasks of daily living. Back pain patients often prefer to avoid inclining their lumbar spine opting to keep it more vertical and straight, allowing the knees to shift forward as they descend to perform a movement task.
They have a tendency to round the lumbar spine with bending as opposed to maintaining biomechanically proficient neutral lumbar lordosis (the gentle reverse curve in the low back). Instead of maximising hip centric rotation through the ball and socket hip joint designed for rotation, the bending task is shared with intra-lumbar flexion which is designed to act as a support strut for the torso, not a centre of rotation for bending.
A feedback loop is created where by Movement Dysfunction drives atrophy (wasting) of the Multifidus and Multifidus atrophy drives more Movement Dysfunction. The progressive changes are evident on MRI Imaging of the Lumbar spine where fatty tissue fills in the space where the healthy Multifidus normally resides.
How do you identify multifidus dysfunction?