The Most Overlooked Source of Back Pain: Fatty Infiltration of the Multifidus

Your back hurts, and no one can figure out why. It can be incredibly frustrating when you've had x-rays, MRI's and more doctors visits than you care to remember.

Well, there is a very common source of back pain that is often overlooked. It's impossible to see on X-rays and often overlooked on MRI.

What is the most overlooked source of back pain?

Fatty infiltration of the multifidus. If you have a patient that has an MRI, first of all, take a look at those pictures. Don't just look at the report. Furthermore, take a good look at those axial slices when you go down to L4-L5-S1. You will see the multifidus in what I call it the channels or gutters directly posterior to the lamina. The multifidus there should look like a beautiful marble sized steak and then on the outside should be superficial fat, which is white. If you cannot tell the difference between what is the fat and what is the muscle tissue- then you have fatty infiltration of the multifidus.

This is very important because very few docs are talking to their patients about that right now. But if there is deconditioning and fatty infiltration of the musculature, it is going to result in needed more than one or two adjustments to get where they want to be. They are genuinely deconditioned, so it helps you set better expectations for your patients.

The pain occurs in this area because essentially they are unstable. Normal movement patterns will place a tremendous amount of stress and strain on the facets, discs, and all other supporting structures when the muscles are deconditioned. Those other structures aren't designed to handle the extra load and will often fail- thus resulting in pain.

This is also relevant information to know if that patient is exploring a surgical intervention such as a laminectomy or decompression. How well do you think that's going to hold together? Probably not very well.

One more questions, do you think spinal injections are miraculously going to take care of 50 years of degenerative change? I don't think so!

So, I would encourage you to be different, be better. A lot of physicians are not looking at those axial pictures, and if you are, you probably haven't checked out the integrity of the multifidus lately. I would encourage you to do so for next patient that comes in that has an MRI. Look at those actual pictures. Take a look at multifidus and see what you think about the integrity of the muscle and set a better expectation for the recovery of your patient. Your practice is where they should be if they have this challenge. Establishing proper motion with adjustments, gapping the facets, getting movement into the disc and improving the multifidus through exercise and rehab is typically a great start to a successful plan of care.

Looking for Neck and Back Pain Relief? Try adding Chiropractic!

If you visited a medical doctor for low back pain, you definitely want to consider adding chiropractic.

In 2012, Spine Journal released a research study where they found 73 percent of people who added chiropractic care to medical care had their pain much better or even completely gone. If you had medical care alone, you only had a 17 percent chance to get those same results.

Chiropractors are trained to work on your muscles (soft tissue), your spinal alignment and range of motion motion to help reduce pressure on the nerves that exit your spine. Also, chiropractic adjustments have been shown to decrease pain by stimulating your central nervous system and brain, without having to resort to taking dangerous drugs.

So if you're struggling with back pain and maybe you've gone to a medical doctor definitely consider adding chiropractic care. It is going to drastically increase the likelihood that you get the results you desire.

What is an Annular Tear and How Can You Find Relief?

Have you been told you have an annular tear on one of your spinal discs and it's causing you back pain? 

In this article, we'll explore what an annular tear is, how long it takes to heal, and what are some of the best treatment options.

Most commonly these tears can occur in the lumbar spine at L4-L5 and L5-S1, which is part of your low back or lumbar spine.

Annular Tear Causes

Annular tears happen to your spinal disc. The discs of your spine are located between the bones of vertebrae; like a sandwich. The discs are designed to act as small shock absorbers and disperse the impact or load of gravity as you move your body throughout the day. 

Every single segment of your spine moves a little bit in each directly- forward (flexion), backward (extension) and side to side (lateral bending and rotation). The cumulative result of each segment moving a little bit is our full range of motion! 

 But as we age and encounter injuries, sometimes small micro tears can happen on the outside of your spinal discs. Those outside rings of your spinal discs are called the annular fibrosis, and that's why a tear in that portion is called an annular tear. 

When annular tear happens, it does not mean that all the fluid inside your disc immediately gets push out. The inside portion of the disc, called the nucleus pulposus is more like crab meat and less like water. 

Your discs are pretty tough but when a tear occurs it often results in immobilizing, debilitating pain. Many patients that I've spoken with just feel their back lock up when the tear happens, and they're unable to move. That can be really scary. But usually, after a few days, you can slowly get back to their normal patterns of life.

Annular Tear Treatment

Controlled careful motion actually helps heal your discs after a micro-tear happens. Medications or injections for torn discs can sometimes take away the pain, but they don't really promote actual healing. That's why conservative measures like chiropractic care, light exercise, and sometimes even light traction can be a great way to keep your spine mobile and improve your healing. 

Can a Chiropractic Adjustment Make You Stronger?

Did you know that a chiropractic adjustment doesn’t just help reduce your pain levels it enables you to get stronger? It’s true.

Researchers measured the electrical activity in the arms and legs before, during and after a chiropractic adjustment. What did they find? An increase in cortical drive post chiropractic adjustment. That’s science-speak for more strength.

Why it Matters:

Stronger is Better¦ better stamina, better balance, better coordination, better performance in every area of your life. What will you do with more strength?

• Your brain powers your movements and your strength through your nervous system
• Adjustments have been shown to increase your cortical drive, which helps make your stronger
• While one adjustment may not make you a champion powerlifter, this exciting new research is important for all of us who want to live an active lifestyle

Next Steps:

Pay attention. That’s right, consider being more mindful of where having more strength can be more positive in your life.

Science Source:

Impact of Spinal Manipulation on Cortical Drive to Upper and Lower Limb Muscles. Brain Sciences. 2017. 7,2

Solving the Opioid Crisis...with chiropractic?

Over the past few years, our country has been fighting one of the most deadly epidemics in history: addiction to prescription pain medications. What’s more, thanks to a pharmaceutical industry that has billions of dollars to spend on lobbying and advertising…t's been an uphill battle.

In the United States alone, over 300 million prescriptions for pain relievers are filled each year.

Many of the people filling those medications started taking them due to back pain, and until recently, prescribing pills has been the standard of medical care for acute pain. That’s why we have so many people addicted to painkillers, and it’s estimated that 2% of the population will eventually become addicted to these prescription painkillers.

There is a better, safer way; a way to find relief without becoming addicted to these dangerous medications.

New research shows that when Chiropractic care is added to standard medical care, over 73% of people have significant improvement or complete relief! What’s more, when people focus on correcting the cause of the problem and experience relief naturally, they don’t need to keep taking that higher and higher dose of medication to reduce their pain.

That’s why many healthcare organizations are looking towards Chiropractic care as a tremendous ally in the fight against prescription medication abuse and addiction.

•  Medications are no longer recommended as a first-line treatment for back pain.
• Over 73% of people who added Chiropractic to their medical care found significant or complete relief from back pain.
• Adjustments can help you address the cause of the pain, not just mask the symptoms.

Science Source:

Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain. SPINE Volume 38, Number 8, pp 627-634. @2013