Muscle Function Assessment in Low Back Pain

Low back pain represents a leading cause of disability worldwide, with musculoskeletal dysfunction and altered motor control often implicated in its onset and persistence. Central to understanding and treating low back pain is the assessment of key stabilising muscles such as the lumbar multifidus, erector spinae and transversus abdominis. Techniques range from real-time ultrasonography and surface electromyography to magnetic resonance imaging and numerical modelling. Ultrasonography offers a non-invasive, dynamic view of muscle thickness changes and contraction ratios, while electromyography provides insight into recruitment patterns. Numerical models increasingly integrate anatomical data with mechanical properties to simulate load distribution and predict tissue response. Together, these approaches inform tailored rehabilitation programmes, aim to restore coordinated muscle activation and support evidence-based clinical decision-making on exercise prescription and ergonomic interventions.

Research from Nature Portfolio

A recent study examined individuals with unilateral sacroiliac joint pain to quantify differences in contraction ratios of the lumbar multifidus and erector spinae using real-time ultrasonography. Sixty participants were compared with healthy controls, revealing a significantly lower contraction ratio on the painful side. Conversely, healthy subjects demonstrated greater ipsilateral muscle engagement. These findings highlight side-specific deficits and suggest that assessment of contraction ratios can guide the design of rehabilitation programmes targeting asymmetrical muscle function in low back pain.

Muscle Function Assessment in Low Back Pain publication trend

The graph below shows the total number of articles in muscle function assessment in low back pain across all publications each year (not limited to Nature Index journals).

Technical terms

Real-time ultrasonography: Imaging technique providing live visualisation of muscle structure and movement.

Contraction ratio: The change in muscle thickness from rest to contraction, expressed as a proportion.

Transversus abdominis: Deep lateral abdominal muscle crucial for spine stabilisation.

Lumbar multifidus: Series of small, deep spinal muscles important for segmental control.

Erector spinae: Group of superficial back muscles responsible for trunk extension and posture.

Electromyography: Measurement of electrical activity associated with muscle activation.

References

1. Numerical modeling of the abdominal wall biomechanics and experimental analysis for model validation. Frontiers in Bioengineering and Biotechnology (2024).
2. Contraction ratio of multifidus and erector spinae muscles in unilateral sacroiliac joint pain: A cross-sectional trial. Scientific Reports (2025).
3. Ultrasound Evaluation of Onset Core Muscle Activity in Subjects with Non-Specific Lower Back Pain and Without Lower Back Pain: An Observational Case–Control Study. Diagnostics (2024).
4. The automatic activity of abdominal muscles during stable and unstable standing postural tasks in older adults with and without low back pain- A cross-sectional study. BMC Geriatrics (2024).
5. Reliability of Sonography Measures of the Lumbar Multifidus and Transversus Abdominis during Static and Dynamic Activities in Subjects with Non-Specific Chronic Low Back Pain. Diagnostics (2021).