Getting to the Core of Back Pain

Are you training your core muscles and yet still have back pain? Many people work on strengthening their core muscles, which include the abdominal and deep low back muscles. The idea is to reduce back pain by using the core muscles to stabilize the spine. Researchers in the field of physical therapy may have a recommendation.

The results of this study show there may be another muscle involved. The psoas muscle (a hip flexor) may be just as important. When the size of the psoas muscle was measured from side to side, there was a decrease in the number of muscle fibers on the painful side.

Fifty patients between the ages of 18 and 65 years of age were included in this study. Everyone had back pain on one side (unilateral pain) lasting at least 12 weeks. MRI was used to measure the shape and size of two muscles: the psoas muscles and the multifidus muscles. (The multifidus muscles run along the back of the spinal column). Muscles on each side of the spine were compared.

A link was found between the amount of a patient's pain and the size of the muscles at the same spinal level. The researchers also found smaller muscle size at the levels above and below the painful area.

The authors conclude that the psoas muscle provides stability to the spine. When there's back pain on one side, the muscles on that side lose size and strength. The psoas muscle is sensitive to changes and should be trained along with the other core muscles.



References: Karen L. Barker, PhD, MCSP, et al. Changes in the Cross-Sectional Area of Multifidus and Psoas in Patients with Unilateral Back Pain: the Relationship to Pain and Disability. In Spine. November 15, 2004. Vol. 29. No. 22. Pp. E515-E519.