If you, like so many, experience regular or constant back pain, you’re no doubt looking for a solution. There’s no shortage of services, products, routines, and formulas targeting back pain. However, in many cases, the solution to relieve back pain is easier and more accessible than it may seem. With so many years of experience in supporting people as they overcome back pain, I’ve seen firsthand what works. And one often overlooked area to focus on isn’t in the back at all.

I’m talking about your core—that vital group of muscles, which is essential for stabilizing the hips, pelvis, and lower back. A strong, engaged, and flexible core is one of the best ways to address back pain at the source, helping you to feel your best again. 

In my latest guide, I’ll explain how core exercises, in particular multifidus activation, can help you move past your back pain and get back to your usual pain-free life.

What is the Core?

When you think of your body’s core muscles, you might first think of your ab muscles. While the abdominals are a key part of the core, they’re far from the only part. In fact, much of this muscle group is less visible and found deeper within the body. However, these tissues are still absolutely essential for stabilizing the body and reducing (or eliminating) ongoing back pain.

Beyond stabilizing the spine and pelvis, your core muscles also surround and protect your internal organs, coming together to create a strong column that supports the very centre of your body. What we refer to as the core is actually made up of several main components. These are:

• Diaphragm – This thin, dome-shaped muscle sits just below your lungs. It moves between a concave and convex shape, allowing your lungs to fill with air as you breathe. Despite being seemingly unrelated to back pain, it can actually have a big effect. This is because the diaphragm is connected to your spine at two vertebrae.
• Pelvic Floor – If the diaphragm is the ‘ceiling’ of the core, this is the aptly named ground floor. This springy mesh is a layer of muscles and ligaments which supports your internal organs and stabilizes the pelvis. Because the pelvis is a key player in supporting the lower back, a problem with this part of the core can easily present as back pain over time.
• Transversus Abdominis – A girdle-like muscle laying closest to the internal organs. It stabilizes your torso and helps maintain internal pressure in the abdomen, which naturally stabilizes the spine as well. If this muscle becomes weakened, it can lead to pain in the spine.
• Multifidus – A deep muscle that runs along your spine. It acts like laces of the girdle that is the transversus abdominis, helping to cinch snugly around the pelvis to better stabilize the spine and protect it from injury and strain.
• Rectus Abdominis – This outer core muscle group is found between the ribs and the pelvic bone at the front of your pelvis—these muscles are colloquially known as your abs or a ‘six-pack’. They allow your body to move and bend between the ribcage and pelvis.
• External Oblique Muscles – Found on each side of your ab muscles, these outer core muscles allow your body to twist at the torso without injury to the spine. 
• Internal Oblique Muscles – Found just within the hip bones, this pair of outer core muscles works with the external obliques to allow the body to twist without placing excess stress on the spine.

How Does the Core Affect Back Pain?

Several scientific studies have identified the core (also known as the trunk) as a key factor in back pain, particularly in the lower back.

What does this mean? A more securely stabilized spine, reducing pain and making accidental injury much less likely.

When all the various layers of core muscles are working well together, they’re able to maintain much better stability of the spine, which is crucial for well-being and day-to-day function. With that in mind, it’s clear to see why the multifidus is so important despite its small size and deep position.

What’s So Important About the Multifidus?

The multifidus is something of an unsung hero when it comes to stabilizing the spine and addressing chronic back pain. Its deep position in the body and relatively small size means it’s sometimes overlooked in fad workout routines for the core. But in reality, the multifidus is actually essential for a resilient core and a robust spine.

The multifidus isn’t the same type of muscle as, say, your biceps or quadriceps. It’s actually a series of short, triangle-shaped muscles running the entire length of your spine. Each section of the multifidus connects two to four vertebrae together, stabilizing them and ensuring the muscles are keeping spine movements under control.

Multifidus muscles are generally important for spine stability, but they shine the most when it comes to rotating and flexing your torso to the side or stabilizing against these motions. These are very common motions to make in your day-to-day life, but they also present a high risk of injury if the multifidus and surrounding muscles are weak or delayed activation patterns exist. Even if the other muscles are in good condition, an atrophied multifidus can lead to muscle imbalance during these motions, putting excess strain on the spine. Over time, this strain can lead to frequent or chronic back pain, especially in the lumbar area. 

The multifidus can become weakened by a number of things, including an overly sedentary lifestyle, immobility, or pre-existing conditions and injuries. As the multifidus becomes weaker and atrophied (less muscular bulk), it leads to a phenomenon known as deconditioning, where the muscle tissue which isn’t able to support your spine properly, which places even more strain on the other core muscles. They overcompensate, working harder to support the spine. Not only does this destabilize the spine, but it also leads to excess strain and pain in these other muscle groups, making them less able to stabilize the spine, causing more muscle pain, and so on.

You can address this cycle of pain and immobility at the source—and it all begins by working on engaging and strengthening the multifidus. 

Getting Support with Back Pain

While there are certain exercises that are shown to help out with multifidus activation and strengthening, the core and the spine are delicate areas to rehabilitate on your own. The number one best way to strengthen this crucial part of the body is to work with a trusted physiotherapist.

Using their skills, education, and experience, a great physiotherapist will determine exactly which parts of your core muscles need the most improvement, whether it’s your multifidus, your pelvic floor, your transversus abdominis, or, more likely, a combination of several muscle groups. They’ll work closely with you to create a customized treatment plan, making adjustments along the way to make sure your recovery is as smooth and efficient as possible.

Interested in learning how you can feel your best again? Ready when you are! Don’t hesitate to get in touch today if you have any questions, or if you’d like to book an initial assessment you can click here to get that started.