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Lumbar multifidus muscle morphology is associated with low back-related pain duration, disability, and leg pain: A cross-sectional study in secondary care
Journal article   Open access   Peer reviewed

Lumbar multifidus muscle morphology is associated with low back-related pain duration, disability, and leg pain: A cross-sectional study in secondary care

Jeffrey Cooley, Per Kjaer, Tue Jensen, Angela Jacques, Jean Theroux and Jeffrey Hebert
PloS one, Vol.18(6), e0285993
2023
DOI: https://doi.org/10.1371/journal.pone.0285993
PMID: 37267391
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Published1.04 MBDownloadView
CC BY V4.0,  Open Access

Abstract

Back pain Clinical outcomes Confidence intervals Leg Longitudinal studies Low back pain Morphology Muscles Pain Physical workload Questionnaires Regression analysis Regression models Research ethics Signs and symptoms Spine Spine (lumbar) Statistical analysis Stiffness Workload
Background Systematic reviews and studies exploring associations between morphologic change of paraspinal muscles and low back pain or related outcomes such as disability, radiculopathy, and physical workload, have reported conflicting results. This study explores the associations between lumbar multifidus muscle quality and clinical outcomes relating to low back pain. Methods Cross-sectional study of spinal clinic outpatients presenting with a primary complaint of low back and/or leg symptoms. Univariable and multivariable regression models were used to investigate associations between MRI-based multifidus muscle cross-sectional area at L4 and L5 and clinical outcomes for low back pain, leg pain, disability, restricted motion, and strenuous nature of work. Results were reported with β-coefficients, odds ratios (OR), or incidence rate ratios (IRR) and their corresponding 95% confidence intervals, based on a 10% difference in muscle quality for each clinical variable. Multivariable analyses were adjusted for age, sex, and BMI. Results 875 patients [487 females; mean (SD) age: 43.6 (10.2) years] were included. In the multivariable analyses, muscle quality was significantly associated with disability (0–23 scale) [β: -0.74, 95% CI: -1.14, -0.34], leg pain intensity (0–10 scale) [β: -0.25, 95% CI: -0.46, -0.03], and current pain duration of more than 12 months [OR: 1.27, 95% CI: 1.03, 1.55]. No associations were found for low back pain intensity, morning stiffness, painful active range of motion, or work nature. Conclusions Patients with higher lumbar multifidus muscle quality reported lower levels of low back pain-related disability and leg pain intensity, indicating that muscle quality may play a role in the etiology of lumbar spine disorders. However, the clinical importance of these associations is uncertain due to the low magnitude of identified associations. Future longitudinal studies are needed to understand the effect of lumbar multifidus muscle quality on lumbar-related pain and disability.

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9 Times Cited - Web of Science

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Collaboration types
Domestic collaboration
International collaboration
Citation topics
1 Clinical & Life Sciences
1.129 Back pain
1.129.98 Low Back Pain
Web Of Science research areas
Orthopedics
ESI research areas
Clinical Medicine
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