From the Guidelines
There is a significant association between multifidus muscle atrophy and facet joint syndrome occurrence, as evidenced by the complex interplay between spinal stability, muscle function, and joint health. The multifidus muscle plays a crucial role in stabilizing the spine during movement, and its atrophy or weakening can compromise spinal stability, increasing stress on the facet joints 1. When the facet joints become inflamed, irritated, or degenerated, it can lead to pain and dysfunction, characteristic of facet syndrome.
Key Points to Consider
- The multifidus muscle's role in spinal stability and its impact on facet joint health is well-established, with atrophy of this muscle potentially leading to increased stress on the facet joints.
- Facet syndrome can result from the inflammation, irritation, or degeneration of the facet joints, which may be exacerbated by multifidus muscle atrophy.
- The relationship between multifidus atrophy and facet joint problems is bidirectional, with each condition potentially contributing to the development or worsening of the other.
- Treatment approaches focusing on multifidus rehabilitation, such as specific stabilization exercises, may help manage facet syndrome by addressing both muscle atrophy and joint dysfunction simultaneously.
Clinical Implications
The association between multifidus muscle atrophy and facet joint syndrome occurrence has significant implications for the diagnosis and treatment of low back pain. Clinicians should consider the evaluation of multifidus muscle integrity as part of a comprehensive assessment for facet joint syndrome, given the potential for multifidus atrophy to contribute to the development or exacerbation of facet joint problems 1. Furthermore, treatment strategies that incorporate multifidus rehabilitation may offer improved outcomes for patients with facet syndrome by addressing the underlying muscle atrophy and joint dysfunction.
From the Research
Association between Multifidus Muscle Atrophy and Facet Joint Syndrome
- The relationship between degenerative zygapophysial joint (facet) arthropathy and multifidus muscle atrophy has been evaluated in several studies 2, 3, 4, 5.
- A study published in 2022 found that facet overhang is an independent risk factor for deep part of the multifidus atrophy in patients with degenerative lumbar spinal stenosis 2.
- Another study published in 2013 found that the splitting approach is an important cause of multifidus muscle injury and atrophy in posterior lumbar spine surgery, and denervation and disuse may be important factors in multifidus muscle atrophy 3.
- A study published in 2017 investigated the effect of stabilization of the degenerative segment on changes in the pattern of paraspinal muscle activity and found that stabilization itself can produce multifidus atrophy 4.
- A study published in 2021 found that unilateral multifidus injury with or without facet joint compressive clamping does not have a clear impact on the characteristics of surrounding spinal musculature within 28 days post-surgery in rats, and the impact of multifidus injury on facet joint degeneration is inconclusive 5.
Key Findings
- Facet overhang is associated with multifidus muscle atrophy 2.
- The splitting approach can cause multifidus muscle injury and atrophy 3.
- Stabilization of the degenerative segment can produce multifidus atrophy 4.
- Unilateral multifidus injury may not have a clear impact on surrounding spinal musculature or facet joint degeneration 5.
Relevant Studies
- 2: Facet overhang: A novel parameter in the pathophysiology of multifidus muscle atrophy.
- 3: Effect and possible mechanism of muscle-splitting approach on multifidus muscle injury and atrophy after posterior lumbar spine surgery.
- 4: Does stabilization of the degenerative lumbar spine itself produce multifidus atrophy?
- 5: Investigating how combined multifidus injury and facet joint compression influence changes in surrounding muscles and facet degeneration in the rat.