The difference in multifidus muscle morphology and motor control in non-specific low back pain with clinical lumbar instability and healthy subjects: A case-control study.

BACKGROUND

Low back pain (LBP) with clinical lumbar instability (CLI) is considered a subgroup of back pain. Poor core stability function and/or lack of motor controls are thought to play a role in inappropriate inter-segmental movements and pain. There is no study investigating the changes in the lumbar multifidus muscle (LMM) morphology and motor control in this subgroup of patients.

OBJECTIVE

To assess motor control components and morphological changes of LMM in the patients suffering from chronic nonspecific low back pain (CNSLBP) with CLI.

DESIGN

Observational case-control study.

METHODS

Thirty-two patients suffering from (CNSLBP) with CLI and 32 healthy individuals were included. The muscle force element of lumbar motor control was assessed by using (the active straight-leg raise test, leg lowering test, and Trendelenburg test). Ultrasonography was used to assess changes in the LMM morphology.

RESULTS

There was a significant decrease in motor control (p = 0.0001), an increase in LMM fatty infiltration (p = 0.002), and a decrease in the thickness of LMM in patients suffering from CNSLBP during contraction (p = 0.006), during rest (p = 0.018). The cross-section area of the LMM showed no statistically significant differences during rest on the right and left sides (p = 0.827, 0.220 respectively) and contraction (p = 0.160, 0.278 respectively) between patients and healthy subjects.

CONCLUSION

Motor control and the morphology of LMM in patients with CNSLBP with CLI may provide insight into the mechanisms of underlying pain and their effect on muscle function and structure.