Deep vs Superfical Paraspinals
The chronic low back pain multifidi and longissimus cause can be severe. Of the seven primary muscle groups that refer pain into the low back these are the only two of them live in the lumbar spine.
Note that the pain of trigger points in the multifidi remain as localized ‘spots’. You may have just one, or there may be several trigger points in different multifidi at different points along the spine. Trigger points in longissimus usually refers pain into the glutes, sometimes, high enough to feel something like low back pain.
The truth is, much of the soft tissue surrounding the lumbar spine is connective tissue anyway. Most of the muscles that influence this area are located elsewhere in the body. And, in just one study, of 283 patients referred for chronic intractable lumbar pain, 96% had trigger points (Rosomoff, Fishbain, Goldberg – 1990).
Longissimus is the long, thick muscle visible on both sides of the spine in well muscled individuals. Sometimes we can also see iliocostalis curving off to the side. We use these muscles to assist our glutes and hamstrings in spinal extension. We also use them for extension of the leg at the hip. When we think of big, strong back muscles, these are the ones.
The over-development of the superficial paraspinals often happens as part of postural patterns or workout routines that don’t emphasize the deeper paraspinals. For example, let’s say your workout routine emphasizes deadlifts and squats. You are building up your spinal erectors, including longissimus, glutes and hamstrings.
This can also happen through inactivity. When the smaller, deep paraspinals begin to atrophy, they are not able to effectively stabilize our spines. This makes the larger, superficial paraspinals work harder in an attempt to make u