Low back pain and fat in muscle & not on the bread

We are now facing an epidemic of low back pain. It is now the greatest cause of disability according to the WHO. It contributes to 11% of the total disability in the UK (Ref 1). This can be attributed to the change in lifestyle that the 21st century has brought with it. Today an increasing number have desk based jobs. Most desk based jobs involve sitting down for the majority of the day. In the long term this takes a toll on the back and spine. There are other causes of back pain such as heavy-duty lifting and age related wear and tear.
The lower back is referred to as the lumbar region. Core muscles surround the lumbar spine and provide it the support it needs. When lifting or carrying loads these muscles come into play and protect the spine. If these muscles are not toned and strong, one can injure the spine. One of these muscles is the multifidus. It lies closest to the spine.
Cross section of the lumbar spine showing the core muscles surrounding the lower back.

Infiltration of the multifidus muscle with fat

MRI scan studies show that this muscle is slowly invaded by fat in patients with lower back pain (Ref 2). Fat does not have the protecting features which muscles have. Hence it can potentially expose the spine and the back to more mechanical damage. Higher levels of fat infiltration is also associated with stiffness and lower ranges of motion (Ref 3).
Cross section of the lumbar spine showing infiltration of fat into the multifidus muscle
However, fear not, there is a positive twist to the story. Fat infiltration in the lumbar multifidus muscle can be reversed. Core stability exercises allows the strength and tone of the protecting muscles to be rebuilt (Ref 4).


Created and designed by Dr. George Ampat, Consultant Orthopaedic Spinal Surgeon

Disclaimer: Dr. Ampat has a commercial interest in Feet and Spine which sells ergonomic office chairs, sit-stand tables, orthotics and comfort shoes.