Treating back pain can be tricky. We feel that deep pull that locks us up, then we feel pain in certain positions, doing daily activities, or even when we breathe. It freezes us, and we stretch and it feels better for a little bit but then returns. We get adjusted by our chiropractor or get a massage and we feel great again for a couple of days, but our muscles still want to protect us, so they return to the pattern they had before treatment. We are right back where we started.
What is causing this?
Multifidi Could Be the Culprit
In the vast majority of cases of back pain, the culprit is the tiny muscles called Multifidi. The muscles are deep under layers of larger muscle groups and attach to the spinous processes of each vertebra. The origins of the muscle differ depending on whether cervical, thoracic or lumbar, but generally speaking they insert on the lateral aspect and tips of the spinous processes of vertebrae 2-5 levels above the origin. The Multifidi extend the spine, rotate the spine and stabilize the vertebrae during flexion. When they are tight, they impede the dorsal rami of the spinal nerve roots emerging from the spinal cord causing deep, often shooting pain. These muscles are difficult to massage because they are deep to the larger muscles of the back, and the bony prominences of the vertebrae are interspersed between their muscle bellies. This makes manual treatment or adjustment difficult.
Is there a treatment modality uniquely suited to reaching the tiny bellies of these muscles, resetting them, and allowing for manual treatments to stick more easily?
The answer is yes. Acupuncture is able to easily reach the multifidi, threading through the thick layers of muscle that protect the spine, and the bony aspects of the vertebrae to reach those tiny bellies. Once the belly is contacted the gnarled and knotted tissue of the Multifidi release, putting them back into neutral so that they can rest, recover, and take in new blood and fluid for proper physiological function. Inserting a sterile metal implement into muscles ruled by nerve conductivity, which is electrical in nature, will reset the proprioceptors in the muscle spindles. These proprioceptors maintain proper position of the fibers and allow them to fire properly and create a contraction, lengthening or stabilization depending on which action is required. The immune response to a foreign invader, in this case an accurately placed needle, calls for natural anti-inflammatories (white blood cells) to be sent to the site aiding in reducing inflammation and boosting recovery times. While the effect on symptomology will vary due to their nature and severity, the effect on the tissue is immediate and will typically continue to work for 2 to 3 days after a single acupuncture treatment. A consistent course of weekly acupuncture will increase the effect and repattern the muscles so that they not only stop the pain, but establish a new physiological pattern that will allow for free movement again. While length of treatment protocols vary due to the severity of the injury, whether it is acute or chronic in nature, or the existence of other injuries, in most cases the prognosis is good. Adding a regimen of corrective exercise in addition to spinal rotations and stretching can help aid in the repatterning of muscle tissue that is the direct result of acupuncture.