The multifidus muscle is a deep spinal stabilizer located along the vertebrae from the cervical spine to the sacrum. It plays a critical role in maintaining posture, stabilizing the spine, and protecting against back injury during movement.
When the multifidus muscle becomes dysfunctional, weakened, or inhibited, it can lead to chronic low back pain, poor spinal stability, and increased risk of injury. Dysfunction is often overlooked and misattributed solely to disc or joint problems.
Common Causes of Multifidus Muscle Dysfunction
Acute or chronic low back injury
Nerve irritation or compression (especially lumbar medial branch nerves)
Prolonged inactivity or deconditioning
Post-surgical atrophy (after lumbar spine procedures)
Poor posture or repetitive strain
Chronic pain cycles that inhibit normal muscle activation
Spinal joint inflammation or arthritis (facet joints)
Over time, the muscle may atrophy and be replaced with fatty tissue, reducing its ability to stabilize the spine.
Symptoms of Multifidus Dysfunction
Chronic or recurring low back pain
Pain that worsens with standing, prolonged sitting, or bending
Feelings of spinal instability, “giving way,” or weakness
Poor posture or limited range of motion
Difficulty with core control or balance
Associated tightness or pain in surrounding muscles (e.g., paraspinals, glutes)
Conservative Treatment Options
Targeted Physical Therapy
Motor control retraining to reactivate the multifidus
Core strengthening with low-load stabilization exercises
Biofeedback-guided therapy to improve muscle activation
Postural training and functional movement rehabilitation
Exercise-Based Interventions
Quadruped leg lifts, bird dogs, and other spine-safe exercises
Pilates or clinical yoga focused on core control
Neuromuscular electrical stimulation (NMES) in some cases
Manual Therapy
Myofascial release, joint mobilization, and soft tissue work to reduce inhibition
Interventional Pain Management Options
When multifidus dysfunction is related to or worsened by nerve irritation or chronic joint inflammation, interventional treatments can help break the pain cycle and support muscle rehabilitation:
Medial Branch Nerve Block
Used to identify and treat facet joint pain, which can cause multifidus atrophy via nerve inhibition
Can reduce pain and allow more effective physical therapy
Radiofrequency Ablation (RFA)
Targets medial branch nerves to interrupt pain transmission
May be combined with physical therapy to support multifidus reactivation
ReActiv8® Neuromodulation Therapy
FDA-approved implantable device that delivers electrical stimulation to restore multifidus muscle control
Specifically designed for chronic mechanical low back pain with multifidus dysfunction
Ideal for patients who have failed conservative care but are not surgical candidates
Trigger Point Injections or Dry Needling
Address myofascial pain in surrounding musculature contributing to dysfunction
When to Seek Help
You should consult a specialist if you:
Have chronic low back pain that has not responded to traditional treatment
Experience recurrent flares, instability, or difficulty with core control
Have had spinal surgery and now feel weaker or less stable
Suspect muscle atrophy or loss of coordination in the lower back
Restore Strength and Stability with Targeted Multifidus Treatment
At Parkview Spine & Pain, we focus on restoring function from the inside out. Using advanced diagnostics, physical rehabilitation, and innovative technologies like ReActiv8®, RFA, and image-guided nerve blocks, we help patients retrain their spine’s natural stabilizers and return to pain-free movement.
👉 Schedule your consultation today to explore your personalized recovery plan for multifidus dysfunction and chronic low back pain.