Should you be exercising if you have back pain and degenerative disc disease? The answer for my patients has always been a resounding “likely,” it all depends on what’s wrong. However, a new study would suggest that maybe we should all be pushing these patients harder.
The multifidus is a muscle located in the back, stretching down both sides of the spine. The primary function of the multifidus is to provide spinal stability and support. It’s highly unlikely, unless you’re a regular reader of this blog, that you know what the multifidus muscle is because doctors rarely focus on it or talk about it. However, when a patient has back pain, it’s a structure that should be examined as it can become inflamed and even atrophy (shrink) if a problem with the multifidus is left unaddressed.
Problems with the multifidus muscle are actually fairly easy to see on MRI. Despite this, since multifidus back pain doesn’t really have a surgical solution, radiologists don’t typically read them on MRI, instead focusing on bones, discs, nerves, and so on as surgeons and doctors believe they have a better understanding of how to treat these. Focusing only on structures that can be surgically repaired is quickly becoming an old-school approach to assessing back pain, one that is likely to change in the not-too-distant future. Why? Interventional orthopedics has now entered the scene, and it focuses on nonsurgical solutions for all musculoskeletal structures, including the multifidus muscle.
To learn more about the multifidus muscle why your doctor doesn’t discuss it when you have back pain, watch my video below:
So when the multifidus is inflamed and causing back pain, what can you do to treat it? Our feature study today looks at how something as simple as exercise may reduce or even prevent multifidus inflammation, even in the presence of disc degeneration. Let’s review it.
The new study consisted of two groups of mice, one sedentary and one active. At nine months, MRIs were conducted to determine the degree of disc degeneration in each subject. The multifidus muscles were then studied in both the sedentary and active mice with disc degeneration to assess inflammation. The results? In the sedentary mice, researchers found that the disc degeneration disrupted the expression of inflammatory-marker genes and caused inflammation in the multifidus muscle. In the physically active mice with disc degeneration, inflammation was significantly reduced or prevented.
Would the results translate to a human population? I’m sure more research will be coming down the pike that will eventually answer this question. Certainly the disc degeneration would also need to be addressed; however, it’s promising that exercise, in the meantime, may help relieve the multifidus inflammation it creates. And exercise is certainly preferable to the long list of dangerous risks associated with taking anti-inflammatory drugs (NSAIDs) to quell pain and inflammation. Not to mention, exercise is chock-full of many other benefits.
There’s also recent evidence that exercise or saying active as you age keeps your immune system healthy and actively engaged. Our immune system, like many other body systems, naturally weakens and becomes more sluggish the older we get. A weak immune system can’t properly fight disease and keep us healthy. Exercise may be just the rejuvenating potion our immune system needs.
Brief bouts of exercise may not only give your brain a boost but also multiple bouts of moderate-or greater-level exercise throughout the day may be just as beneficial to your health as one long workout. Exercise may also improve the bacterial environment in your gut, and it helps you lose weight and maintain weight loss. Additionally, we’ve also covered a study that found that exercise did indeed outperform NSAIDs for pain relief, function, and symptoms in patients with knee arthritis.
Its benefits don’t stop there. Take a look at a few more:
The upshot? While this is a rat study, it’s nonetheless interesting that exercise was able to tamp down inflammation in a key stabilizing muscle. So what should you do if you have degenerative disc disease? Find an exercise or a level of it that doesn’t dramatically increase your pain. You can then increase your activity as long as your pain doesn’t go above a 2 or a 3. I would err on the side of more rather than less activity. Finally, find a physician, physical therapist, or alternative-healthcare practitioner who can reduce the symptoms should your back blow up. In other words, “just do it”!
*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…