The relationship between cross-sectional area of multifidus muscle and disability index in patients with chronic non-specific low back pain

Musculoskelet Sci Pract. 2019 Jul:42:1-5. doi: 10.1016/j.msksp.2019.03.005. Epub 2019 Mar 21.


Background: Nonspecific low back pain (NSLBP) is a common problem that may have an effect on the level of functional ability. Imaging techniques indicated the degeneration of multifidus muscles in patients with low back pain. But its relationship with disability in NSLBP is unclear.

Objective: To assess the relationship between changes in multifidus muscle morphology in MRI as paraclinical data with changes in the level of disability as clinical data in patients with CNLBP, whose MRI studies are normal. Moreover, the relationship between multifidus CSA and its thickness was determined.

Design: Cross-sectional study.

Methods: A total of 45 subjects with CNLBP participated in this study. Multifidus muscle thickness and cross-sectional area (CSA) for both sides in L4-L5 and L5-S1 levels were measured with MRI and Image J software. Level of disability was assessed with Roland-Morris disability index.

Results: There was no significant relationship between multifidus muscle's CSA or thickness variations among the L4-L5 and L5-S1 levels and disability index score. Furthermore, Pearson's test showed significant positive relationship between thickness and CSA of muscles (p˂0.05).

Conclusion: The relationship between lumbar multifidus Thickness and disability in CNLBP with normal MRI study, is not proven in this study. Multifidus muscle thickness in L4-L5 or L5-S1 level can be representative of its CSA in patients with CNLBP and normal MRI.

Keywords: Low back pain; MRI; Multifidus cross-sectional area; Multifidus thickness; Roland-Morris disability questionnaire.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Chronic Pain / physiopathology*
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Low Back Pain / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paraspinal Muscles / anatomy & histology*
  • Paraspinal Muscles / physiopathology*